title: Psychological Outcomes in Parents of Critically Ill Hospitalized Children.
abstract: Parents of children in pediatric intensive care units (PICUs) are subjected to significant psychological stress. The purpose of this study was to determine the prevalence of, and factors associated with anxiety, depressive symptoms and decisional conflict in parents of children hospitalized in the PICU. The study employed a descriptive, cross-sectional design to investigate the psychological status of 118 parents of 91 children (74 mothers and 44 fathers) admitted to the PICU, using measures of anxiety (STAI), depression (CES-D), and decisional conflict (DCS). Using hospital data and self-administered questionnaires, information on child and parent characteristics and psychological outcomes were collected. Objective measures of parental sleep also were examined using actigraphy and sleep diaries. The research findings indicated that 24% of parents achieved scores characteristic of severe anxiety. Proportions of parents with symptoms indicative of major depression and significant decisional conflict were 51% and 26% respectively. For all psychological outcomes, higher levels of social support were protective. Inconsistency in sleep schedule and sleep location affected psychological outcomes and are possible targets for future interventions. Given evidence that parents of children admitted to the PICU are at risk for developing post-traumatic stress symptoms, future studies should examine the effects of hospitalization on long-term parental psychological outcomes. Screening for those at risk and implementing interventions to promote coping strategies and reduce decisional conflict may be beneficial. Pediatric nurses have a critical role in assessing parents' psychological distress and promoting family health during a child's hospitalization.
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; The Hospital for Sick Children (SickKids), Toronto, Canada. Electronic address: robyn.stremler@utoronto.ca.
authors.forename: Robyn
authors.initials: R
authors.lastname: Stremler
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; The Hospital for Sick Children (SickKids), Toronto, Canada.
authors.forename: Summer
authors.initials: S
authors.lastname: Haddad
authors.affiliation: The Hospital for Sick Children (SickKids), Toronto, Canada.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.affiliation: The Hospital for Sick Children (SickKids), Toronto, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Parshuram
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D002170:Canada; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy*; D003430:Cross-Sectional Studies; D003657:Decision Making; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000523:psychology*; D018570:Risk Assessment; D013315:Stress, Psychological / Q000453:epidemiology
keywords: Anxiety; Child; Decisional conflict; Depression; Hospitalized; PICU; Parents