1
|
Ikeda M, Hoshino H, Aikawa G, Matsuishi Y, Kotani M, Enomoto Y, Shimojo N, Inoue Y. Translation and Adaptation of the Japanese Version of the Revised Parental Stressor Scale: Pediatric Intensive Care Unit. Cureus 2024; 16:e64389. [PMID: 39130874 PMCID: PMC11317023 DOI: 10.7759/cureus.64389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2024] [Indexed: 08/13/2024] Open
Abstract
Introduction The physical, cognitive, and psychiatric disorders that occur in patients after leaving the intensive care unit (ICU) are collectively called post-intensive care syndrome (PICS). Moreover, PICS-family (PICS-F) refers to the long-term psychological and social disorders that occur in the family. The symptoms of PICS-F can be psychological, and stress is a known cause of these symptoms. The Parental Stressor Scale: Pediatric Intensive Care Unit (PSS: PICU) was developed to assess stress levels and related factors among the families of patients admitted to the PICU. It has been translated into several languages and was revised in 2021. However, a Japanese version of the revised PSS: PICU (J-R-PSS: PICU) has not yet been developed. This study aimed to develop a J-R-PSS: PICU and to test its acceptability for clinical use. Materials and methods A back-translation method, involving initial translation, review by bilingual experts, and subsequent re-translation to ensure accuracy, was used to develop the J-R-PSS: PICU. Families with patients in the PICU for >48 hours between November and December 2021 and those who were transferred out of the ICU were recruited. Moreover, the study documents with a QR code for a web questionnaire were provided and explained to family members. Stress scores and stressors of family members were collected from web questionnaires using the PSS: PICU as the primary endpoint. Other information about the patients and their families was collected from clinical records and questionnaires. Participants and an expert panel evaluated the clarity of each item, and the expert panel evaluated the relevance of each item. Results Twenty family members who met the inclusion criteria and provided informed consent were included. The J-R-PSS: PICU was developed using a back-translation method. For clarity, all items were clarified after a single modification by an interdisciplinary team. For relevance, all the items had a content validity index at an item level of ≥0.8 and a scale level of 0.94. Alpha coefficients were 0.93 for the overall scale and 0.69-0.97 for its subscales. Conclusion We developed the J-R-PSS: PICU with high content validity and internal consistency using a back-translation method.
Collapse
Affiliation(s)
- Mitsuki Ikeda
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN
- Department of Nursing, University of Tsukuba Hospital, Tsukuba, JPN
| | - Haruhiko Hoshino
- Adult Nursing/Acute Care, Department of Nursing, Faculty of Medical Technology, Teikyo University, Itabashi, JPN
| | - Gen Aikawa
- College of Nursing, Kanto Gakuin University, Yokohama, JPN
| | - Yujiro Matsuishi
- Adult and Elderly Nursing, Faculty of Nursing, Tokyo University of Information Sciences, Chiba, JPN
- Laboratory of Artificial Intelligence, Intelligent and Mechanical Interaction Technologies (IMIS), University of Tsukuba, Tsukuba, JPN
| | - Misaki Kotani
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN
- Department of Nursing, University of Tsukuba Hospital, Tsukuba, JPN
| | - Yuki Enomoto
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN
| | - Nobutake Shimojo
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN
| | - Yoshiaki Inoue
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN
| |
Collapse
|
2
|
Zhang Y, Zhou H, Bai Y, Chen Z, Wang Y, Hu Q, Yang M, Wei W, Ding L, Ma F. Development and validation of a questionnaire to measure the congenital heart disease of children's family stressor. Front Public Health 2024; 12:1365089. [PMID: 38751578 PMCID: PMC11094312 DOI: 10.3389/fpubh.2024.1365089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Families of children with congenital heart disease (CHD) face tremendous stressors in the process of coping with the disease, which threatens the health of families of children with CHD. Studies have shown that nursing interventions focusing on family stress management can improve parents' ability to cope with illness and promote family health. At present, there is no measuring tool for family stressors of CHD. Methods The items of the scale were generated through qualitative interviews and a literature review. Initial items were evaluated by seven experts to determine content validity. Factor analysis and reliability testing were conducted with a convenience sample of 670 family members. The criterion-related validity of the scale was calculated using scores on the Self-Rating Anxiety Scale (SAS). Results The CHD Children's Family Stressor Scale consisted of six dimensions and 41 items. In the exploratory factor analysis, the cumulative explained variance of the six factors was 61.085%. In the confirmatory factor analysis, the six factors in the EFA were well validated, indicating that the model fits well. The correlation coefficient between CHD Children's Family Stressor Scale and SAS was r = 0.504 (p < 0.001), which indicated that the criterion-related validity of the scale was good. In the reliability test, Cronbach's α coefficients of six sub-scales were 0.774-0.940, and the scale-level Cronbach's α coefficient value was 0.945. Conclusion The study indicates that the CHD Children's Family Stressor Scale is valid and reliable, and it is recommended for use in clinical practice to assess CHD children's family stressors.
Collapse
Affiliation(s)
- Yi Zhang
- Department of Nursing, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Hang Zhou
- Department of Clinical Psychology, Yunnan Provincial Hospital of Infectious Disease, Kunming, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhisong Chen
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanjiao Wang
- Psychiatric Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiulan Hu
- ICU in Geriatric Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mingfang Yang
- Urology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei Wei
- Neurosurgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lan Ding
- General Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fang Ma
- Department of Nursing, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| |
Collapse
|
3
|
Montoro-Pérez N, Oliver-Roig A, Montejano-Lozoya R, Richart-Martínez M. Psychometric properties of parental stress scales used in paediatric health care settings: A systematic review 1. J Clin Nurs 2024; 33:911-931. [PMID: 37926938 DOI: 10.1111/jocn.16920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/28/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
AIM To identify scales that assess parental stress in the paediatric clinical population and to analyse their psychometric properties. METHODS Four electronic databases (PubMed, Web of Science, PsycINFO, and Scopus) and metasearch engines (Google Scholar and Open Grey) were searched with no time period limitations. Methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach modified by COSMIN. Finally, recommendations were made for the instruments with the highest quality of evidence. RESULTS A total of 38 studies reporting on 11 different instruments for assessing parental stress in the paediatric clinical setting were included. Six instruments were 'A' rated (recommended) in the final phase in line with COSMIN guidelines. The Paediatric Inventory for Parents was the instrument that evaluated the highest number of psychometric properties and obtained the highest methodological quality, global assessment, and quality of evidence for the different psychometric properties. CONCLUSIONS This systematic review provides an overview of the measurement properties of the parental stress instruments used in the paediatric clinical setting. The Paediatric Inventory for Parents stands out as being one of the most robust instruments for measuring stress in parents with a hospitalised or sick child. Evidence needs to be generated for all the parental stress scales used in the clinical setting. IMPACT Given that the psychometric properties of the existing parental stress scales used in paediatric health care settings have not been systematically assessed, the present review utilised comprehensive methods according to COSMIN. NO PATIENT OR PUBLIC CONTRIBUTION REPORTING METHOD: PRISMA statement and COSMIN reporting guidelines for studies on measurement properties of patient-reported outcome measures.
Collapse
Affiliation(s)
- Néstor Montoro-Pérez
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Oliver-Roig
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
| | | | - Miguel Richart-Martínez
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
| |
Collapse
|
4
|
Freccero A, Scala M, McLeod KA, Donahue B, Webb M, Briggs M, Najm I, Sinha M, Santagata L, Dahlen A, Nasr A. The Safety of Body Wraps on Skin-to-Skin Care in the Neonatal Population: A Pilot Study. Adv Neonatal Care 2024; 24:E11-E19. [PMID: 38127581 DOI: 10.1097/anc.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Despite well-established benefits of skin-to-skin care (SSC) for preterm infants and parents, standardized guidelines for implementation do not exist. Furthermore, the literature offers little evidence-based information to guide best practice. PURPOSE To discover whether SSC using a body wrap to hold preterm infants would increase the duration of SSC, decrease parental stress during SSC, and minimize adverse events to ensure that body wraps are safe and feasible. METHODS Twenty-nine dyads of parents and preterm infants younger than 34 weeks postmenstrual age were enrolled. The first 15 dyads to meet inclusion criteria were assigned to a standard of care group for SSC with no body wrap. The remaining 14 dyads were assigned to an experimental group for SSC with a body wrap. Each dyad performed 2 SSC holds. Parents completed the Parental Stressor Scale and Parent Feedback Form. Adverse events were also documented. RESULTS No statistically significant differences were found between the 2 groups in total SSC time ( P = .33), the number of adverse events ( P = .31 for major events; P = .38 for minor events), average parental stress ( P = .22), and parental confidence performing SSC ( P = .18). IMPLICATIONS FOR PRACTICE AND RESEARCH This study found that SSC with a body wrap is safe for preterm infants in a neonatal intensive care unit (NICU). This is the first study to explore the use, safety, and effectiveness of body wraps during SSC with preterm infants in an NICU. Future research should be conducted with larger sample sizes to further evaluate the safety and efficacy.
Collapse
Affiliation(s)
- Allison Freccero
- Departments of Rehabilitation Services (Drs Freccero, McLeod, Donahue, and Webb and Ms Briggs) and Nursing (Mss Najm, Sinha, and Santagata), Lucile Packard Children's Hospital Stanford, Palo Alto, California; Departments of Neonatology (Dr Scala) and Pediatrics (Dr Nasr), School of Medicine, Stanford University, Lucile Packard Children's Hospital Stanford, Palo Alto, California; and Quantitative Sciences Unit, School of Medicine, Stanford University, Palo Alto, California (Dr Dahlen)
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Demers LA, Wright NM, Kopstick AJ, Niehaus CE, Hall TA, Williams CN, Riley AR. Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101575. [PMID: 36291511 PMCID: PMC9600460 DOI: 10.3390/children9101575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022]
Abstract
Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize them to PICU-related distress. Trauma-informed care (TIC) in the PICU, while under-examined, has the potential to enhance quality of care, mitigate trauma-related symptoms, encourage positive coping, and provide anticipatory guidance for the recovery process. This narrative review paper first describes the need for TIC in the PICU and then introduces the principles of TIC as outlined by the American Academy of Pediatrics: awareness, readiness, detection and assessment, management, and integration. Current clinical practices within PICU settings are reviewed according to each TIC principle. Discussion about opportunities for further development of TIC programs to improve patient care and advance knowledge is also included.
Collapse
Affiliation(s)
- Lauren A. Demers
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Naomi M. Wright
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Psychology, University of Denver, Denver, CO 80208, USA
| | - Avi J. Kopstick
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Texas Tech University Health Science Center El Paso, El Paso, TX 97705, USA
| | - Claire E. Niehaus
- Division of Psychology and Psychiatry, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Trevor A. Hall
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Correspondence: ; Tel.: +1-503-418-2134
| | - Cydni N. Williams
- Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrew R. Riley
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| |
Collapse
|
6
|
Debelić I, Mikolčić A, Tihomirović J, Barić I, Lendić Đ, Nikšić Ž, Šencaj B, Lovrić R. Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11450. [PMID: 36141723 PMCID: PMC9517134 DOI: 10.3390/ijerph191811450] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Hospitalization of a child in the paediatric intensive care unit (PICU) is extremely stressful, both for the child and for his or her family. The purpose of this study was to gain deeper insight into the stressful experiences of parents of children hospitalized in the PICU. This study included 96 parents. The data were collected using a translated and standardized scale "The Parental Stressor Scale: Paediatric Intensive Care Unit (PSS: PICU)". This study confirms high exposure of parents to numerous PICU stressors. The most intense PICU stressor for parents was child's breathing depending on the ventilator (4.22 ± 1.17), and the least intense was child's demanding behaviour (1.17 ± 0.33). A significant positive correlation between the level of parents' perceived stress and the number of their children was recorded (r = 0.240, p = 0.02), while there was no significant correlation between the level of stress and other sociodemographic variables. A significantly higher level of stress was experienced by parents with primary school education (p = 0.032) and parents who are not healthcare professionals (p < 0.01). It is necessary to establish a system that will enable continuous assessment of parents' stress levels and timely prevention of stressful experiences for parents in the PICU.
Collapse
Affiliation(s)
- Ivana Debelić
- School of Nursing, Medicinska Škola Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Anamaria Mikolčić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jovana Tihomirović
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Iva Barić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Specialist Practice of Occupational and Sports Medicine, Ilija Celebic, 31000 Osijek, Croatia
| | - Đurđica Lendić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Paediatric Clinic, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Željka Nikšić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Paediatric Clinic, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Barbara Šencaj
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of School Medicine, Teaching Institute of Public Health for the Osijek-Baranya County, 31000 Osijek, Croatia
| | - Robert Lovrić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| |
Collapse
|
7
|
Alzawad Z, Marcus Lewis F, Ngo L, Thomas K. Exploratory model of parental stress during children's hospitalisation in a paediatric intensive care unit. Intensive Crit Care Nurs 2021; 67:103109. [PMID: 34247940 DOI: 10.1016/j.iccn.2021.103109] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/18/2021] [Accepted: 05/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This exploratory study (a) examined pre-existing and peri-trauma risk factors of parental stress during a child's PICU hospitalisation using the Integrative Trajectory Model of Paediatric Medical Traumatic Stress and (b) identified the type of PICU-related stressors that predicted parental stress during the child's PICU hospitalisation. METHODS A cross-sectional, descriptive correlational design with 81 parents of children admitted 48 or more hours to a Paediatric Intensive Care Unit (PICU). Questionnaires measured parent's and child's demographic and clinical characteristics and parent-reported stressors using the Parental Stressors Scale (PSS:PICU). Analysis included descriptive statistics and multiple linear regression analyses with simultaneous predictor entry. RESULTS Male parents tended to be significantly more stressed than female parents. Parental stress was significantly increased when parents had one or more stressful life events one-month prior to PICU admission, when the child required ventilatory support, or the child had a cardiovascular diagnosis. Parental stress was also predicted by the child's appearance, procedures, child's behaviour, behaviour of staff, and parental role. CONCLUSION Nurses are in a prime position to identify parents at potentially high risk for psychological morbidity when they know a parent has had a stressful life event prior to admission, has a child with a cardiovascular diagnosis or requires ventilatory assistance. Nurses can diminish parental stress by interpreting the child's appearance for parents, helping parents understand the procedures being done for the child, interpreting the child's behaviour, explaining the staff's behaviour, and assisting parents to define their parental role during the child's hospitalisation.
Collapse
Affiliation(s)
- Zainab Alzawad
- The University of Iowa, College of Nursing - 322 CNB, Iowa City, IA 52242, United States.
| | - Frances Marcus Lewis
- University of Washington, Dept Child, Family and Population Health Nursing, United States; Fred Hutchinson Cancer Research Center, United States
| | - LizAnne Ngo
- University of Washington, College of Education, United States
| | | |
Collapse
|