TESTIMONIO

The second hypothesis evaluated whether the relationship between infant health

indicators, stress, couple functioning, and family burden were moderated by family

resources when controlling for number of children, time since discharge, and number of

stressful life events. This hypothesis was assessed using moderation analyses (Preacher &

Hayes, 2008). A moderator impacts the relationship between two variables, such that the

impact of a predictor variable on an outcome variable changes in direction or strength

depending on the level of the moderator (Baron & Kenny, 1986). This analysis was

conducted using PROCESS (Hayes, 2013) in SPSS. PROCESS is a macro program that

uses ordinary least squares or logistic regression-based path to analyze mediation and

moderation analyses (Hayes, 2013). Parental report of infant health indicators that were

significant predictors in Hypothesis 1 for each specific outcome were included as the

predictors and family resources was included as the moderator. A moderation analysis

was conducted for each individual predictor. Parental stress, couple functioning, and

family burden were run as separate outcomes. The covariates included time since NICU

discharge, number of children in the household, and number of stressful life events since

infant’s birth.

For parental stress, three separate models were examined based on the significant

predictors in Hypothesis 1 (length of stay in NICU, presence of additional diagnoses, and

number of rehospitalizations). For this outcome, model one included length of stay as the

predictor, family resources as the moderator, and time since discharge, number of

children, and number of stressful life events as covariates. The overall model for length

of stay and family resources predicting parental stress was significant, F(6, 160) = 2.122,

p = .054, R

= 17.4%. Family resources significantly predicted parental stress (see Table

12). However, length of stay in the NICU and the interaction between family resources

and length of stay were not significant. Model two included the presence of additional

diagnoses after discharge as the predictor, family resources as the moderator, and the

same covariates. The overall model for additional diagnoses and family resources

predicting parental stress was significant, F(6, 158) = 6.038, p < .001, R

= 24.3%. The

main effect for family resources and additional diagnoses were significant, however, they

did not significantly interact to predict parental stress (see Table 12). Finally, model three

included number of rehospitalizations as the predictor, family resources as the moderator,

and the same covariates. The overall model explained a significant proportion of the

variance in parental stress, F(6, 160) = 4.553, p < .001, R

= 17.5%. The main effect of

family resources predicting parental stress was the only significant relationship in this

model (see Table 12).

For couple functioning, two models were examined based on Hypothesis 1.

Specifically, number of medical devices infant used at discharge and number of

rehospitalizations were entered as separate predictors with family resources being the

moderator when controlling for time since discharge, number of children, and number of

stressful life events. The overall model for number of medical devices at discharge and

family resources predicting couple functioning was significant, F(6, 174) = 4.880, p <

.001, R

= 21.2%. The main effects for family resources and number of medical devices

at discharge were both significant, however, the interaction was not (see Table 13). The

next model included number of rehospitalizations as the predictor, family resources as the

moderator, and couple functioning as the outcome when controlling for the same

covariates. The overall model explained a significant proportion of the variance in couple

functioning, F(6, 174) = 4.639, p < .001, R

= 20.4%. Family resources and number of

rehospitalizations were significant predictors for couple functioning, but the interaction

was not significant.

For family burden, four models were run based on the significant predictors in

Hypothesis 1. The predictors included whether infant was on ECMO during NICU stay,

number of medical devices infant used during NICU stay, number of specialists seen

since discharge or during first year following discharge, and number of medications the

infant is currently prescribed at the time of the survey. Family resources was included as

the moderator and time since discharge, number of children in household, and number of

stressful life events since the child’s birth were entered as covariates for each model. The

overall model for ECMO and family resources predicting family burden was significant,

F(6, 156) = 3.388, p = .004, R

= 12.2%. The main effect of family resources on family

burden was the only significant finding in the model. The presence of ECMO during

NICU stay and the interaction between ECMO and family resources were not significant.

See Table 14. Overall, number of medical devices used during NICU stay, family

resources, the interaction, and covariates explained a significant proportion of variance in

family burden, F(6, 160) = 8.786, p < .001, R

= 21.5%. Family resources and number of

medical devices infant used during NICU stay were significant predictors of family

burden, but the interaction was not (see Table 14). The overall model for number of

doctors and family resources predicting family burden was significant, F(6, 161) =

18.315, p < .001, R

= 37.4%. The main effects of number of doctors and family

Table 14). Finally, number of medications and family resources explained a significant

proportion of variance in family burden when controlling for covariates, F(6, 160) =

7.312, p < .001, R

= 26.6%. Specifically, family resources and number of medications

were significant predictors of family burden. However, they did not significantly interact

to predict family burden (see Table 14).

Results indicate that family resources did not serve as a significant moderator for

the relationships between infant health indicators and parental stress, couple functioning,

and family burden. However, it was a significant individual predictor for each of these

outcomes.