Posttraumatic Stress in Parents of Hospitalized Children With Medical Complexity

Parents of children with medical complexity (CMC) are exposed to repeated episodes of pediatric medical traumatic stress, placing them at risk of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD). The objectives of this study are (1) to establish the prevalence and severity of PTSS and PTSD in parents of hospitalized CMC and (2) to determine whether a hospitalization influences PTSS and whether PTSS were associated with subjective experiences during the hospitalization.

This prospective cohort study enrolled parents of hospitalized CMC at a Canadian children's hospital and used a validated questionnaire to measure PTSS at baseline and 2 to 6 months later. Potential predictor variables related to demographics, child illness, caregiving, and experiences in hospital were collected. Multivariable regression models were used to determine relevant associations with PTSS.

Of 75 enrolled participants, 58 completed baseline questionnaires and 48 completed follow-up. Twenty-nine percent of participants met cutoff for PTSD at baseline and 33% at follow-up. Increased PTSS was found in association with female gender, higher number of previous traumatic events, history of anxiety/depression, higher caregiving responsibilities, insomnia, and anxiety symptoms in hospital. Most subjective experiences of hospitalization showed no relationship with PTSS. For most participants, PTSS was stable and persistent over time.

PTSS/PTSD are frequently found among parents of hospitalized CMC. Caregiving responsibilities, anxiety and insomnia are potentially modifiable risk factors. A combination of integrated tangible and mental health supports, in hospital and community, could be an opportunity to mitigate PTSS in this high-risk population.