Back to Page
Authors: Yu-Ping Huang, Hsiao-Chien Chen, Ji-Nan Xu, Shun-Ling Chen
Keywords: pediatric intensive care unit, parent, stress, coping strategy
Abstract: Background: For parents, seeing their children admitted into an intensive care unit with advanced life-support equipment and care constitutes a stressful event. Parents feel anxiety about being separated from their children and being unable to care for them. In addition, parents witness their children suffering physical pain and emotional distress. Children rely on support from their parents, so family-centered care is principle in the pediatric intensive care units (PICUs). Therefore, examining parents’ stress and the coping strategies they adopt when their children enter a PICU is crucial. Aim: To investigate parental stress and coping strategies among parents with children in a PICU and identify factors related to parental stress and associated coping strategies. Methods: This cross-sectional study was conducted in the PICUs of two medical center hospitals in Central Taiwan. The Chinese version of the Parental Stress Score in the PICU (PSS: PICU) was used to examine parental stress. Higher parental stress scores indicated higher stress. The Chinese version of the Jalowiec Coping Scale was used to examine parental coping strategies. The higher the coping scores, the more frequent the use of coping strategies was. The inclusion criteria specified that participants be parents who (1) had children aged <18 years admitted to PICU for at least 48 hours, (2) were willing to participate in the study, and (3) had Mandarin as their first language. Excluded participants comprised (1) sick children suspected to be experiencing abuse or (2) sick children transferred from other intensive care units. Results: This study included 81 parents (mean age, 37.45 ± 5.75 years). The mean age of their children was 5.95 ± 5.45 years. The top three most stressful experiences were the children’s behavior or appearance implying pain (3.68 ± 1.23), the children being unable to talk or cry (3.65 ± 1.31), and tubes being used to administer treatment to the children (3.48 ± 1.26). Parental stress was significantly negatively associated with children experiencing unplanned PICU admissions or lacking PICU admission experience and with ventilator use. The highest ranking item for coping strategies was hoping things would improve (4.53 ± 0.77). The parents adopted more emotional coping strategies when their child’s condition was more severe, when their child had been admitted to the PICU more than five times, or when their child’s PICU stay exceeded 15 days. Parental stress was significantly positively associated with emotional coping strategies (γ = 0.38, p < 0.01), which meant that parents adopted more emotional coping strategies when they experienced increased stress. Conclusion: Children experiencing pain and being fitted with tubes were major stressors for parents. Thus, health care professionals should actively seek to decrease children’s physical and psychological discomfort and cooperate with parents in providing individual effective measures that comfort children. Parents tended to adopt emotional strategies to manage their stress; thus, health care professionals should communicate with parents and provide them with relevant information regarding their children, thereby fostering a sense of control and of satisfaction with the roles of parents. Contribution: Providing health care professionals with understanding of parental stress and parental coping strategies at PICUs in Taiwan can address a knowledge gap. Study results can also help these professionals to design effective interventions for reducing parental stress and improving coping strategies to improve quality of life for parents and children at PICUs.