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Testing a theoretical model: correlates of parental stress responses in the pediatric intensive care unit
M S Miles1, M C Carter, J Hennessey
1University of North Carolina, Chapel Hill.
Insights
Parental stress in pediatric intensive care units (ICUs) is influenced by personal, situational, and environmental factors. Understanding these stressors helps support families during a child's critical illness.
Area of Science:
- Psychology
- Pediatric Nursing
- Healthcare Management
Background:
- Parental stress is a significant concern for children hospitalized in intensive care units (ICUs).
- Existing theoretical frameworks require empirical evaluation to understand the multifaceted nature of parental stress in this critical setting.
Purpose of the Study:
- To evaluate a theoretical framework identifying personal, situational, and ICU environmental stressors impacting parental stress.
- To assess the interactive effects of these factors on parental stress responses.
Main Methods:
- Utilized multiple regression techniques to analyze data from 510 parents in five midwestern ICUs.
- Employed validated instruments including the Parental Stressor Scale: Pediatric ICU and State-Trait Anxiety Scale.
Main Results:
- Personal and situational variables significantly predicted higher stress levels.
- Alterations in parental role and child's behavior/emotional responses were major ICU environmental contributors to stress.
- Trait anxiety, perception of severity, admission type, parental role alteration, child's response, and appearance predicted state anxiety.
Conclusions:
- The study supports the theoretical framework as a useful model for understanding parental stress in pediatric ICUs.
- Additional factors like uncertainty may enhance predictive models of parental stress.
Abstract:
This study was designed to evaluate a theoretical framework, based on stress theory, which identifies potential sources of stress in parents of children hospitalized in an intensive care unit (ICU). The framework suggests that personal, situational, and ICU environmental stress stimuli interactively impact on the overall parental stress response. Multiple regression techniques were used to evaluate the interaction of personal family factors, situational stimuli, and ICU environmental stressors and to assess their impact upon the overall parental stress response. Data were collected from 510 parents of children hospitalized in one of five midwestern ICUs. Instruments used were the Parental Stressor Scale: Pediatric ICU (Carter & Miles, 1984), the State-Trait Anxiety Scale (Spielberger, Gorsuch, & Luschene, 1970), the Review of Life Experiences Scale (Hurst, Jenkins, & Rose, 1978), and a personal-experiential questionnaire. Results indicate that a number of personal and situational variables were predictive of higher stress. In addition two aspects of the ICU environment contributed the most variance to the overall stress of parents: alterations in the parental role and the child's behavioral and emotional responses. In evaluating the full framework, one personal variable (Trait Anxiety); two situational variables (perception of severity and type of admission); and three ICU environmental dimensions, (parental role alteration, the child's behavior and emotional response, and the child's appearance) significantly predicted stress (State Anxiety). The findings support the theoretical framework underlying this study as a useful model for studying and evaluating parental stress during a child's admission to an ICU. Results also suggest that additional personal family and situational factors, such as uncertainty, may need to be added to the model to more fully predict parental stress responses.