背景與目的：早產兒父母比足月兒父母親職壓力高，過去研究發現早期介入有助於減輕母親壓力，但較少文獻同時探討父母親壓力。本研究探討以家庭為中心介入對極低出生體重早產兒足月齡至4歲之父母親職壓力的影響。方法：此多中心隨機臨床試驗收集246位極低出生體重早產兒，實驗組接受以家庭為中心之介入至1歲，常規組接受一般照護。足月、6、12、24和48個月時使用親職壓力量表檢測父母親壓力，並評估兒童發展及記錄介入組居家活動執行者。結果：母親在所有壓力分數均高於父親壓力（p<0.05）。介入組父親從足月到4歲在兒童（–13.1 vs.–5.1，p=0.014）和總壓力分數（–18.6 vs. –6.0，p=0.033）較常規組父親呈現較大降幅，兩組母親壓力降幅則相似。父母親職壓力與兒童動作與行為發展相關（p=0.0001~0.06），但與居家活動執行者無關。結論：以家庭為中心介入有效降低早產兒父親從足月至4歲的親職壓力，而早產兒母親比父親感受較高壓力。本研究能作為臺灣極低出生體重早產兒早期介入設計與成效評估之參考。

Background and Purpose: Parents of preterm children tend to show higher parenting stress than parents of term children. Some intervention programs have been shown to alleviate short-term maternal stress in preterm children; however, long-term concurrent maternal and paternal parenting stress has rarely been investigated. _ is study was therefore aimed to examine the effects of the family-centered intervention program on paternal and maternal stress in preterm children with very low birth weight (VLBW: birth weight < 1,500 g) from term to 48 months of age compared to the usual care program (UCP). Methods: _ is multi-centered randomized controlled trial included 246 preterm children with VLBW that the intervention group received in-hospital and after-discharge interventions and the UCP group received standard care from hospitalization to 12 months of age. _ e intervention contained child-, parent-, and dyad-focused services, including environmental modification, feeding support, massage, developmental skills training, techniques to enhance parent-infant interaction, home activities, and parental support. Both maternal and paternal stress were assessed using the Parenting Stress Index-Long Form when children approached term, 6, 12, 24, and 48 months of age. All children were examined developmental outcomes and the executors of home activities in the intervention group were recorded during the experimental period. Results: Maternal stress was significantly higher than paternal stress in the parent domain, child domain, life stress, and total stress (all p < 0.05). _ e fathers of intervention group showed a significantly greater reduction of parenting stress from term to 48 months of age than the UCP group fathers in the child domain (–13.1 vs. –5.1, p = 0.014) and total stress (–18.6 vs. –6.0, p = 0.033). However, the mothers of the intervention and UCP groups were comparable in the change of parenting stress across ages. Higher maternal stress was associated with poorer child behavior (all p < 0.0001); whereas, a greater reduction of paternal stress had borderline relations with better child motor development (p = 0.051 and 0.06). _ ere was no relation between the executors of home activities and parenting stress in the intervention group. Conclusion: Family-entered intervention was effective in reducing paternal parenting stress in preterm children with VLBW, especially toward 48 months of age. Furthermore, mothers of preterm children with VLBW perceived higher parenting stress than fathers throughout the term to 48 months of age. _ e results provide insightful information for the design and outcome assessment of early intervention for preterm children with VLBW in Taiwan.