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Association between parental education level & outcomes for children with long-term ventilator dependence:
Sydney R Hornberger1, Yin Zhang2, Nanhua Zhang3
1Indiana University School of Medicine: West Lafayette Campus, 715 Clinic Dr, West Lafayette, IN 47907, United States; Cincinnati Children's Hospital Medical Center: Division of Research in Patient Services, 3333 Burnet Ave, Cincinnati, OH 45229, United States.
Insights
Parental education level did not consistently predict adverse outcomes for children with long-term ventilator dependence (LTVD). Parent communication behaviors moderated the relationship between education and child health outcomes.
Area of Science:
- Pediatric Healthcare
- Family Medicine
- Health Outcomes Research
Background:
- Advances in medical technology enable home care for children with long-term ventilator dependence (LTVD).
- Social determinants of health, including parental education, influence child health outcomes.
- Parental communication behaviors may impact the relationship between socioeconomic factors and child health.
Purpose of the Study:
- To investigate the correlation between parental education level and outcomes for children with LTVD.
- To determine if parent communication behaviors moderate this relationship.
- To understand the role of parental education as a social determinant of health in LTVD care.
Main Methods:
- Secondary data analysis utilizing chi-square tests.
- Generalized linear mixed effect models to assess moderation effects.
- Examined correlations between parental education, child outcomes, and communication behaviors.
Main Results:
- Lower parental education was linked to increased child respiratory infections and parental uncertainty post-discharge.
- Fewer unplanned provider contacts were observed with lower parental education.
- Parent communication styles (Verifying Understanding, Negotiating Roles) moderated these associations.
Conclusions:
- Lower parental education did not consistently correlate with adverse outcomes, contrary to prior research.
- Parental determination may play a role in achieving optimal outcomes.
- Healthcare providers should not assume differing outcomes based solely on parental education level.
Purpose:
The purpose of this study was to examine the correlation between parental education level and outcomes for children with long-term ventilator dependence (LTVD) and their families and whether parent communication behaviors with hospital nurses moderated the relationship. Advances in medical technology and policy changes allow children with LTVD to be cared for at home. The child's diagnosis and disease severity affect their health outcomes, as do their family's social determinants of health (SDoH) such as parent education.
Design And Methods:
This secondary data analysis used chi-square tests to evaluate the correlation between parental education level and outcomes. Generalized linear mixed effect models were used to examine the moderation effect of parent communication behaviors.
Results:
Lower parental education level was associated with more child respiratory infections and more parental uncertainty within one month following hospital discharge. Lower parent education level was also associated with fewer unplanned contacts with providers within one week post-discharge. Additionally, parent use of Verifying Understanding communication behaviors moderated the relationship between parental education level and number of respiratory infections and amount of parental uncertainty. Finally, parent use of Negotiating Roles moderated the association between education level and number of unplanned visits.
Conclusions:
Contradicting previous research, lower parental education level does not consistently correspond to adverse outcomes and may be explained by parents' determination to ensure optimal outcomes for their children with LTVD.
Practice Implications:
Overall, healthcare providers should not be concerned that children with LTVD will have different outcomes based on their parents' education level.
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