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The pediatric intensive care unit environment as a source of stress for parents
M S Miles1, M C Carter, I Riddle
1University of North Carolina, Chapel Hill.
Insights
Parental stress in pediatric intensive care units (PICU) is high, particularly concerning the child's behavior and emotions and alterations in the parental role. Parents feel most stressed by their child's pain and their own inability to protect or help their child.
Area of Science:
- Pediatric Intensive Care
- Parental Psychology
- Child Health
Background:
- Hospitalization in a pediatric intensive care unit (PICU) presents unique stressors for parents.
- Understanding parental stress is crucial for improving family-centered care in critical care settings.
Purpose of the Study:
- To identify the most stressful aspects of the pediatric intensive care unit (PICU) environment for parents.
- To explore parental perceptions of stress related to their child's condition and their role as caregivers.
Main Methods:
- Survey data collected from 324 mothers and 186 fathers across five midwestern PICUs.
- Utilized the Parental Stressor Scale: Pediatric ICU to assess seven environmental dimensions.
- Analyzed stress levels associated with child's behavior, appearance, procedures, and parental role alterations.
Main Results:
- Parental Role Alteration and Child's Behavior and Emotions were the most significant stressors.
- Key stressors included child's pain, fear, sadness, communication difficulties, and parental feelings of helplessness.
- Parents reported higher stress from altered parent-child dynamics than from the physical ICU environment.
Conclusions:
- Alterations in the parent-child relationship significantly contribute to parental stress in the PICU.
- Feelings of helplessness in the parental role are a primary source of distress for parents with hospitalized children.
- Interventions should focus on supporting parents' roles and addressing their emotional responses to their child's critical illness.
Abstract:
Parents of children hospitalized in one of five midwestern pediatric intensive care units (ICU) were interviewed about the stress experienced from aspects of the ICU environment. Subjects were 324 mothers and 186 fathers of 350 children. Data were collected using the Parental Stressor Scale: Pediatric ICU which assesses seven dimensions of the environment: Child's Behavior and Emotions, Child's Appearance, Sights and Sounds, Procedures, Staff Communication, Anomie, and Parental Role Alteration. The dimensions Child's Behavior and Emotions and Parental Role Alteration were found to be the most stressful aspects of the experience. The items from the dimension Child's Behavior and Emotions that were most stressful were seeing my child in pain, seeing the child frightened and sad, and the inability of the child to communicate with the parent. The items from the Parental Role Alteration dimension with the highest stress scores were: feeling unable to protect my child and not knowing how to best help my child. Findings suggest that alterations in the parent-child relationship are more stressful than aspects of the physical environment. In particular, feeling helpless in the parenting role is a great source of stress for parents.