Parents' and Health Professionals' Perceptions Concerning Parental Stress during a Child's Hospitalization

Graves, Janet K.; Ware, Mark E.

doi:10.1207/s15326888chc1901_5

Cited by 25 publications

(14 citation statements)

References 3 publications

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“…There are numerous studies from developed countries, which have emphasized the role of addressing parental stress and concerns in PICU in addition to routine care of patients. [4][5][6][11][12][13][14][15][16][17][18][19] In a study on parental stressors from Ludhiana, India, Pooni et al, 8 found that there is significant stress among parents of children admitted in PICU, where the average parental stress score was 3. In the present study, the average parental stress score was 3.5, which points out there is significant stress.…”

Section: Discussionmentioning

confidence: 99%

Parental stress: a study from a pediatric intensive care unit in Mangalore

Kumar

Avabratha²

2015

Int J Contemp Pediatr

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INTRODUCTIONPediatric intensive care unit (PICU) is a highly stressful environment to most parents. Having one's child admitted to a PICU is difficult for parents. The very criteria for admission to a PICU are frightening and can realistically prompt fear that their child could die or become severely disabled. 1The intensive care setting is a busy and frightening place dominated by sick children, medical personnel, advanced medical equipments, bright lights and shrill monitors. Initially, parents experience extreme levels of anxiety that approach near-panic level, followed by a reduction of anxiety in the following days.2 One of the greatest stressors for parents in the PICU is the alteration or loss of the parental role, including physical separation, limited opportunities to care for the child, and no longer being ABSTRACT Background: Pediatric intensive care unit (PICU) is a highly stressful environment to most parents. Knowledge of stress allows us to plan counselling strategies for the suffering parents. The objectives were to identify common parental stressors during their child's critical illness and to examine the relationship of demographic variables with their stress. Methods: It was a prospective observational study done in PICU of a tertiary care medical college hospital in Mangalore. One hundred parents of children (1 month to 15 years) admitted to PICU for at least 24 hours were interviewed using the Parental Stress Scale (PSS: PICU), which rates 22 factors on a scale from 1 (not stressful) to 5 (extremely stressful). The demographic and clinical characteristics of children were also recorded and analysed statistically. Results: The average parental stress score was 3.5. The main causes of extremely stressful situations were the sight of their child being unresponsive, sight of monitors & equipment in PICU, other sick children in PICU, crises in other children in the PICU. Parents of children who got admitted in PICU for the first time were more stressed. Younger parents were more stressed than older parents, irrespective of the illness and clinical status. Age of the child, sex, socioeconomic status, urban/rural, father/mother did not vary stress levels, all had similar stress level (score>3). Among the procedures, majority (52%) parents felt intravenous cannulation as more stressful followed by blood sampling (43%). Conclusions: Young parents and first PICU admission were more stressful. Socioeconomic status, residential area and age of children did not affect level of stress. Many of these stress factors can be looked into and remedial steps can be taken to relieve some of these stressors.

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Section: Discussionmentioning

confidence: 99%

Parental stress: a study from a pediatric intensive care unit in Mangalore

Kumar

Avabratha²

2015

Int J Contemp Pediatr

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“…41 However, other authors have found that mothers and fathers seem to experience the same level of stress elicited by different stimuli. 42 Other researchers have found no significant difference in stress levels between mothers and fathers. 35,39,43 In general, there were disproportionately small numbers of participating fathers in the study samples.…”

Section: Stressors Identified In Families Of Critically Ill Childrenmentioning

confidence: 93%

“…35,39,43 In general, there were disproportionately small numbers of participating fathers in the study samples. 42,43 Two studies concluded that parents' and PICU nurses' perspectives on parental stressors have significant discrepancies. Parents reported feeling more stressed by their child's behavioral and emotional response, but nurses expressed greater concern about staff communication.…”

Section: Stressors Identified In Families Of Critically Ill Childrenmentioning

confidence: 99%

“…Several others reported this direct relationship between severity of illness and negative family social impact. 12,42,68,80 A crucial area of study is marital conflict and divorce. 10,12 Negative impact on marital and domestic-partner relationships has been described elsewhere.…”

Section: Impact On Families Of Critically Ill Childrenmentioning

confidence: 99%

“…Maternal stress was reported as directly related to illness severity, duration of PICU stay, distance of the unit from family home, and length of mechanical ventilation. 42,70 It seems likely that maternal stress levels are indicators of overall family social impact, but this remains to be clearly demonstrated. 67 Family Coping in Pediatric Critical Illness "Coping" can be defined as the behavioral and cognitive efforts used to manage internal and/or external stressful demands that outweigh an individual's immediately available resources.…”

Section: Impact On Families Of Critically Ill Childrenmentioning

confidence: 99%

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Impact of Pediatric Critical Illness and Injury on Families: A Systematic Literature Review

et al. 2006

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OBJECTIVE. We sought to inform decision-making for children and families by describing what is known and remains unknown about the impact of childhood critical illness and injury on families. This report also was designed as a tool for research planning and design so that meaningful studies are performed and duplication is avoided.DESIGN. After a national scholarship competition and the identification of 3 medical student summer scholars, a literature search was conducted by using the National Library of Medicine and a PubMed keyword search system at the National Institutes of Health.RESULTS. A total of 115 reports were reviewed and assigned to the 5 following categories characterizing the impact of pediatric critical illness/injury on families: stressors, needs, specific domains (psychological, physical, social), coping, and interventions. The reports reviewed indicate that pediatric critical illness and injury is stressful for the entire family. The effects on parents, siblings, and marital cohesion were variably described. Needs of family members (eg, rest, nutrition, communication) were identified as being unmet in many studies. Permanent impact on siblings and marital relationships has been considered detrimental, but these conclusions are not adequately quantified in presently available studies. Reviewed reports minimally investigated cultural diversity, effects on fathers versus mothers, siblings, socioeconomic status, and financial burden. Studies were often anecdotal and included small sample sizes. Methodologic limitations were numerous and varied and seriously narrowed the significance of the studies we reviewed. The reports that we evaluated were largely limited to those of Englishspeaking families, white people, and married mothers.CONCLUSIONS. Future research should use more rigorous methods in the measurement of impact of childhood critical illness and injury on families. Families of critically ill and injured children would benefit from the practitioners of pediatric critical care acquiring enhanced knowledge and sensitivity about famliy communication and dynamics.www.pediatrics.org/cgi

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A translational evaluation of renewal of inappropriate mealtime behavior

Ibañez

Piazza

Peterson

2019

J of App Behav Analysis

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The term renewal describes the recurrence of previously extinguished behavior that occurs when the intervention context changes. Renewal has important clinical relevance as a paradigm for studying treatment relapse because context changes are necessary for generalization and maintenance of most intervention outcomes. The effects of context changes are particularly important during intervention for pediatric feeding disorders because children eat in a variety of contexts, and extinction is an empirically supported and often necessary intervention. Therefore, we used an ABA arrangement to test for renewal during intervention with 3 children diagnosed with a feeding disorder. The A phase was functional reinforcement of inappropriate mealtime behavior in a simulated home setting with the child's caregiver as feeder, B was function-based extinction in a standard clinic setting with a therapist as feeder, and the return to the A phase was function-based extinction in a simulated home setting with caregiver as feeder. Returning to Context A resulted in renewal of inappropriate mealtime behavior across children, despite the caregivers' continued implementation of function-based extinction with high levels of integrity.

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Parents' and Health Professionals' Perceptions Concerning Parental Stress during a Child's Hospitalization

Cited by 25 publications

References 3 publications

Parental stress: a study from a pediatric intensive care unit in Mangalore

Parental stress: a study from a pediatric intensive care unit in Mangalore

Impact of Pediatric Critical Illness and Injury on Families: A Systematic Literature Review

A translational evaluation of renewal of inappropriate mealtime behavior

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