Elsevier

Academic Pediatrics

Volume 19, Issue 4, May–June 2019, Pages 454-463
Academic Pediatrics

Development and Pilot Testing of a Coping Kit for Parents of Hospitalized Children

https://doi.org/10.1016/j.acap.2018.11.001Get rights and content

Abstract

Objective

Serious pediatric illness places great stress on families. Parents who learn coping skills may better manage these stressors. This study sought to develop and refine a stress coping intervention for parents of hospitalized children, assess the intervention acceptability among these parents, and gather preliminary data on stress, negative and positive affect, anxiety, depression, and self-efficacy.

Methods

We conducted an observational study in 2 phases, enrolling parents of children who were inpatients with serious illness, 10 in Phase 1 and 40 in Phase 2. All parents completed at baseline measures of stress and psychological well-being and were introduced to the Coping Kit for Parents. Follow-up interviews were conducted at 1 week (all parents) and 1 month (Phase 2 parents only) regarding the acceptability of the intervention.

Results

At baseline, parents reported that stressful situations were frequent (mean = 30.6, standard deviation [SD] = 6.8) and difficult (mean = 26.2, SD = 7.1) and revealed elevated levels of negative affect (mean = 27.3, SD = 7.7), depression (mean = 8.5, SD = 3.7), and anxiety (mean = 11.3, SD = 3.1) and moderate levels of self-efficacy related to their child's illness (mean = 3.3, SD = 0.5). The majority of parents used the kit regularly and on a scale of 1 to 7 agreed that the kit was helpful (mean = 6.0, SD = 0.9), interesting (mean = 5.7, SD = 1.3), practical (mean = 5.7, SD = 1.4), enjoyable (mean = 6.0, SD = 1.3), and they would recommend it to other parents (mean = 6.4, SD = 0.9).

Conclusions

The Coping Kit for Parents is an acceptable stress management intervention that could be made available to parents of children with serious illness at pediatric hospitals with minimal staff training or time commitment.

Section snippets

Methods

This study was approved by The Children's Hospital of Philadelphia (CHOP) Institutional Review Board, and all participants provided informed consent.

Phase 1: Rapid Cycle Testing (n = 10)

Phase 1 was conducted from November 2016 to February 2017. Seventy parents were screened for Phase 1 (Fig.3), and 9 mothers and 1 father were enrolled (Table2). Two parents of 1 patient participated for a total of 9 separate patients. We made minor changes to the Coping Kit materials after Phase 1 based on the feedback from these parents, including changing the way the cards were held together (eg, switching from a binding of 1 ring to 2 rings in response to a parent complaint, “It kind of

Discussion

We found that the Coping Kit for Parents was used enthusiastically by the majority of parents 3 or more times a week. The need for a stress intervention in this population was evident, as parents were experiencing moderate depression and anxiety, high levels of negative affect, elevated stress, and lower self-efficacy related to their child's illness.15, 19,21, 22

Some parents reported wishing they had received the Coping Kit in the past when they were in more stressful situations related to

Conclusions

Parents of seriously ill children experience stress, negative affect, anxiety, and depression, which combined may affect their own well-being as well as their ability to care for their children. The Coping Kit for Parents is a brief and flexible stress management intervention that could be made available to all parents of children with serious illness who are hospitalized at a pediatric hospital with minimal staff training.

Acknowledgments

We thank Juliet Kilcoyne for designing the cards.

Financial disclosure: Supported by the Aetna Foundation, a national foundation based in Hartford, Connecticut, that supports projects to promote wellness, heath, and access to high-quality health care for everyone. The views presented here are those of the authors and not necessarily those of the Aetna Foundation, its directors, officers, or staff. The Aetna Foundation had no role study design; in the collection, analysis and interpretation of

References (35)

  • DR DeMaso et al.

    The experience journal: a computer-based intervention for families facing congenital heart disease

    J Am Acad Child Adolesc Psychiatry

    (2000)
  • I Bjelland et al.

    The validity of the Hospital Anxiety and Depression Scale: an updated literature review

    JPsychosomatRes

    (2002)
  • B Young et al.

    Parenting in a crisis: conceptualising mothers of children with cancer

    Soc Sci Med

    (2002)
  • AR Rosenberg et al.

    Resilience and psychosocial outcomes in parents of children with cancer

    Pediatr Blood Cancer

    (2014)
  • RG Frank et al.

    Disease and family contributors to adaptation in juvenile rheumatoid arthritis and juvenile diabetes

    Arthritis Care Res

    (1998)
  • AE Darlington et al.

    Parental coping in the context of having a child who is facing death: a theoretical framework

    Palliat Support Care.

    (2018)
  • LP Barakat et al.

    Parental problem-solving abilities and the association of sickle cell disease complications with health-related quality of life for school-age children

    J Clin Psychol Med Settings

    (2014)
  • SK Doupnik et al.

    Parent coping support interventions during acute pediatric hospitalizations: a meta-analysis

    Pediatrics

    (2017)
  • BM Melnyk et al.

    Testing the theoretical framework of the COPE program for mothers of critically ill children: an integrative model of young children's post-hospital adjustment behaviors

    J Pediatr Psychol

    (2007)
  • JP Yi-Frazier et al.

    Promoting Resilience in Stress Management for Parents (PRISM-P): an intervention for caregivers of youth with serious illness

    Fam Syst Health

    (2017)
  • ML Stehl et al.

    Conducting a randomized clinical trial of an psychological intervention for parents/caregivers of children with cancer shortly after diagnosis

    J Pediatr Psychol

    (2009)
  • ME Seligman et al.

    Positive psychology progress: empirical validation of interventions

    Am Psychol

    (2005)
  • P Ramachandra et al.

    A brief self-administered psychological intervention to improve well-being in patients with cancer: results from a feasibility study

    Psychooncology

    (2009)
  • A Altschuler et al.

    Audio recordings of mindfulness-based stress reduction training to improve cancer patients' mood and quality of life—a pilot feasibility study

    Support Care Cancer

    (2012)
  • LE Mouradian et al.

    Art-based occupation group reduces parent anxiety in the neonatal intensive care unit: a mixed-methods study

    Am J Occup Ther

    (2013)
  • MV Thygeson et al.

    Peaceful play yoga: serenity and balance for children with cancer and their parents

    JPediatr Oncol Nurs

    (2010)
  • EM Dykens et al.

    Reducing distress in mothers of children with autism and other disabilities: a randomized trial

    Pediatrics

    (2014)

    • Cited by (0)

    The authors have no conflicts of interest to disclose.

    View full text
    Copyright © 2018 by Academic Pediatric Association