Efficacy of Peer Support on Caregiver Well-Being and Patient Outcomes in the Neonatal Intensive Care Unit: A Systematic Review.

Background: Caregivers of infants staying in the neonatal intensive care unit (NICU) experience a variety of stressors, and peer support programs have been used to formally connect newer NICU caregivers with experienced NICU caregivers to provide education and emotional support.

Purpose: This systematic review will synthesize the efficacy of peer support programs for caregivers after infants' NICU stays.

Data sources: Relevant articles were retrieved from PubMed, Embase, and Web of Science.

Study selection: Studies employing a randomized, quasi-experimental, observational, or qualitative study design and studying caregiver outcomes after participation in a peer mentorship program were considered. Articles included at least 3 patients who stayed in a NICU. Out of 3594 articles originally identified, 7 articles met all inclusion criteria.

Data extraction: Articles' level of evidence and MINORS criteria were assessed and were reviewed by at least 2 authors; the senior author adjudicated any discrepancies.

Results: All considered NICU peer support programs found improvements in caregiver stress/anxiety and depression/anger. Four studies described improvements in caregiver-perceived competency and interactions with infants. Two studies additionally reported increased caregiver hopefulness and confidence. Three studies explicitly stated that participants were satisfied with the peer support program. One randomized controlled trial did not find any benefit to peer support participants relative to controls. No studies reported worsening of caregiver outcomes.

Implications for practice and research: This systematic review suggests that peer support has the potential to improve caregiver well-being and self-efficacy after NICU admission, though more rigorous study is needed.