Rachel Gabor, MS
Biostatistician
Marshfield Clinic Research Institute, United States
Disclosure information not submitted.
K. Jane Lee, MD, MA
Associate Professor, Pediatrics (Complex Care) and Bioethics & Medical Humanities
Medical College of Wisconsin and Children's Wisconsin, United States
Disclosure information not submitted.
Kathleen Mussatto, PhD, RN, FAHA
Associate Professor, Nursing
Milwaukee School of Engineering University, United States
Disclosure information not submitted.
Title: Parent Activation and Traumatic Stress in the Pediatric Intensive Care Unit
Introduction: Nearly all parents in the PICU experience traumatic stress. Separately, parent activation is a measure of knowledge, confidence, and willingness to engage in the management of a child’s health. We aimed to identify associations between parent activation, parent traumatic stress, the passage of time, and factors that may influence parent traumatic stress in the PICU.
Methods: This was a single-center, prospective study of parents with a child in the PICU. Data were obtained via two surveys, one within 48 hours of PICU admission and a second one month later.
Results: A sample of 101 parents of 74 patients completed the initial survey. Of these, 44 completed the follow-up. Parent activation and traumatic stress near PICU admission were associated with activation (r=0.61, p< 0.001) and traumatic stress (r=0.63, p< 0.001) one month later, respectively. On admission, parents with more preexisting depression and anxiety reported more traumatic stress (r=0.36, p=0.001 and r=0.35, p=0.004), and parents who reported more background life stressors also reported more traumatic stress (r=0.29, p=0.002). One month after admission, parents who thought having a written daily schedule for their child was or could be helpful reported less stress (0.34 vs. 1.05, p=0.001), and the more helpful they found the schedule, the less stress they reported (r=-0.65, p=0.003). The perceived helpfulness of a chaplain correlated with parent activation at admission (r=0.3, p=0.009) and follow-up (r=.48, p=0.007), and parental use of a support website was associated with higher parent activation at admission (80 vs. 70, p=0.010).
Conclusions: Parent activation and parent traumatic stress symptoms within 48 hours of PICU admission predict activation and traumatic stress at one-month follow-up. Parent traumatic stress is associated with parent depression, anxiety, and background life stressors. It is inversely associated with the recognition, use, and perceived helpfulness of parent supports. Parent activation is positively associated with the recognition, use, and perceived helpfulness of supports. These findings advance the theory that parent activation is a relevant concept in the framework of factors that influence parent traumatic stress in the PICU.