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High Parental Concern in Children With Medical Complexity: An Early Indicator of Illness

Flory Nkoy1, Bryan Stone1, Xiaoming Sheng1

  • 1University of Utah, Department of Pediatrics, Salt Lake City, Utah.

Hospital Pediatrics
|January 31, 2023
PubMed

Insights

Parental concern for children with medical complexity (CMC) often signals health changes. Increased pain, oxygen needs, poor intake, and altered mental status significantly correlate with high parental concern in CMC.

Area of Science:

  • Pediatric Healthcare
  • Medical Informatics
  • Parental Health Monitoring

Background:

  • Parents of children with medical complexity (CMC) frequently seek emergency care due to health concerns.
  • Factors influencing parental concern in CMC are not well understood.
  • Understanding these factors is crucial for effective home-based care and reducing hospitalizations.

Purpose of the Study:

  • To explore associations between parental sociodemographic factors and child's clinical factors with high parental concern in CMC.
  • To identify specific clinical indicators that trigger heightened parental concern for children with complex medical needs.

Main Methods:

  • Secondary analysis of a pilot study involving 24 CMC and their parents using the MyChildCMC home monitoring app for 3 months.
  • Parents recorded vital signs, symptoms (pain, seizures, intake, mental status), and oxygen use.
  • Parental concern was rated on a Likert scale, dichotomized (high/low), and analyzed using mixed-effects logistic regression.

Main Results:

  • Analysis of 1223 measurements revealed 9.24% instances of high parental concern.
  • Significant associations with high concern included increased pain (OR 5.10), higher oxygen requirement (OR 28.91), reduced nutrition/fluid intake (OR 71.58), and worsened mental status (OR 2.15).
  • No other sociodemographic or clinical factors were significantly associated with high parental concern.

Conclusions:

  • Changes in clinical parameters of CMC are linked to high parental concern, potentially serving as an early warning for acute illness.
  • Monitoring and addressing high parental concerns can enhance the management of CMC at home.
  • This highlights the importance of parental perception as a valuable component in pediatric complex care.
Abstract

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