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Managing Expectations: Understanding Parents' Perceptions of Their Child's Serious Illness.

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Parents of seriously ill children balance hope with reality. They use cognitive and behavioral strategies to maintain positive and realistic outlooks, influencing their parenting approach.

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meta-synthesisparent treatment communicationqualitative research

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Area of Science:

  • Pediatric Psychology
  • Family Health
  • Childhood Illness

Background:

  • Parenting a seriously ill child presents significant emotional and practical challenges.
  • Existing research on parental coping includes themes of maintaining positive and realistic outlooks.
  • Further exploration is needed to understand the nuances of these parental coping mechanisms.

Purpose of the Study:

  • To extend Hinds and colleagues' "Good Parent" themes by analyzing grounded theories on parental outlooks.
  • To identify cognitive and behavioral strategies parents use to maintain positive and realistic perspectives.
  • To deepen the understanding of how parental expectations influence parenting in pediatric chronic illness.

Main Methods:

  • Systematic review of grounded theory studies published in English language journals.
  • Inclusion criteria: January 2006 to April 2021, relevant to parental outlooks in serious childhood illness.
  • Analysis of 18 selected studies to synthesize findings on parental cognitive and behavioral efforts.

Main Results:

  • Parents employ cognitive strategies (e.g., hope, avoiding negative thoughts) and behavioral actions (e.g., monitoring, information seeking) to maintain a positive outlook.
  • Realistic outlooks involve acknowledging the illness severity, treatment side effects, and challenges in normalizing the child's life.
  • Simultaneously holding positive and realistic outlooks enables parents to remain hopeful while preparing for end-of-life scenarios.

Conclusions:

  • Parental expectations regarding illness trajectory and outcomes significantly shape parenting behaviors and cognitive processes.
  • The interplay between positive and realistic outlooks is crucial for effective parenting of seriously ill children.
  • This research provides a more nuanced understanding of parental coping and adaptation in pediatric chronic and critical care settings.