Resilience-promoting factors for parents of severely injured children during the acute hospitalisation period: A qualitative inquiry

Identifying parent anxiety and family distress of critically ill children in response to changes in hospital visitation policies during the COVID-19 pandemic

Purpose

This research study describes parent anxiety and family distress among three study groups of varying restrictions in parent presence for children in the PICU during a pandemic.

Design and methods

A retrospective study was conducted to describe differences in parent anxiety and family distress for parents of children hospitalized before and during the COVID-19 pandemic. Participants fell into three study groups based on the dates of the child's hospital stay and the level of parent and family presence or restriction they experienced. Participants were asked to complete a survey that included basic demographic information along with utilization of the GAD-7 and FDI measures. The data were assessed using descriptive statistics, Fisher's exact test, and the Kruskal-Wallis test.

Results

A total of 82 parents of children hospitalized during the specified times in the PICU participated. There was a statistically significant difference among the three cohorts in diagnoses (respiratory, cardiovascular, and medical-surgical), p ≤0.001. A larger percentage of children of the study participants were hospitalized with respiratory illnesses (62.5%) in the unrestricted study group when compared to the other study groups with higher patient acuity. There was also a statistical significance among the three study groups regarding whether the second parent was able to visit the child during the PICU admission (p = 0.007).

Conclusions

Our study suggests that restricting parent and visitor presence does not increase parent anxiety or family distress during a child's admission to the PICU. The literature widely supports that having a critically ill child is undoubtedly stressful for parents and families, but the most significant causation for the anxiety and stress remains unknown and is likely multifactorial.

Clinical and research implications

Parents who experienced rigid restrictions in parent and visitor presence did not have increased anxiety. Other impactful variables such as a child's mortality risk and the uncertainty of outcome may have impacted anxiety for parents whose children were critically ill. Further research is needed to understand which stressors are most significant, during a critically ill child's hospitalization, from a parent's perspective. Limiting staff and patient exposure to persons who may have contagious illness (restricting parent and family presence) may not in itself lead to increased anxiety and distress for parents and families. This study may provide context for careful development of hospital visitation policies to ensure balance between patient and family centered care and protection from infectious disease.

Parents’ Views on Family Resiliency in Sustainable Remote Schooling during the COVID-19 Outbreak in Finland

The closure of schools because of the COVID-19 pandemic created a challenge for families and teachers in supporting children’s remote schooling. This study investigates parents’ perspectives on their accommodation to the rapid change to remote schooling from the point of view of sustainable education. The study was conducted at the beginning of the COVID-19 pandemic in spring 2020 via an online questionnaire for parents, to which 316 voluntary participants responded. Data were analyzed using a theory-driven content analysis. According to the results, parents were worried about the learning and wellbeing of their children as well as management of daily life and use of information and communications technology (ICT). The results show the importance of schools and teachers as well as networks in supporting family resilience during rapid changes. Families’ individual needs should be acknowledged and met in a sustainable way to support children’s learning in changing settings, including remote schooling.

Family Support System as an Effort to Optimize Coping Mechanism of Preschool Children During Hospitalization

Introduction: The condition of the child during hospitalisation can experience stress due to environmental changes. Child coping mechanism is very supportive of the adaptation process. The purpose of this study was to analyze the effect of family support system on coping mechanisms during hospitalisation. Methods: It was quasi-experimental with pre-test post-test with control group design. The study population was preschool children who were treated in the Hospital of Bangkalan, East Java Province, Indonesia. Total sample was 60 respondents in treatment and control group and obtained consecutive sampling. The variables were family support system and coping mechanism. Data collection used Children’s Coping Behavior questionnaire and tested by paired t-test. Results: The treatment group showed the coping mechanism was mostly maladaptive (mean=34.07) and after the intervention most of them had adaptive coping (mean=46.87). Whereas in the control group before the intervention, the coping mechanism was mostly maladaptive (mean=36.22) and after the intervention most of the coping groups had maladaptive coping (mean=36.74). Conclusion: Family support systems play an important role in improving the adaptive coping of preschool children during hospitalisation. Nurses should maximise family support as a strategy in interacting with children to enhance coping mechanisms to reduce the stress of hospitalisation.