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Sibling-Controlled Study of Parental Bonding, Coping, and Urgent Health-Care Use in Families With Children With
Brenda Bursch1, Marcy Forgey1, Natacha D Emerson1
1David Geffen School of Medicine University of California Los Angeles (UCLA) at the University of California Los Angeles (UCLA).
Insights
Child coping and parental bonding influence urgent healthcare use in pediatric psychogenic nonepileptic seizures (PNES). Effective coping and supportive parenting may reduce emergency visits for youth with PNES.
Area of Science:
- Pediatric neurology
- Child psychology
- Healthcare services research
Background:
- Pediatric psychogenic nonepileptic seizures (PNES) represent a significant burden on healthcare services.
- Family and individual factors are crucial in PNES development and maintenance, yet predictors of urgent healthcare use remain unclear.
Purpose of the Study:
- To investigate the influence of child coping strategies and parental bonding styles on urgent healthcare utilization in families with children diagnosed with PNES.
- To identify specific child and parent factors associated with seeking emergency medical care.
Main Methods:
- A mixed-effects model was employed, analyzing data from 47 youth with PNES and 25 sibling controls (ages 8-18).
- Urgent healthcare use (ER visits, hospitalizations) was regressed on participant type, parental bonding, and child coping, controlling for medication use.
- Parental bonding and child coping styles were assessed via questionnaires.
Main Results:
- Higher urgent healthcare use correlated with PNES diagnosis, coping through monitoring, and perceiving fathers as rejecting yet overprotective.
- Lower urgent healthcare use was linked to coping via venting and perceiving mothers as caring and overprotective.
Conclusions:
- Findings suggest family-based interventions targeting enhanced child coping skills and improved parental responses can potentially decrease urgent healthcare use in youth with PNES.
- This study offers preliminary evidence supporting the integration of family-centered approaches in managing PNES and its associated healthcare burden.
Objectives:
Pediatric psychogenic nonepileptic seizures (PNES) is a functional somatic symptom condition with significant health-care service burden. While both family and individual factors play an important role in the development and maintenance of PNES, little is known about what predicts urgent health-care use in families with children who have PNES. The aim of the current study was to explore whether child coping and parental bonding styles influence the decision to seek urgent medical care in these families.
Methods:
Data were analyzed from youth of age 8-18 years, 47 with PNES, and their 25 sibling controls. Parents provided the number of youth emergency room visits and hospitalizations in the preceding year. Youth completed a questionnaire about their coping styles and a measure about their mothers' and fathers' bonding styles. Using a mixed model with family as a random effect, we regressed urgent health-care use on participant type (youth with PNES or sibling), parental bonding style, and youth coping style, controlling for number of child prescription medications.
Results:
Higher urgent health-care use was associated with having PNES, coping via monitoring, and perceiving one's father to be rejecting and overprotective. Lower urgent health-care use was associated with coping via venting and with perceiving one's mother to be caring and overprotective.
Conclusions:
This study provides preliminary empirical support for family-based clinical efforts to reduce child urgent health-care use by enhancing effective child coping skills and improving parental response to child impairment and distress in families with youth with PNES.
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