尿毒症儿童父母教养压力调查与分析

目的 调查尿毒症儿童父母教养压力水平,为开展心理干预和社会支持提供科学依据.方法 采取教养压力指标简表对49例尿毒症儿童父母和50例正常儿童父母的教养压力进行调查.结果 尿毒症儿童父亲与母亲教养压力总分和各维度得分均高于正常儿童父母(P<0.01);尿毒症儿童母亲在教养压力总分和亲职愁苦、困难儿童维度得分高于父亲(...     

Effects of Parental Presence during Children's Venipuncture

Objective: To determine whether parental presence during venipuncture (VP) altered self-reported distress of the child, the parent, or the health professional (HP) performing VP.
Methods: During nine consecutive months, 130 nonconsecutive 8–18-year-old children having VP in an urban pediatric ED were prospectively randomized into two groups of 65 patients each. Before VP, every child, parent, and HP completed a questionnaire developed to measure epidemiologic variables believed to influence distress during VP. The patients were randomized to have either a parent present or both parents absent during VP. The patients, the parents, and the HPs privately self-reported their distress during VP on a visual analog scale (VAS). Statistical significance was determined by the Mann-Whitney U (rank-sum) test.
Results: In the parent-present group, distress scores were lower for the parent (p < 0.01) and for the child (p < 0.04) than they were in the parents-absent group. The HP performing VP had no difference in distress scores with and without parental presence (p < 0.55).
Conclusions: Parents and children having VP have less distress with parental presence. Health professional distress is not affected by parental presence.     

Behavior problems among young children in low‐income urban day care centers

The purposes of this study were to describe: (a) the frequency and correlates of behavior problems among a sample of 2‐ and 3‐year‐old children from low‐income families as seen by their parents and day care teachers, (b) the degree to which parents and teachers agree about the children's behavior problems in their respective contexts, and (c) family characteristics that distinguish toddlers with behavior problems both at home and at day care from the rest of the sample. Parents of 133 toddlers from 10 Chicago day care centers completed measures of child behavior problems, child behavioral intensity, parenting self‐efficacy, discipline strategies, and stress. Children's day care teachers also completed a measure of child behavior problems. Parent‐reported behavior problems were associated with higher child behavioral intensity, greater parent stress, lower self‐efficacy, and discipline strategies characterized by irritability, coercion, and inconsistency. Parent and teacher ratings on child behavior were correlated for boys' behavior problems only. Parents reported more child behavior problems than teachers. Approximately 8% of the children were rated as having behavior problems at home and at day care. Although most of the children are functioning well, many of these parents and toddlers are engaged in highly stressful and coercive relationships. © 1999 John Wiley & Sons, Inc. Res Nurs Health 22: 15–25, 1999.     

Stress in Parents of Adults with Intellectual Disabilities Attending Special Olympics Competitions

Background It is important to determine how programmes serving the individual with intellectual disability may also help to reduce stress in parents of adult children with intellectual disabilities. The aim of this study was to test whether parents who frequently watch their children at Special Olympics (SO) competitions report less stress than those who watch with less frequency. Methods A total of 57 mothers and 39 fathers completed the Parenting Stress Index in reference to their children with intellectual disability, whose ages ranged from 17 to 42.3 years. Frequency of parental attendance at competition and volunteering for SO was also assessed. Results Parents who frequently attended their children's competitions reported less stress than those who attended with less frequency. Mothers who volunteer, reported more child‐related stress than those who did not. A number of other gender‐specific relations were found. Conclusions These results support the hypothesis that parents who frequently see their children compete in SO have a more positive parent–child experience than those who do not attend with the same frequency. Experimental research, with controlled pre–post designs, is needed to directly assess any causal effect.     

Swedish parents of children with Down's syndrome

Becoming parents of a child with Down's syndrome (DS) challenges the adjustment ability in parenthood. Individuals with higher sense of coherence (SOC) are supposed to manage stressors better than those with lower SOC. The aims of this study were to investigate parental self-perceived stress, SOC, frequency of gainful employment and amount of time spent on child care in Swedish DS parents (165 parents; 86 mothers, 79 fathers) and to compare those with control parents of healthy children (169 parents; 87 mothers, 82 fathers). The mean age of the children was 4.7 years. Parents responded to questionnaires separately including Hymovich's Parent Perception Inventory as stress measurement and Antonovsky's short version of the Orientation to Life. No differences concerning total employment rate were observed, but the DS mothers were more often employed part-time than control mothers. The DS parents did not spend more time on child care than the control parents and they did not differ in mean SOC score, but the DS parents perceived greater stress. The differences in stress, particularly between the DS and control mothers, were related to time-demanding areas. Parents with high SOC scores experienced significantly less self-perceived stress.     

Parent and adolescent adjustment to pediatric cancer: Associations with coping,social support,and family function

This article presents preliminary results investigating the relationship between parental and adolescent adjustment and coping and their relationship to social support and family functioning in a sample of adolescents (ages 11-18) with cancer and one of their parents. Parents and adolescents from two pediatric oncology clinics completed measures of distress, coping, social support, and family cohesion/adaptability. Low levels of distress were reported by both children and their parents with positive correlations noted between parent and child adjustment. Adolescents reported that their parents and a close friend were the greatest sources of social support and described their families as having a high degree of cohesion and adaptability. Both adolescents and parents used more adaptive than maladaptive coping strategies, although distress was associated with reduced use of adaptive coping. Adolescents are able to adapt to cancer in the context of strong family and social supports. In addition, there is a relationship between parental and adolescents adjustment, and between greater use of adaptive coping styles and lower distress.     

Stress among Parents of Children with and without Autism Spectrum Disorder: A Comparison Involving Physiological Indicators and Parent Self-Reports

Parents of children with Autism Spectrum Disorder (ASD) have been reported as experiencing higher levels of stress and poorer physical health than parents of typically developing children. However, most of the relevant literature has been based on parental self-reports of stress and health. While research on physiological outcomes has grown in recent years, gaps still exist in our understanding of the physiological effects, if any, of stress related to parenting a child with ASD. The present study compared parent-reported stress, anxiety, and depression, as well as selected physiological measures of stress (i.e., cortisol, alpha-amylase, and ambulatory blood pressure and heart rate) between matched groups of parents of children with (N = 38) and without (N = 38) ASD. Participants completed questionnaires, collected saliva samples for the purpose of measuring cortisol and alpha-amylase, and wore an ambulatory blood pressure monitor for 24 h. Parents of children with ASD reported significantly higher levels of parental distress, anxiety, and depression than parents of typically developing children. Parent-reported distress, anxiety, depression, and health were not correlated with physiological measures. With the exception that parents of children with ASD had significantly lower cortisol levels 30 min after waking, no other significant group differences were found for physiological measures. Parents of children with ASD reported significantly higher use of a number of adaptive coping strategies (e.g., emotional support) in comparison to parents of typically developing children. Results are discussed in the context of implications for future research directions, stress research, and practical implications for parental support.     

Crisis child care: an intervention for at-risk families.

Crisis child care programs provide parents in crisis with a break from the stresses of childrearing and provide at-risk children with a safe environment. This study describes parenting stress as the construct of measurement in a pilot project in a predominantly rural midwestern state. The Parenting Stress Index/Short Form (PSI/SF) was used to measure the amount of stress experienced by the parent as a result of the parenting role. Comparisons of the mothers' PSI/SF pretest and posttest scores indicated significant improvement in the construct areas of Total Stress. Parental Distress. Difficult Child, and Life Stress. Comparison of child maltreatment rates indicated that there was a significant decrease (X2 = 16.91, p < 0.0001) in the reported incidence of child maltreatment in the rural counties with a crisis child care program compared with counties that did not offer this intervention. Overall, these findings indicate that crisis child care is an effective preventive intervention for at-risk families. The investigator suggests that nurses enhance their collaborative relationships with these programs to provide a more seamless avenue for both receiving and providing referrals.     

Improving mental health outcomes of parents of infants treated in neonatal intensive care units: A scoping review

Parents of infants who require neonatal intensive care unit (NICU) hospitalization encounter stressors that place them at a higher risk of developing a mental health issue during and after NICU discharge. This population is often underdiagnosed, leading to potential detrimental effects on parenting behaviours, parent/infant bonding, and child neurodevelopment. This review explores what mental health issues parents experience during and after NICU discharge, what mental health resources are currently available, what mental health screening tools are used, and what factors place NICU parents at an increased risk of developing a mental health issue. The review revealed that mental health issues are not isolated; if a parent experiences psychological distress, it can progress to depression or post-traumatic stress disorder (PTSD) if left untreated. Psychotherapy most frequently contributed to a reduction in mental health symptoms, but was rarely offered beyond NICU discharge.     

Stress and Perception of Procedural Pain Management in Chinese Parents of Children With Cancer

ObjectivesChildren with cancer are exposed to repeated painful and invasive procedures. This study examines Chinese parents' stress and perception toward their children's procedural pain control.MethodsWe recruited 265 parents of children (aged <18 years) diagnosed with hematological cancer (74.7%) and solid tumors (25.3%) from two major public hospitals. Parents used a scale (0–10) to rate perceived pain experienced by their child when undergoing lumbar puncture (LP), bone marrow aspirate, or/and biopsy. They reported their stress level and attitudes toward analgesics using the adapted Pain Flexibility Scale for Parents and Parental Medication Attitude Questionnaire. General linear modeling was used to identify factors associated with perception outcomes.ResultsParents (72.8% mothers, age 36.5 [6.8] years) expressed that they were worried (31.7%) and had difficulty with concentration (57.7%) when the child was in pain. Among parents whose children had undergone LP (n = 207), 39.1% perceived that their child still experienced severe pain (pain score >7) even with existing pain control measures. Parents reported concerns over side effects of analgesics (69.4%) and addiction (35.1%). Half of the parents (47.2%) perceived that analgesics should only be reserved for severe pain. Parents who were older (estimate = 2.07, SE = 0.87; P = 0.0054) and had lower education attainment (estimate = ?3.38, SE = 1.09; P = 0.0021) had a more negative attitude toward analgesics use. Higher parental distress was associated with avoidance of analgesics use (r_s = 0.17, P = 0.0052).ConclusionOur findings suggested that subgroups of Chinese parents demonstrated distress with their child's pain and harbored misconceptions over analgesics use. Future work includes devising targeted psychoeducation interventions for these parents.     

Social and Professional Support for Parents of Adolescents with Severe Intellectual Disabilities

Background Previous research has identified various dimensions of social support that are positively associated with parental well‐being. However, most research does not include multiple measures of social support and uses heterogeneous samples in terms of child characteristics such as age and severity of intellectual disability. Methods Thirty‐three parents of adolescent children with moderate–profound intellectual disabilities completed measures of parental well‐being (stress, anxiety and depression, and caregiving satisfaction), social support (informal and formal sources, and practical and emotional support), and child characteristics (adaptive and problem behaviours). Results Correlation analyses showed that parental well‐being was associated with the child's adaptive and problem behaviours and with the child's autism diagnosis. Parents’ ratings of the helpfulness of informal sources of support (spouse, extended family, friends, etc.) was most reliably associated with parental well‐being, and remained so after controlling for child characteristics. Parents’ access of service and professional support was not associated with parental well‐being, but there was some evidence that it was related to their child's needs. Conclusions The research emphasizes the significance of including multiple measures of social support in research with families of children with an intellectual disability. Furthermore, the possibility that parents, during their child's adolescence, may be especially vulnerable to the disruption of their informal support networks is an important practical consideration.     

Parent Responses to Child Pain During Intensive Interdisciplinary Pain Treatment and 1-Year Follow-Up

Targeting parents’ responses to their child's pain during intensive interdisciplinary pain treatment (IIPT) could influence child functioning. This longitudinal, observational study investigated changes in these responses and concurrent relationships between parent responses and changes in levels of child functioning and pain. Parents of youths 10 to 19 years of age (mean = 15 years, SD = 1.98 years) participated in twice weekly, parent-only groups while their teens were enrolled in IIPT (mean length of treatment = 3.93 weeks, SD = 1.16 weeks). Parent responses to child symptoms, as well as child pain and functional disability, were assessed weekly during treatment (n = 114) and at 3 follow-up visits: 1 month (n = 96), 6 months (n = 68), and 12 months (n = 45). Longitudinal multilevel modeling analyses indicated statistically significant decreases during treatment in parents’ protective, monitoring, and minimizing responses and further improvement in all responses during follow-up. These changes were associated with concurrent changes in child disability. However, changes in parent behaviors occurred independently from changes in child pain levels. Baseline child characteristics affected neither baseline parent responses to pain nor changes over time. Results indicate that, in the context of IIPT, parental responses are amenable to change and that these changes may impact child pain-related functioning, providing further support for the role of parent-specific programming within IIPT.PerspectiveDuring intensive IIPT, parents made statistically significant changes in responses to their child's pain, which was associated with improvements in child disability, but not child pain. Changes were sustained through 1-year follow-up. Targeting parental responses to child pain is feasible and may relate to improved child functioning.     

Parenting stress and related factors in parents of children with Tourette syndrome

The objective of this study was to assess the stress of parents and its influencing factors in caring for children with Tourette syndrome. A total of 150 subjects, either fathers or mothers of children diagnosed with Tourette syndrome between the ages of 6 and 12, were recruited by purposive sampling from the membership roster of the Taiwan Tourette Family Association. Study tools included a Parenting Stress Index Form and Social Support Index Form. The standardized score for parent perception of parenting stress was 83.5. The main stressor of parents of children with Tourette syndrome was found to be child care difficulties. A correlation was found between parenting stress and child gender, age, school situation and disease severity; parent age and family income. A significant negative correlation (r=-.459, p<.01) was found between social support and parenting stress. It was revealed that social support had a significant effect on parenting stress in this study. Multiple linear regression analysis found disease severity and family income to be the variables with the greatest predictive power for parenting stress, explaining 42% of total variance. Results showed that factors affecting parenting stress included family income and disease severity. These findings should help clinical professionals develop more effective health care strategies to address the needs of children with Tourette syndrome and their parents.     

Reported stress of parents of burned children differs on the Spanish and English versions of the parenting stress inventory

The Parenting Stress Inventory (PSI) is a 101-item self-report questionnaire measuring stress in children and their parents. For several years, we have been administering the English and Spanish versions of the PSI to parents of children with >40% total body surface area burn at discharge, 6 months, 1 year, and every year at followup at clinic. The aim of the present study was to evaluate differences between Spanish- and English-speaking families with respect to stress and to further examine potential psychometric differences between the instruments that may contribute to these differences. In the present study, we found the instruments to be equivalent but have significant differences between the two versions, suggesting cultural differences in how coping and stress are manifested in these groups. Spanish-speaking parents noted significantly more distress than the English-speaking parents. Both groups indicated most severe problems on the Child domains of the PSI, suggesting that parents perceived their interactions and relationship as it pertain to their child to be most troubled.     

Parental stress and satisfaction in the non-tertiary special care nursery

Title. Parental stress and satisfaction in the non‐tertiary special care nursery Aim. This paper is a report of a study examining the effects of using headbox oxygen and continuous oxygen positive airway pressure treatments for respiratory distress on stress and satisfaction of parents with infants in a special care nursery, and the relationship between parental stress and satisfaction. Background. Continuous positive airway pressure respiratory support is increasingly used in special care nurseries worldwide. Almost nothing is known about effects of different types of respiratory support on the stress and satisfaction of parents with babies in the special care nursery. Method. Questionnaires were used from August 2004 to June 2006 in five special care nurseries to measure parental stress using an adaptation of the Parental Stressor Scale: Neonatal Intensive Care Unit and 5‐point scales to measure overall stress and satisfaction. Findings. Questionnaires were returned from 42 parents of babies receiving headbox oxygen and 51 parents of babies receiving continuous positive airway pressure (62% response rate). High stress was commonly reported. Stress did not differ statistically significantly between the two treatments. Parents with babies receiving continuous positive airway pressure were more satisfied compared to the headbox group. Stress and satisfaction were not statistically significantly correlated. Conclusion. Clinicians need not favour either method of respiratory support when attempting to minimize parental experience of environmental stress. Further research is needed to test parental stress reduction strategies in the special care nursery.