Parental Coping Research Articles

Pandemic-induced economic stress in an otherwise-privileged sample predicts parents’ socialization of child prosociality and parent coping

Pandemic-induced economic stress in an otherwise-privileged sample predicts parents’ socialization of child prosociality and parent coping

Selective Feeding-An Under-Recognised Contributor to Picky Eating.

Background: Amongst children presenting to an interdisciplinary clinic with complaints of picky eating, we aim to identify the proportion who have underlying selective feeding and to describe its implications on growth and nutrition, as well as parental coping responses. Methods: We conducted a retrospective chart review of first-visit consults from January 2020 to July 2022. Caregiver and child mealtime behaviours were assessed using the standardised Caregiver's Feeding Styles Questionnaire (CFSQ) and by direct observation. Caloric intake and oromotor skills were assessed by dietitians and speech therapists, respectively. Medical concerns were addressed by the doctor. Results: Out of 152 children referred for concerns of "picky eating", 128 (84.2%) were diagnosed as having selective eating, while the rest were diagnosed with delayed oromotor skills, poor appetite, oral aversion and 4 were deemed to have normal feeding behaviour for their age. Of the 128 selective eaters, 67 (52%) children had comorbidities such as autism spectrum disorder (ASD) (n = 59), attention-deficit/hyperactivity (ADHD) (n = 2) and underlying medical conditions (n = 6). The remaining 61 children were "otherwise well". Of the "otherwise well" children, 47.5% had inadequate caloric intake and 31% had failure to thrive. The commonest feeding style among caregivers of "otherwise well" picky eaters was authoritarian (36%). The majority (80%) of these caregivers also experienced helplessness. Conclusions: We conclude that picky eating in young children is a symptom with several possible underlying aetiologies. It is associated with nutritional consequences for the child and significant stress on caregivers. Being able to recognise those who need referral for specialist intervention and multidisciplinary management (such as selective feeding and delayed oromotor skills) would be important.

Development and Validation of a "Stress and Coping Assessment Tool Associated with Maintaining Oral Health among Children with Special Health-care Needs".

In our routine pediatric dental practice, many of us encounter parents and caretakers of Children with Special Health Care Needs (CSHCN) who complain about the difficulties they face in daily tooth brushing of their children. Some parents may have to accept defeat as their children face overwhelming medical conditions to cater to; ultimately leading to paradigm shift of oral hygiene leading to increase of dental caries and gingival problems. To develop and validate a comprehensive tool that can help us in assessing parent related stressors and coping factors with regard to maintenance of oral hygiene of their children. Data related to stress and coping factors encountered during maintenance of oral hygiene of their children and their experiences during the child's dental treatment (if any) were collected from parents of CSHCN. Validation and feedback from content evaluation panel experts were done. A comprehensive assessment tool with 45 items (29 stresses related items and 16 coping related items) was developed after validation. We could develop and validate a 'Stress and Coping Assessment Tool associated with maintaining Oral health among Children with Special health care needs' - abbreviated as "SCATOCS" with a hope to benefit and manage oral health care to the referred population.

Study protocol for a randomized controlled trial of Adapt 2 Asthma (A2A), a culturally relevant coping skills and asthma management intervention for Latinx Families

BackgroundLatinx children in the United States experience disparities in asthma control and asthma-related functional outcomes compared to non-Latinx White children, including more school absences, emergency department visits, and hospitalizations for asthma. Stress appears to play a role in asthma control, but interventions designed to address the role of stress in asthma control for Latinx children are limited.MethodThe current randomized controlled trial tests the effects of Adapt 2 Asthma (A2A), a family-based coping skills and asthma management intervention tailored to the stressors, strengths, and cultural beliefs of Latinx families, compared to an asthma self-management control arm (the Asthma Plan for Kids; APK). Latinx families of children ages 8 to 14 years old with asthma (target N = 280) are identified and enrolled from primary care clinics and randomly assigned to either A2A or APK. The intervention is delivered by lay health workers trained and receiving ongoing consultation from the study team. The primary outcome is child- and parent-reported asthma control, while secondary outcomes are child’s quality of life, lung function, school absences, and emergency department visits, and child and parent coping and family asthma management behaviors. Participants will be assessed at baseline, post-intervention, and at 6- and 12-month follow-up timepoints.DiscussionThis study has the potential to provide new evidence regarding the effects of culturally relevant coping and asthma management intervention strategies for Latinx children with asthma.Trial RegistrationClinicaltrials.gov NCT05118282. Registered on 11 November 2021.

Relationships Between Family Sense of Coherence, Coping and Role Performance in Parents of Children with Disabilities: Structural Equation Modeling.

This descriptive study was designed with a clear focus: to use structural equation modeling to determine the intricate relationships between family sense of coherence, coping, and role performance in parents of children with disabilities. The study was conducted with a sample of 185 parents of children receiving special education at the primary school level in a province in Türkiye. Data was collected using a parent introduction form, the Family Sense of Coherence Scale-short form (FSOC-S), the Family Role Performance (FRP) scale, and the Revised-COPE Scale (R-COPE). The effect of FSOC-S on FRP and R-COPE was statistically significant. The effect of FRP on R-COPE was statistically significant. Moreover, FSOC-S predicted 22.4% of FRP, while FSOC-S and FRP predicted 17.1% of R-COPE. The study's findings underscore the urgent need for interventions to improve the family's sense of coherence and positive coping attitudes. These interventions are crucial for parents to effectively manage the challenges they face while caring for a child with a disability. The study also highlights the significant role of positive coping attitudes and family sense of coherence in enhancing role performance in parents of children with disabilities.

Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning–based random forest approach

BackgroundQuality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality.MethodsThis study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3–5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results.ResultsThe score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver.ConclusionsThe proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies.

"Grief Explodes all Relationships": Experiences of Grief and Coping Among Parents and Siblings Following the Death of a Child.

The death of a child is an intense loss for families, which impacts the wellbeing of parents, surviving siblings, and the family as a whole. This study expanded on existing literature by collecting qualitative accounts from bereaved parents and siblings about their experiences before, during, and after the death of a child in their family. In total, 15 participants from 9 families completed semi-structured interviews. Findings highlighted three periods of the grieving process, which were not linear but rather ongoing and often happening simultaneously: (1) Crisis; (2) Learning to cope; and (3) Establishment of a new equilibrium. Parents and siblings reported experiences unique to their role in the family and developmental stage, as well as shared experiences within the family system. Findings have implications for palliative care and bereavement professionals in terms of supporting parent, sibling, and family coping before, during, and after the death of a child.

Exploring relationships between parental stress, coping, and psychological outcomes for parents of infants with CHD.

This study aimed to explore relationships between parental stress, coping, and outcomes for parents of infants with CHD, via observational approach reflecting domains of the Parental Stress and Resilience in CHD (PSRCHD) model. Fifty-five parents of 45 infants with CHD completed questionnaires with measures of parental stress, Problem-Focused Coping (PFC), Emotion-Focused Coping (EFC), Avoidant Coping (AC), mental health (symptoms of anxiety and symptoms of depression), post-traumatic growth (PTG) and quality of life (QoL). Demographic and infant clinical data were obtained. Parental stress showed significant small to medium positive correlations with MH and PTG, but no significant correlations with QoL. EFC and AC showed significant small to medium positive correlations with MH, and medium negative correlations with parental QoL. EFC and PFC had significant small to medium correlations with PTG. PFC and AC had significant small to medium correlations with infant QoL. Hierarchical multiple regression analyses indicated that parental symptoms of anxiety, PTG, parental QoL, infant QoL were significantly predicted by models comprising of parental stress, coping styles, and clinical controls (adjusted R2 = 13.0-47.9%, p range < 0.001-.048), with results for parental symptoms of depression falling marginally above significance (adjusted R2 = 12.3%, p = .056). Parental stress, coping styles, and length of hospital stay are related to psychological outcomes in parents of infants with CHD. Future research may use the PSRCHD framework to assess mechanisms underlying CHD parents' stress and coping experiences and investigate longitudinal relationships between parental factors and parent and child outcomes.

Challenges of preterm families: parenthood and participation in the Neonatal Intensive Care Unit in Northern Italy

ABSTRACT Prematurity can disrupt the psychological transition to parenthood, with the unfamiliar environment of the Neonatal Intensive Care Unit (NICU) often exacerbating parental concerns about their baby’s health and survival. This study explores factors influencing parental coping mechanisms during their NICU stay, focusing on gender differences and parental perceptions of staff support. Sixteen Italian parents of preterm infants (born before 37 weeks of gestation and hospitalized for at least 10 days) participated in remote narrative interviews. Thematic analysis revealed key differences in the emotional experiences and care participation between mothers and fathers, shaped by traditional Italian gender norms and further impacted by COVID-19 restrictions limiting fathers’ access to the NICU. Additionally, parents who were more involved in their infant’s recovery through interactions with doctors reported higher levels of personal well-being. These findings highlight the importance of fostering parent-staff communication and support, particularly during times of crisis, to promote positive outcomes in the parent-infant relationship and enhance parental well-being. Recommendations include tailored interventions to ensure mothers and fathers are actively engaged in their infant’s care.

Posttraumatic stress symptoms in parents of children with newly diagnosed cancer: 1-year trajectories and relationship variables as predictors.

The way in which parental posttraumatic stress symptoms (PTSS) unfold in the first year after a cancer diagnosis in their child is poorly understood. The aims of this study were to identify parental PTSS trajectories and to examine couple-related predictors (dyadic coping and we-disease appraisals), sociodemographic predictors (education and sex), and medical predictors (child's physical impairment) of trajectory membership. A 1-year prospective study was conducted, and 157 parents of children newly diagnosed with cancer were assessed. PTSS was measured with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) at 3-6 weeks (T1), 6 months (T2), and 12 months (T3) after the diagnosis. The trajectories were identified with Latent Class Growth Analysis, the predictors were explored with binomial logistic regression. Two distinct trajectories were found. The majority of parents (86.0%) followed a low PTSS trajectory, characterized by initially low scores that slightly decreased over 12 months. In contrast, 14.0% of parents displayed a stable, high PTSS trajectory. A high trajectory of child's physical impairment and low scores in parental dyadic coping were significantly associated with the likelihood of a high parental PTSS trajectory. The findings provide new insights into the critical period of the first year after a child's cancer diagnosis. While most parents display a resilient, low PTSS trajectory, a minority consistently experience high PTSS levels. Child's physical impairment and dyadic coping should be considered as predictors for early identification of vulnerable parents. Incorporating dyadic coping in parental support following a childhood cancer diagnosis could be beneficial for parental mental health.

Association between parental factors and child's behaviors during moderate sedation in pediatric dental care.

Managing young children with negative behaviors can be challenging in dental settings. Moderate sedation (MS) is often used as a treatment option for such children. However, children's behavior during MS may vary depending on several variables. These variables include parental factors, such as parental anxiety, coping strategies, and pain catastrophizing. However, this area, particularly in Saudi Arabia, remains underexplored. Therefore, this study aimed to assess the association among parental anxiety, coping style, pain catastrophizing, and children's behavior during MS among Saudi children. Based on sample size calculation, this cross-sectional observational study included 85 children aged 3-5 years undergoing dental treatment under MS at King Saud University, Riyadh, Saudi Arabia. Parental anxiety, coping styles, and pain catastrophizing were assessed using the Modified Dental Anxiety Scale, Brief Coping Orientation to Problems Experienced Scale, and Pain Catastrophizing Scale. Child behavior was evaluated using the Houpt scale during sedation visits, which was video-recorded and independently analyzed by a single evaluator. Data were analyzed using Pearson's chi-squared test, Mann-Whitney U test, and stepwise multivariate logistic regression analyses. The results showed no significant association among parental dental anxiety, pain catastrophizing, and child behaviors during MS. Specific parental coping strategies, such as acceptance, were positively associated with positive sedation outcomes (P = 0.03), while active coping strategies were linked to less favorable outcomes (P = 0.03). Female children had higher sedation failure rates (P = 0.02), and the number of dental treatments was positively associated with success rates (P = 0.03). Parental anxiety and pain catastrophizing did not significantly affect the success of sedation. However, acceptance as a coping strategy was significantly associated with sedation success in pediatric dental care under MS, whereas active coping strategies were associated with less favorable outcomes.

Parental Stress and Coping Strategies in Parents of an Educational Institution in Times of COVID-19

As a consequence of the COVID-2019 pandemic, parents had to adapt to a new way of life, facing different stressors through the use of coping strategies. The aim of the study was to establish the relationship between parental stress and coping strategies in parents of an educational institution in the district of Cartavio, Peru. The research was descriptive-correlational, non-experimental cross-sectional design, with a sample of 108 parents, using the Parental Stress questionnaire, in its reduced version and adapted to the Peruvian context, and the Stress Coping Estimation Inventory (COPE). The results indicate a positive relationship between parental stress and the strategy of behavioral disengagement; parental stress levels belonged mostly to the medium category with 67.5%; the predominant stress coping strategies were active coping and positive reinterpretation - personal development, both with 18.5%. It is concluded that there is a relationship between the parental stress strategy and behavioral disengagement.

Influence of parental attitudes and coping styles on mental health during online teaching in the COVID-19 pandemic

During the COVID-19 pandemic, the online delivery model became the primary mode of education. With multiple pressures on society and families, mental health issues for parents have become particularly pronounced. Most of the current research has focused on the psychological state of education practitioners and children, with little attention to parents’ mental health issues. Therefore, this study explored the attitudes and coping styles of parents who experienced the process of their children being taught online over a long period and the factors influencing their mental health. This cross-sectional study was conducted between November 2021 and January 2022, using an anonymous online questionnaire to survey 1500 parents with children aged 6–13 years. The Chinese versions of the Patient Health Questionnaire Depression Scale (PHQ-9), the Parenting Stress Scale (PSS), the General Mental Health Questionnaire (GHQ-12), and the Brief Coping Style Scale (SCSQ), and a related factors questionnaire were used to survey the subjects. The normal distribution of the data was examined using the Shapiro–Wilk method. A multivariate regression analysis was conducted to identify factors significantly associated with parental mental health during the COVID-19 pandemic. Only 30.24% of parents agreed with online classes during the pandemic, and 52.28% used positive coping methods during stressful situations. Multivariate regression models identified significant factors associated with parental mental health: parent’s gender, child’s grade level, perceived stress about online classes, whether the child has ADHD, positive or negative coping styles, and subjective attitudes of support for online classes or not. The results of the study suggest that as online classes become more socially acceptable, it is necessary to be concerned about the risk of mental illness for parents and develop policies and interventions, especially for parents who adopt negative coping styles and endorse online classes. The focus should be on the stress of online classes on parents, improving the acceptance of online classes and psychological well-being, regulating the way parents deal with their children, and targeting subgroups of children with ADHD symptoms during the COVID-19 pandemic.

Dyadic coping experiences of parents of children with vascular anomalies.

Vascular anomalies (VAs) are a spectrum of rare pediatric disorders that require coordinated care from multiple subspecialists. Parents often struggle to coordinate care for their child's complex rare disorder. Even when they do access expert care, parents of children with VAs report high levels of stress and uncertainty. While previous research has explored parents' experiences navigating care for VAs, we know very little about how parents cope with stress together. Given the effect that dyadic coping can have on individual, couple, family, and child outcomes, we aimed to gain a better understanding of dyadic coping in the context of VAs. We collected data using semi-structured interviews with 27 parents (13 dyads and one individual parent). Data were analyzed using dyadic thematic analysis. Parents experienced stress related to medical, personal, logistical, and financial aspects of their child's healthcare. They relied on eight coping strategies: active coping, seeking emotional support, seeking informational support, cognitive avoidance, distraction, cognitive reframing, acceptance, and internalization. When analyzed together, we found evidence of five dyadic coping dynamics: collaborative, supportive, delegated, separate, and negative. Dyadic coping is complex and multilayered for parents of children with VAs. While the child's diagnosis is considered a shared stressor, both parents may not share preferred coping strategies. Parents of the same child may also be coping with different medical, relational/social, personal, or logistical stressors altogether. Psychosocial interventions designed to facilitate parental coping should address these complex coping dynamics.

Exploring Stress and Coping in Caregivers of Children with Pulmonary Vein Stenosis: A Mixed-Method Study.

(1) Background: This mixed-method study aims to identify and describe factors associated with acute and long-term parenting stressors and coping strategies in caregivers of children with intraluminal pulmonary vein stenosis (PVS). (2) Methods: Parents of children with severe PVS were recruited from a large quaternary hospital to complete a survey that included demographics, the Pediatric Inventory for Parents (PIP), and the Coping Health Inventory for Parents (CHIP). We determined the Social Vulnerability Index (SVI) based on self-reported home address. A subset of caregivers completed a 60 min semi-structured interview via Zoom exploring the impact their child's diagnosis had on their family; experience managing stress in the hospital and at home; current resources and processes for coping; and potential recommendations for hospitals to build resilience and coping. We used multivariable linear regression to examine the association between SVI and parental stress and coping while adjusting for possible confounders. Thematic analysis identified themes related to stress and coping. Finally, we assessed instances of convergence and difference between the qualitative and quantitative results. (3) Results: Participants included 32 caregivers who were 91% female with a mean age of 39 years. The children of participants were 66% female, with a mean age of five years. The parents reported a high amount of stress with an average PIP score of 120, nearly 46 points higher than similar studies in the congenital heart community. We observed no significant associations between SVI and either parental stress or coping in adjusted models. We identified 13 themes, including medical care, hospital, family, support systems, and home medical routine or support. (4) Conclusions: Our study found high levels of illness-related parental stress among caregivers of children with PVS. Stress evolved over time from what caregivers described as 'survival mode' to a future-oriented outlook. Currently, caregivers rely heavily on support networks that are not available to all caregivers or may experience strain over time. Caregivers indicated that communication and parental role functioning were coping strategies that could be better supported by providers and health systems.

Family Coping With COVID-19: Unexpected Parental Loss and Surviving Parent Coping, Grief and Posttraumatic Growth Outcomes Based on Child Age.

Guided by the conceptual framework of widowed parenting, the current study takes a relational approach to understand more about how the characteristics of parents of young and adult children relate to coping following the unexpected death of a partner due to COVID-19, and how these variables predict complicated grief and posttraumatic growth. A sample of 81 widowed parents completed self-report measures examining parenting self-efficacy, relationship uncertainty, coping, complicated grief, and posttraumatic growth. Results of hierarchical regression analyses suggest that, when controlling for time since death (1) relationship uncertainty and avoidant coping significantly predict complicated grief for parents in the sample with adult children, and (2) widowed parenting self-efficacy and both problem-focused and emotion-focused coping significantly predict posttraumatic growth for parents in the sample with young children. Results of the current study may inform future practices (e.g., use of Emotionally Focused Family Therapy) to aid families grieving an unexpected loss.

Storytelling to support legacy making for bereaved parents of children with cancer.

Honoring a child's legacy is an essential aspect of meaning-making for bereaved parents, yet little is known about storytelling as a mechanism. Through narrative analysis of 19 bereaved parent interviews focused on legacy, we examined the role of storytelling in creating and sustaining legacy. Most participants (89%) told stories centered around the child's impact and parent's coping, including the child's character and interpersonal relationships during and after their lifetime as well as how the child's legacy influenced parents' grief experiences. Future research is needed to explore the potential impact of storytelling initiatives to support legacy-making for bereaved caregivers.

The Predictive Power of Religious Coping on Care Burden, Depression, Stress, and Anxiety of Parents of Pediatric Oncology Patients in Turkey.

This study aimed to determine the predictive power of religious coping of parents of children with canceron caregiver burden, depression, anxiety, and stress in Turkey. It was designed as a descriptive and cross-sectional study, utilizing correlational analysis and regression models to explore associations between variables. Data were collected from 164 parents in the pediatric hematology-oncology clinics of a university hospital between November 2023 and March 2024. There was a negative correlation between caregiver burden score and negative and positive religious coping scores. Caregiver burden scores werepositively correlated with depression, anxiety, and stress scores. Results indicated that caregiver burden, education level, employment status, family structure, family income, and age at diagnosis significantly predicted positive religious coping. For negative religious coping, caregiver burden, education level, family structure, and family income were significant predictors. This suggests that religious coping may help reduce caregiver burden, underscoring the importance of promoting constructive coping strategies to support caregivers' well-being.

Vaccine Hesitancy in the Autism Spectrum Disorder Context: Parental Vaccine Decision-Making and Coping with Stress Strategies.

Despite no scientific evidence linking vaccines to Autism Spectrum Disorder (ASD), vaccine hesitancy persists among parents of children with ASD. This study aims to compare vaccine hesitancy and behaviors among parents of children with ASD, other Neurodevelopmental Disorders (NDD), and without NDD, and to examine the relationship between stress coping mechanisms and vaccine hesitancy, including comparing coping mechanisms between diagnostic groups as well as their association with hesitancy. In this cross-sectional study, one parent of each child with ASD, non-ASD NDD, or without NDD was included. Data were collected using a researcher-created form, the Vaccine Hesitancy Scale in Turkish, and the Coping Style Scale Brief Form. Vaccine hesitancy, parents' COVID-19 vaccination status, and vaccination status of children's younger siblings were analyzed through univariate and multivariate analyses, with a focus on correlations between vaccine hesitancy and coping styles. The study included one parent from each of 299 children. Parents of children with ASD showed an adjusted odds ratio of 2.66 (95% CI 1.35-5.06) for high vaccine hesitancy, 2.57 (95% CI 1.17-5.65) for not receiving the COVID-19 vaccine, and 1.40 (95% CI 0.45-4.40) for younger siblings not receiving routine vaccines. A weak but significant correlation was observed between vaccine hesitancy and the use of restraint coping style among these parents (r = 0.280; p = 0.010). The study underscores the importance of targeted educational efforts and personalized communication to address vaccine hesitancy among parents of children with ASD. Enhancing vaccination coverage in this community requires further research to develop interventions tailored to their specific needs.

Lessons learned during the pandemic: Parental coping and the positive effects of COVID‐19

AbstractObjectiveThis exploratory mixed‐methods study examined the perceptions of parental experience, coping, and resiliency of 690 parents in the United States during the pandemic.BackgroundIn response to being faced with additional stressors from the onset of COVID‐19 pandemic, many families tapped into coping strategies and resilience.ResultsA survey administered during July–September of 2020 determined that parental stress, difficulties with COVID‐19, and family functioning significantly impacted overall parental experience. Health concerns did not have a significant impact on parenting. Qualitative data were coded and analyzed to answer two open‐ended questions regarding parents coping and positive effects of the pandemic. Four subthemes emerged: (a) readjusting connections, (b) intentional wellness, (c) family cohesion, and (d) deceleration of time.ConclusionThe findings of this study suggest that parents were able to develop coping strategies and find positives even during the early stages of the pandemic.ImplicationsThis study provides support for Walsh's (2020) description of “bouncing forward” versus the traditional notion of “bouncing back” in the face of change and uncertainty, especially for higher resourced families. A common experience for participants was the reported use of intentional strategies that aided in processing, healing, and hope during this time of uncertainty.