Objective Parents of children with chronic medical needs report increased parenting challenges, poor sleep, and maladjustment. The impact of parenting stress on both sleep and adjustment has yet to be evaluated for parents of infants and young children with congenital heart disease (CHD). We studied the relations among parenting stress, sleep, and adjustment in parents of infants and toddlers with CHD. We expected that sleep quality would mediate the relationship between parenting stress and adjustment. Methods Sixty-nine parents of infants and toddlers with CHD were evaluated on self-report measures of illness-related parenting stress (Pediatric Inventory for Parents), sleep (Pittsburgh Sleep Quality Index), and psychological adjustment (Brief Symptom Index-18). Results The parents of infants and toddlers with CHD reported elevated levels of parenting stress, sleep problems, and maladjustment. The positive relationship between parenting stress and parent maladjustment was mediated by sleep quality. Conclusions Findings suggest that parents of infants and toddlers with CHD report high parenting stress, poor sleep, and maladjustment. Analyses indicate the stress-adjustment relationship is mediated by quality of sleep. Given the multiple demands on parents of infants and children with CHD, it is important to attend to parents’ overall functioning and mental health. Our findings highlight targets for intervention to improve the well-being of parents of young children with CHD.

Objectives Parents of children with cancer (PCCs) experience stress as they navigate managing their child’s illness. Arguably, social support is critical to PCCs’ well-being. This review examines the literature on social support in PCCs. Methods Studies of social support in PCCs were collected from PsycINFO, CINHAL, and MEDLINE. Data were extracted from 37 studies published between January 2010 and May 2021 related to the conceptualization, measurement, and availability of social support in PCCs. Relationships between PCCs’ social support, well-being, and unique parent and child factors were also synthesized. Risks of biases were assessed using domains of the Effective Public Health Practice Project. Results Social support in PCCs is conceptualized as (a) perceived availability and satisfaction with social support and (b) social support seeking as a coping strategy. Parents of children with cancer report receiving as much or more support than typical adults, but PCCs engage in less social support seeking. Family and significant others are the most prevalent sources of support, and emotional support is the most received type of social support. Social support is positively related to well-being and negatively related to distress, anxiety, and posttraumatic stress. Findings related to social support differences based on parent and child unique factors were minimal and present opportunities for future research. The risk of bias was generally low, with caution that most studies cannot demonstrate directionality of findings due to cross-sectional study designs. Conclusions Given the consistent positive association between social support and well-being in PCCs, clinicians should assess and encourage social support for this vulnerable population.

Objective Sickle cell disease (SCD) is a group of inherited blood disorders. The central feature of this chronic condition is pain. Several identified risk factors exacerbate the impact of pain on quality of life (QOL) in SCD; however, there are relatively fewer investigations of strengths-based resilience variables that might buffer the influence of pain on living with SCD. The purpose of this study was to examine strength-based resilience processes in youth with SCD and their parents. Grounded in an ecological resilience-risk model, we evaluated whether adolescent and parent protective factors (pain acceptance, mindfulness, and psychological flexibility) moderated the relation between adolescent-reported pain burden and QOL. Methods Ninety-three 12- to 18-year-old adolescents with SCD and their parents participated. Adolescents completed assessments of pain characteristics, pain acceptance, mindfulness, and QOL. Parents completed instruments measuring demographic and disease variables and parent psychological flexibility. Results Pain variables were associated with protective factors in predicted directions. Adolescent acceptance and mindfulness were positively correlated with QOL. Parent psychological flexibility and adolescent QOL were not related. After controlling for demographic, pain, and disease variables, moderation analyses indicated that adolescent pain acceptance buffered the relation between SCD pain burden and QOL. Moderation analyses were not significant for adolescent mindfulness or parent psychological flexibility. Conclusions Results suggest that strengths-based factors may play an important role for adolescents’ QOL within the context of SCD pain. Interventions that enhance teenagers’ ability to accept pain might be particularly useful to improve QOL in adolescents living with SCD pain.

Asthma is the most common childhood chronic illness. Its management requires that caregivers have access to a variety of information. For example, asthma action plans (AAP) are written instructions for responding to escalating asthma symptoms. Icons have been used to facilitate the accessibility of health information and we investigate whether they benefit parents of young children. We conducted a 4-part study with 36 participants where we 1) gathered requirements for an asthma management mHealth tool 2) assessed the comprehension of icons to be used in an AAP 3) compared the usability of a text-based (T-B) vs. icon-based (I-B) AAPs 4) and gathered feedback about an mHealth tool we designed. Results suggest that the icons we developed were highly matched to their meaning (92% translucency). Usability findings showed that in general both AAPs were equally matched. However, benefits accrued to I-BAAP users in relation to greater accuracy and speed of response in scenarios that required parents to identify asthma symptoms. Twothirds of parents indicated that they would prefer to use the I-BAAP to manage their child's asthma. The remaining third preferred the T-BAAP because it contained more details. We conclude with recommendation on how designers and researchers can improve mHealth tools for caregivers of asthmatic children.