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Predictors of stress among parents in pediatric intensive care unit: a prospective observational study
Mohd Aamir1, Kundan Mittal, Jaya Shankar Kaushik
1Department of Pediatrics, Pt B D Sharma PGIMS, Rohtak, Haryana, 124001, India.
Insights
Parental stress in the pediatric intensive care unit (PICU) is significantly influenced by a child's intubation status. Factors like procedures and child behavior most impact parental stress, not parental demographics.
Area of Science:
- Pediatric Intensive Care
- Parental Psychology
- Healthcare Environment
Background:
- Parental stress is a significant concern for children admitted to the Pediatric Intensive Care Unit (PICU).
- Understanding the factors contributing to this stress is crucial for developing effective support strategies.
Purpose of the Study:
- To identify sociodemographic and clinical factors contributing to parental stress in the PICU setting.
- To analyze the impact of specific child conditions and treatments on parental stress levels.
Main Methods:
- A prospective observational study was conducted in a North Indian tertiary care hospital's PICU.
- Parental stress was assessed using the Parental Stress Scale (PSS:PICU) questionnaire after 48 hours of admission.
- Data on child's clinical parameters and parental demographics were collected and statistically analyzed.
Main Results:
- Parental stress was highest concerning procedures and the child's behavior and emotional state.
- Intubated children led to significantly higher parental stress scores compared to non-intubated children (p < 0.001).
- Professional communication was a significant stressor for parents of infants aged 0-12 months (p=0.02).
Conclusions:
- The PICU environment significantly stresses Indian parents, with child intubation being a primary factor.
- Parental stress levels were not significantly affected by the parents' gender or socioeconomic status.
- Clinical factors, including intubation and specific procedures, are key determinants of parental stress.
Objective:
To determine the sociodemographic and clinical factors leading to stress among parents whose children are admitted in pediatric intensive care unit (PICU).
Methods:
A prospective observational study was conducted in PICU of a tertiary care hospital of north India. Parents of children admitted to PICU for at least 48 h duration were eligible for participation. At the end of 48 h, parental stress was assessed using parental stress scale (PSS:PICU) questionnaire which was administered to the parents. Baseline demographic and clinical parameters of children admitted to PICU were recorded. The parental stress was compared with demographic and clinical characteristics of children using appropriate statistical methods.
Results:
A total of 49 parents were finally eligible for participation. Mean (SD) parental stress scores was highest in domains of procedures [1.52 (0.66)] and behavior and emotional [1.32 (0.42)] subscales. Mean (SD) total parental stress score among intubated children [1.31 (0.25)] was significantly more than among non intubated children [0.97 (0.26)] (p < 0.001). However, parental stress score were comparable in terms of gender (p = 0.15) and socioeconomic status (p = 0.32). On subscale analysis, it was found that professional communication is a significant stressor in age groups 0-12 mo [0.61(0.41)] (p = 0.02). It was observed that parents of intubated children were significantly stressed by the physical appearance of their children (p < 0.001), procedures performed on them (p = 0.008) and impairment in parental role (p = 0.002). Total parental stress score had a positive correlation with PRISM score (r = 0.308).
Conclusions:
Indian parents are stressed maximally with environment of PICU. Factor leading to parental stress was intubation status of the child and was not affected by gender or socio demographic profile of the parents.
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