Factors Associated with Psychological Well-being among Parents of a Critically Ill Child in Pediatric Intensive Care Unit
Keywords:Critical illness, parents, psychological well-being, pediatric intensive care unit (PICU)
A child’s hospitalization in a pediatric intensive care unit (PICU) is a stressful and suffering situation affecting the parents. This correlational study aims to investigate the predicting factors of parents’ psychological well-being with regard to a critically ill child in the PICU. The participants were 100 parents with a child hospitalized in one of the five PICUs of five tertiary hospitals. The research instruments included the Demographic Recording Form, the Child’s Behavioral and Emotional Responses Scale, the Sense of Coherence Scale-Short Form (SOC-13), Thai Version, the Jalowiec Coping Scale (JCS), the Buddhist Belief Questionnaire, the Modified Version of Social Support Questionnaire, Thai Version, and the Psychological General Well-Being Index (PGWBI). Data were analyzed using descriptive statistics, Pearson’s correlation, Spearman’s rank correlation coefficient, and hierarchical multiple regression. The results of hierarchical multiple regression showed that religious belief, the child's behavioral and emotional responses, sense of coherence, coping, and social support could explain 36 % of the variance in the psychological well-being of parents of a critically ill child. The factors that made significant contributions to the model were religious belief (β = 0.29, p < 0.01), sense of coherence (β = 0.27, p < 0.01), the child’s behavioral and emotional responses (β = -0.24, p < 0.01), social support (β = 0.22, p < 0.05), and coping (β = 0.17, p < 0.05). The results of this study may serve as preliminary information for nurses in planning nursing interventions in order to enhance the psychological well-being of the parents.
D Stawon. Intensive care unit administration. In: D Stawon, C Loahapun, P Sengarun and S Kunathai (Eds.). Pediatric Critical Care. Beyond Enterprise, Bangkok, 2002, p. 12-21.
Ramathibodi Hospital Statistic. Statistic of admission rate in the PICU. Bangkok, Faculty of Medicine Ramathibodi Hospital, Thailand, 2017.
Maharaj Nakorn Chiang Mai Hospital Statistic. Statistic of admission rate in the PICU. Chiang Mai, Maharaj Nakorn Chiang Mai Hospital, Thailand, 2017.
G Colville, J Darkins, J Hesketh, V Bennett, J Alcock and J Noyes. The impact on parents of a child's admission to intensive care: Integration of qualitative findings from a cross-sectional study. Intensive Crit. Care Nurs. 2009; 25, 72-9.
U Jintrawet. 2005, Parental Practices during Their Child’s Admission to Pediatric Intensive Care Unit. Ph. D. Dissertation. Chiang Mai University, Chiang Mai, Thailand.
M Shudy, ML de Almeida, S Ly, C Landon, S Groft, TL Jenkins and CE Nicholson. Impact of pediatric critical illness and injury on families: A systematic literature review. Pediatrics 2006; 118, S203-S218.
R Board and N Ryan-Wenger. Long-term effects of pediatric intensive care unit hospitalization on families with young children. Heart Lung 2002; 31, 53-66.
M Huhtala, R Korja, L Rautava, L Lehtonen, L Haataja, H Lapinleimu and P Rautava. Health-related quality of life in very low birth weight children at nearly eight years of age. Acta Paediatr. 2015; 105, 53-9.
BM Melnyk, L Alpert-Gillis, NF Feinstein, HF Crean, J Johnson, E Fairbanks, L Small, J Rubenstein, M Slota and B Corbo-Richert. Creating opportunities for parent empowerment: Program effects on the mental health/coping outcomes of critically ill young children and their mothers. Pediatrics 2004; 113, 597-607.
M Mirghafourvand, E Ouladsahebmadarek, MB Hosseini, S Heidarabadi, M Asghari-Jafarabadi, and S Hasanpour. The effect of creating opportunities for parent empowerment program on parent’s mental health: A systematic review. Iran J. Pediatr. 2017; 27, e5704.
J Gonya, E Martin, R McClead, L Nelin and E Shepherd. Empowerment programme for parents of extremely premature infants significantly reduced length of stay and readmission rates. Acta Paediatrica 2014; 103, 727-31.
SY Lee, KA Lee, SH Rankin, SJ Weiss and A Alkon. Sleep disturbance, fatigue, and stress among Chinese-American parents with ICU hospitalized infants. Issues Ment. Health Nurs. 2007; 28, 593-605.
M Busse, K Stromgren, L Thorngate and KA Thomas. Parents' responses to stress in the neonatal intensive care unit. Crit. Care Nurs. 2013; 33, 52-9.
SY Lee and LP Kimble. Impaired sleep and well-being in mothers with low birth Weight Infants. J. Obstet. Gynecol. Neonatal. Nurs. 2009; 38, 676-85.
MS Miles and MC Carter. Sources of parental stress in pediatric intensive care units. Fall 1982; 11, 65-9.
CD Ryff. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J. Pers. Soc. Psychol. 1989; 57, 1069-81.
CD Ryff. Psychological well-Being revisited: Advances in science and practice. Psychother Psychosom. 2014; 83, 10-28.
CLM Keyes. Psychological Well-being. In: JE Birren (Ed). Encyclopedia of Gerontology. 2nd ed. Elsevier, Amsterdam, 2007, p. 399-406.
HJ Dupuy. The Psychological General Well-being (PGWB) Index. In: NK Wenger, MECD Furburg and J Elinson (Eds.). Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapies. Le Jacq, New York, 1984, p. 170-83.
CLM Keyes. Mental Health as a Complete State: How the Salutogenic Perspective Completes the Picture. In: GF Bauer and O Hämmig (Eds). Bridging Occupational, Organizational and Public Health. Springer, Dordrecht, 2014, p. 179-92.
World Health Organization, Available at: http://www.who.int/features/factfiles/mental_health/en/, accessed July 2018.
V Vrolarn. 1992, Perception of Uncertainty in Illness, Coping and General Well-being of Parents with Children Admitted in Intensive Care Unit. Master’s Thesis. Mahidol University, Bangkok, Thailand.
LI Pearlin, JT Mullan, SJ Semple and MM Skaff. Caregiving and the stress process: An overview of concepts and their measures. Gerontologist 1990; 30, 583-94.
M Menne. 2006, A Stress Process Model of Chronic Illness: Understanding the Well-being and Decision-making Involvement of Individuals with Dementia. Ph. D. Dissertation. Case Western Reserve University, USA.
A Antonovsky. Unraveling the Mystery of Health: How People Manage Stress and Study Well. Jossey-Bass Publishers, San Francisco, 1987.
G Forsberg-Warleby, A Moller and C Blomstrand. Spouses of first-ever stroke victims: Sense of coherence in the first phase after stroke. J. Rehabil. Med. 2002; 34, 128-33.
WWS Mak, AHY Ho and RW Law. Sense of coherence, parenting attitudes and stress among mothers of children with autism in Hong Kong. J. Appl. Res. Intellect. Disabil. 2007; 20, 157-67.
MB Olsson and CP Hwang. Sense of coherence in parents of children with different developmental disabilities. J. Intellect. Disabil. Res. 2002; 46, 548-59.
RS Lazarus and S Folkman. Stress, Appraisal, and Coping, Springer, New York, 1984.
JM Latour, JB van Goudoever, BE Schuurman, MJ Albers, NA van Dam, E Dullaart, M van Heerde, CW Verlaat, EM van Vught and JA Hazelzet. A qualitative study exploring the experiences of parents of children admitted to seven Dutch pediatric intensive care units. Intensive Care Med. 2011; 37, 319-25.
S Joshi and S Kumari. Religious beliefs and mental health: An empirical review. Delhi Psychiat. J. 2011; 14, 40-50.
E Colón-Bacó. The strength of religious beliefs in important for subjective well-being. Undergraduate Econ. Rev. 2010; 6, 11.
National Statistical Office. Available at: http://www.nso.go.th, accessed January 2018.
HG Koenig. Religion, spirituality and psychotic disorders. Arch. Clin. Psychiat. 2007; 34, 40-8.
A Kaliampos and P Roussi. Religious beliefs, coping, and psychological well-being among Greek cancer patients. J. Health Psychol. 2017; 22, 754-64.
C Schaefer, JC Coyne and RS Lazarus. The health-related functions of social support. Int. J. Behav. Med. 1981; 4, 381-406.
NL Chappell and RC Reid. Burden and well-being among caregivers: Examining the distinction. Gerontologist 2002; 42, 772-80.
S Boonyawat and R Sunsern. Factors influencing well-being of Thalassemic children’s caregivers at home in the Eastern region (in Thai). J. Facul. Nurs. Burapha Univ. 2005; 1, 55-70.
RL Khan, AI Goldfarb, M Pollack and A Peck. Brief objective measures for the determination of mental status in the aged. Am. J. Psychiat. 1960; 117, 326-8.
F Faul, E Erdfelder, A Buchner and AG Lang. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav. Res. Meth. 2009; 41, 1149-60.
JF Hair, WC Black, BJ Babin and RE Anderson. Multivariate data analysis: A global perspective. 7th ed. New Jersey, Pearson Education, 2010.
MC Carter and MS Miles. The parental stressor scale: Pediatric intensive care unit. Fall 1989; 18, 187-98.
S Hanucharurnkul, P Intarasombut and P Putwatana. Daily hassles, sense of coherence and general well-being among nursing faculty members of university (in Thai). Thai J. Nurs. 1989; 38, 169-90.
A Antonovsky. The structure and properties of the sense of coherence scale. Soc. Sci. Med. 1993; 36, 725-33.
A Jalowiec. Confirmatory Factor Analysis of the Jalowiec Coping Scale. In: CF Waltz and OL Strickland (Eds.). Measurement of Nursing Outcomes: Measurement Client Outcomes. Vol I. Spinger, New York, 1988, p. 287-308.
P Mingkwan. 1999, Stress and Coping in the Elderly Stroke Patients. Master's Thesis. Chiang Mai University, Chiang Mai, Thailand.
S Hanucharurnkul. 1988, Social Support, Self-care, and Quality of Life in Cancer Patients Receiving Radiotherapy in Thailand. Ph. D. Dissertation. The Wayne State University, USA.
C Santawaja. 2002, A Casual Model of Psychosocial Adjustment in Post Radiotherapy Cervical Cancer Women. Ph. D. Dissertation. Mahidol University, Bangkok, Thailand.
Mapi Research Institute. Available at: https://mapigroup.com, accessed January 2016.
MF Hazinski. Nursing Care of the Critically ill Child. 3rd ed. Mosby, Missouri, 2013.
M Aamir, K Mittal, JS Kaushik, H Kashyap and G Kaur. Predictors of stress among parents in pediatric intensive care unit: A prospective observational study. Indian J. Pediatr. 2014; 81, 1167-70.
PA Payutto. Dictionary of Buddhism (in Thai). 11th ed. Sahadhmmika, Bangkok, 2002.
RS Gray, L Hahn, S Thapsuwan and N Thongcharoenchupong. Strength and stress: Positive and negative impacts on caregivers for older adults in Thailand. Australas J. Age. 2016, 35, E7-E12.
B Wheaton. The Stress Process as a Successful Paradigm. In: Avison WR, CS Aneshensel, S Schieman and B Wheaton (Eds). Advances in the Conceptualization of the Stress Process: Essays in Honor of Leonard I. Pearlin. Spinger, New York, 2010, p. 231-52.
LI Pearlin. The Stress Process Revisited: Reflections on Concepts and Their Interrelationships. In: CS Aneshensel and JC Phelan (Eds.). Handbook of the Sociology of Mental Health, Springer, New York, 1999, p. 395-415.
A Aksornsri, W Thampaanichawat, K Wichiencharoen and P Sangperm. The effects of concrete-objective information on parental anxiety and parental participation in care for children in pediatric intensive care unit (in Thai). J. Nurs. Sci. 2012; 30, 80-9.
N Beheshtipour, SM Baharlu, S Montaseri and SMR Ardakani. The effect of the educational program on Iranian premature infants' parental stress in a neonatal intensive care unit: A double-blind randomized controlled trial. Int. J. Commun. Based Nurs. Midwifery 2014; 2, 240-50.
K Cheon. 2012, Psychological Well-being of Mothers with Preterm Infants. Ph. D. Dissertation. University of California, USA.
How to Cite
Copyright (c) 2018 Walailak Journal of Science and Technology (WJST)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.