Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




The purpose of this study was to examine potential relationships between cumulative stress exposure in infants in neonatal intensive care units (NICU), as measured using a resting salivary cortisol level at NICU discharge, and the amount (hours per week) or frequency (days per week) of parent presence and skin-to-skin care (SSC). This descriptive study was conducted via a secondary analysis of a dataset representing 78 NICU families from a tertiary level NICU in the Midwest. Median length of stay was 33 days, and a resting salivary cortisol level collected at one month of age was used for infants not discharged at or before one month of age. Data were examined using correlational, linear regression and hierarchical regression analyses. Cumulative parent presence was not significantly associated with infant stress at NICU discharge, however, significant negative correlations between cumulative SSC and infant stress response at NICU discharge were supported. Results of hierarchical regression analyses examining the timing of parent presence supported a model including admission cortisol, infant level of illness, and hours of parent presence in weeks one through four of life for explaining infant stress at NICU discharge; but, more parent presence in week two was associated with more infant stress. Results of hierarchical regression examining timing of SSC supported a model including cortisol at admission, level of illness and the frequency of SSC in week one for explaining NICU infant stress at discharge. During early weeks of life, parents may require more support from NICU staff to be present and engage with their NICU infants. Further study examining potential associations between the amount, frequency and timing of parent presence and NICU infant stress response is warranted.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Included in

Nursing Commons