Parental Stress Scale Research Articles

The mediating role of parenting efficacy in the association between preschool father-child relationship and parental stress

The most important relationships in the life of the preschool children are their relationships with their parents. Until recently, when the child's relationship with their parents is considered, the relationship with their mother has been taken into account, while recently the father-child relationship has become one of the subjects that researchers are increasingly interested in and thus is emphasized. In this study, it was aimed to determine the mediating role of parenting efficacy in the association between father-child relationship and parental stress in preschool period. The research was carried out on fathers who have children between 48-72 months who continue preschool education. The study group consisted of 421 fathers selected among these fathers by random sampling method. Child-Parent Relationship Scale, Parenting Efficacy Scale and Parental Stress Scale were used to collect the research data. The results obtained from the research are as follows: Firstly, parental stress is a significant predictor of father-child relationship and parenting efficacy. Secondly, parenting efficacy is a significant predictor of father-child relationship. Finally, parenting efficacy has a partial mediating role in the relationship between father-child relationship and parenting efficacy. The results of the research may lead to the development of policies and practices that support parenting competence in terms of reducing the parental stress of fathers with preschool children and improving their relationship with their children.

A Quasi-Experimental Study of the Respectful Approach on Early Parenting Competence and Stress

Early parenthood can be stressful. Many parenting interventions emphasize skills training, as opposed to improving the parent-child relationship. We investigated whether the Respectful Approach intervention, based on building the parent-child relationship through observation and respect, improves stress and confidence in parents of infants and toddlers. Using a quasi-experimental design, we compared changes in self-reported levels of stress and parenting competence between 15 parents who attended the Respectful Approach parent-child classes (once a week for six weeks), to a control group of 23 parents utilizing the ‘Parenting Sense of Competence Scale’, ‘Parental Stress Scale’ and ‘Depression Anxiety Stress Scales’. A focus group was held at the conclusion of the intervention to provide feedback about the classes. A significant Time × Group interaction was observed for both parent competence (p = 0.004) and parent stress (p = 0.010). Parents in the intervention group demonstrated a significant increase in parent competence (p = 0.001) with no significant change observed in the control group (p = 0.787). Parent stress significantly increased in the control group (p = 0.017) and marginally decreased in the intervention group (p = 0.134). Qualitative analysis revealed that the intervention parents felt they were calmer and better understood their children. These findings suggest that the Respectful Approach intervention may improve parental stress and parenting competence. Our results justify development of a randomized controlled trial to further quantify the effect of this approach.

Maternal-Infant Bonding and Its Relationships with Maternal Depressive Symptoms, Stress and Anxiety in the Early Postpartum Period in a Polish Sample.

A large body of literature indicates that there is a relationship between maternal psychological well-being and the early maternal–infant bond. However, this relationship is not fully understood, due to the different theoretical frameworks of maternal–infant bonding and different data collections points. Thus, the aim of this study was to examine the relationship between the maternal bond and the maternal psychological state including anxiety, stress, and maternal depressive symptoms. In this cohort study, 150 women who gave birth after 37 weeks of pregnancy completed the following self-reports 1–3 days post-delivery: Socio-demographic questionnaire, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS). The obtained results showed that the maternal level of stress, anxiety and postnatal depressive symptoms are significantly correlated with the maternal–infant bond in Polish mothers. In addition, regression analysis shows that postpartum depressive symptoms and maternal stress are significantly associated with the maternal–infant bonding process in the early postpartum period. This finding emphasizes the importance of identifying maternal mental state difficulties in the early postpartum period in order to provide interventions to help build healthy maternal–infant bonding.

Parental Depression Symptoms at Neonatal Intensive Care Unit Discharge and Associated Risk Factors

To investigate the prevalence and risk factors associated with parental depressive symptoms at neonatal intensive care unit (NICU) discharge and determine the relationships among depressive symptoms, stress, and social support. Parents participating in the Giving Parents Support trial (n=300) were surveyed before NICU discharge. Depressive symptoms, stress, and social support were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU), Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS). Regression analyses examined relationships among depressive symptoms, stress, social support, and parent/infant factors. At NICU discharge, 45% of parents reported depressive symptoms and 43% reported elevated perceived stress. Increased odds of elevated depressive symptoms were associated with older gestational age (P=.02), female infant (P=.02), and longer length of stay (P=.045). Odds of depression were 7.87 (95% CI, 2.15-28.75) for parents of infants with gestational age ≥37weeks compared with gestational age <28weeks. Parental NICU stress was higher in younger parents (P<.01). Depressive symptoms were positively associated with parental stress. Each 1-point increase in PSS:NICU score was associated with a 2.1-point (95% CI, 1.6-2.9; P<.001) increase in CESD-10 score. Social support was inversely associated with depressive symptoms. The prevalence of depressive symptoms in parents at NICU discharge was high, even among parents of term infants. Older gestational age, greater parental stress, and lower levels of social support were strong correlates of depressive symptoms. Strategies to support parents, including depression screening, stress reduction strategies, and mental health referrals, are needed.

Parenting Stress of Mothers Having Children with Thalassemia

Background: Parents of children with thalassemia faces numerous challenges while coping various problems arises from the disease.&#x0D; Objective: The study was conductedto assess parenting stress of the mothers having children with thalassemia.&#x0D; Materials and Methods: This was a cross sectional study conducted amongmothers having children with thalassemia. A total of 253 mothers were included in this study conveniently.Data were collected by face to face interview by using a semi-structured questionnaire. Data analysiswere done by SPSS software. Level of stress was measured by using a modified parenting stress scale. The study was carried out during January to December 2016.&#x0D; Place and period of study: This study was conducted in International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka Shishu Hospital thalassemia center, Thalassemia foundation hospital and Bangabandhu Sheikh Mujib Medical University.&#x0D; Results: The study revealed that 25-34 years age group was more (83.4%). Majorityofthemothers was Muslim (97%), married (95%), educated up to SSC (64%), house wife (87%). Average monthly family income of the mothers was 26257 BDT and most of them were living in nuclear family (68%). Majority of the mothers had 2 children (82.2%), maximum was within 1-10 years age group (65.2%) and bearingchild within 15-24 years (64%). Most of the mothers had male children (63%), received antenatal checkup (84%) and normal delivery (70%) at hospital (58%). Complication during pregnancy was found in few mothers (15%) and included malnutrition with anemia. Majority of the children were diagnosed thalassemia within 2 years of age (79.8%) and physical complications included reduced hemoglobin level and physical activity. Few thalassemic children had splenectomy (13%), majority of the children’s condition was not improved (72%). Most of the respondents visited hospital once in a month (46%). Among all mothers, few had social support (28%) and greater part received financial support (84%). Majority of the mothers faced moderate level stress (52.2%). Mean of parenting stress was 40.16(±8.07). Minimum and maximum score of parenting stress was 22 and 59 respectively.&#x0D; Conclusion: The parents having children with Thalassemia are burdened and under stress because of the chronic nature of the illness. All the findings suggests that time decisions with proper psychological supports and appropriate managements system can overcome the long term sufferings of the patients and thus reduce the stress of parents.&#x0D; JOPSOM 2019; 38(2): 22-29

Reliability and Validity of the Kannada Version of the Parental Stress Scale

Background: Parental Stress Scale (PSS) is a self report scale of 18 items which represents positive andnegative components of parenthood. Administration of scale doesn’t require any specific training but as it isself report scale it is important that parents should be able to read it by themselves for better understandingof questions. Therefore it is necessary to translate and validate the tool in local language.Objective: Objective of this study was to translate the Parental Stress Scale in Kannada language and checkits reliability in comparison with original English tool.Methods: Translation procedure was followed according to WHO guidelines for translation and adaptationof instruments. The original English version of PSS was translated by two translators into Kannada. It wasfurther subjected to expert panel opinion. Amendments were done in the Kannada version as per the panel’sopinion. A reverse translation of the amended tool was then done by a translator back to English fromKannada. The translated scale was later tested for reliability and validity.Results: The Cronbach’s alpha value of translated version of PSS was found to be 0.915 with an ICC valueof 0.82. The translated version of tool was found to be reliable and culturally acceptable in North-Karnatakaregion.Conclusion: The translated version of PSS has an excellent internal consistency and good reliability. It canbe used to measure parental stress scores among the population from North-Karnataka region.

Impact of maternal stressors and neonatal clinical factors on post-partum depression screening scores

Background Higher rates of postpartum depression (PPD) are reported in mothers of neonatal intensive care unit (NICU) hospitalized infants. The relationship of neonatal clinical risk factors and self-reported maternal stress levels to positive PPD screening is not well characterized. Objective To determine the feasibility of postpartum depression screening in a regional perinatal center, and assess the association of NICU-specific comorbidities and maternal stress levels with PPD screening scores. Design/Methods Prospective study of mothers of NICU-hospitalized infants conducted between 21and 30 days of their infant’s life. Mothers completed the Edinburgh Postpartum Depression scale (EPDS) and the Parental Stressor Scale: NICU (PSS: NICU) in the environmental, infant behavior and parental domains. Total EPDS scores and positive PPD screening were correlated with NICU comorbidities, demographic factors and PSS: NICU scores. Results The incidence of positive PPD screening was 19% (25/135). In bivariate analysis, positive PPD screen was associated with exclusive breastfeeding (67% vs, 35%, p < .05) and maternal age <35 years (32% vs. 12%, p < .05). No observed differences in maternal and infant demographic factors or neonatal comorbidities were seen in mothers with positive PPD screening. Mean PPD screening scores were higher in infants with intraventricular hemorrhage of any grade and necrotizing enterocolitis. In adjusted analysis, overall and domain-specific PSS: NICU scores were associated with positive PPD screening. Conclusion Cumulatively and within each PSS: NICU domain, parental stress correlated with positive PPD screening but was unrelated to NICU comorbidities. Reducing modifiable factors which exacerbate parental stress may impact the incidence of positive PPD screening among NICU mothers.

The Mediating Role of Parenting Stress in the Relationship Between Anxious and Depressive Symptomatology, Mothers’ Perception of Infant Temperament, and Mindful Parenting During the Postpartum Period

To investigate whether mindful parenting differs according to maternal anxious and/or depressive symptomatology and mothers’ perception of infant temperament and to explore the potential mediating role of parenting stress in the relationship between anxious and depressive symptomatology, perception of infant temperament, and mindful parenting. The sample comprised 560 mothers (18–46 years) with a child 12 months old or younger, who completed the Hospital Anxiety and Depression Scale, the Parental Stress Scale and the Interpersonal Mindfulness in Parenting Scale—Infant version. Approximately 22.1% of the mothers presented clinically significant anxious and depressive symptomatology levels. Those mothers had significantly higher levels of parenting stress and lower levels of mindful parenting than mothers with normal levels of anxious and depressive symptomatology. Mothers who perceived their infant temperament as difficult had significantly higher levels of parenting stress and lower levels of mindful parenting than those who perceived their infant temperament as easier. A path model was tested through structural equation modeling. Parenting stress mediated the relationship between anxious and depressive symptomatology and mothers’ perception of infant temperament and mindful parenting. Parenting stress seems to be an important mechanism explaining the associations between maternal anxious and depressive symptomatology, the perception of infant temperament, and mindful parenting. During the postpartum period, it is important to identify mothers with anxious/depressive symptomatology, as they appear to contribute to parenting stress and to be related to parenting skills. Psychological interventions may focus on reducing that symptomatology and parenting stress and promoting mindful parenting skills.

Evaluation of Mother's Stress during Hospitalization Can Influence the Breastfeeding Rate. Experience in Intensive and Non Intensive Departments.

A mother’s milk offers several benefits to infant’s health, but, some factors may lead to a reduction in the duration of breastfeeding, such as maternal stress. The objective of our study is to determine if the rate of breastfeeding can be influenced by stress induced by infants’ hospitalization. A preliminary observational non-randomized study was carried out in Bambino Gesù Children’s Hospital between October 2016 and January 2017, in order to elucidate a possible relationship between breastfeeding and maternal stress, linked to hospitalization. We modeled the modified version of the PSS NICU (Parental Stressor Scale—neonatal intensive care unit) questionnaire, which investigated parental stress during hospitalization. This included 33 items with a score from 0 to 5. The overall score, high stress, was established at 85 points or higher. The principal statistically significant correlation was between ‘high PSS score’ and reduced breastfeeding during hospitalization (p-value: 0.048; OR: 2.865, 95%; CI: 1.008–8.146). This relation was not influenced by other descriptive characteristics of the mother. The PSS questionnaire can be an instrument to evaluate the influence of stress in breastfeeding and to monitor the rate and success of lactation. Our study highlights that the stress from hospitalization could influence the success of breastfeeding, mostly in intensive settings and during long hospitalizations.

Mothers' Perceptions of Quality of Family-Centered Care and Environmental Stressors in Neonatal Intensive Care Units: Predictors of and Relationships with Psycho-emotional Outcomes and Postpartum Attachment.

Maternal attachment to promote role development in mothers of preterm infants is critical for babies' optimal growth and development. However, few models specify how neonatal intensive care units (NICUs) and their environments work to foster postpartum attachment (PPA) after preterm birth. We investigated relationships of quality of family-centered care and NICU environmental stressors with maternal PPA, to determine whether these are mediated by mothers' psycho-emotional response and whether pathways to PPA are moderated by developmental immaturity (gestation, birthweight). A cross-sectional study using structural equation modeling was conducted on 294 mothers of premature infants with experience in NICUs in over 49 tertiary hospitals in 12 cities or provinces of South Korea. Data were collected using Korean versions of instruments including the Quality of Family-centered Care, Parental Stressor Scale: NICU, and Maternal Postpartum Attachment Scale. Maternal self-representation was a key predictor of PPA (β = .68), accounting for 42.2% of variance. Multi-group analysis indicated that NICU environmental stressor sensitivity (β = .26) and maternal self-representation (β = .67) were predictive of PPA in mothers of moderately preterm and low birthweight (32-36weeks' gestation, 1500-2499g birthweight) infants. Quality of family-centered developmental care (β = .11) and NICU environmental stressor sensitivity (β = - .16) had significant indirect effects on PPA through psycho-emotional responses. Healthcare professionals should be aware of the importance of family-centered interventions focusing on psychosocial support and family participation in baby care, based on their environmental role in promoting PPA.

Stress experienced by mothers of preterm newborns in a neonatal intensive care unit.

To evaluate the stress level of mothers of preterm infants with gestational age ≤34 weeks, hospitalized in neonatal intensive care. A cross-sectional study with 74 mothers of premature infants in neonatal intensive care, who answered the "Parental Stress Scale: Neonatal Intensive Care Unit" instrument, validated in Brazil. The mean stress level was 4.41 (± 0.77) and the general stress level was 4.36 (± 0.76), with a significant difference (p <0.001) between the subscale "Alteration in parental roles" and other subscales, meaning that mothers were in a very stressful situation. All items in the subscale "Alteration in parental roles" of the "Parental Stress Scale: Neonatal Intensive Care Unit" were identified as the main source of stress experienced by mothers. This study suggests carrying out further studies with other methodologies to increase the knowledge of maternal stress in the national context, applying care interventions involving the parents.

Assessment of stress among parents of neonates admitted in the neonatal intensive care unit of a tertiary care hospital in Eastern India.

BACKGROUND:An infant admitted to the neonatal intensive care unit (NICU) is a potentially stressful event for parents. Severe stress is experienced by parents, affecting their mental health and relationship, and infants' development. The current study aims to assess the stress levels among parents of neonates admitted to NICU and to identify the factors influencing their stress levels.MATERIALS AND METHODS:A cross-sectional study was conducted in a tertiary care hospital of Eastern India over 2 months. Stress levels were assessed using Parental Stressor Scale: NICU questionnaire among 100 NICU parents (mother or father) with more than 24 h of admission. Stress was quantified using the Likert scale. The statistical analysis was performed using the SPSS software.RESULTS:In this study, 60.8% parents experienced severe and extreme stress level for overall stress. The mean for overall stress experienced was 3.71 ± 0.70. There was no significant difference in overall stress between father and mother (P = 0.65). The highest levels of stress experienced were in sight and sound subscale (3.23 ± 0.41) followed by relationship with the baby and parental role,” i.e., 2.46 30. There was no significant association in overall stress score with maternal age, parity, education level, previous baby being admitted to the NICU (P > 0.05). Stress in sight and sound domain was statistically significantly higher (P = 0.009) among parents of babies with stay of ≤7 days.CONCLUSION:These results support wider use in research and clinical practice to identify parental stress. Interventions can be developed to ameliorate its negative effects on individual, interpersonal, and societal levels. The stress score was not significantly different between fathers and mothers of neonates admitted to NICU and the length of stay was significantly associated with sight and sound domain. Appropriate counseling should be targeted toward both parents. Future intervention studies should be planned to decrease the stress level among parents.

Maternal stress in neonatal intensive care unit very often overlooked by health professionals.

Context:Admission of a neonate in a neonatal intensive care unit (NICU) can be very stressful for the mother, which often remains unattended by health-care professionals. Early identification of maternal stress, environmental stressors, and providing remediation will prove instrumental in providing a holistic family-based patient care.Aims:The aim of the study was to analyze the stress levels among mothers whose babies were admitted to NICU.Settings and Design:This was a cross-sectional question-based observational study conducted in the pediatric department of a peripheral hospital in Pune, Maharashtra.Subjects and Methods:This was a cross-sectional, observational, hospital-based study. Maternal stress level was assessed using the Parental Stressor Scale: NICU (PSS: NICU) questionnaire among 73 mothers. Stress score was quantified using Likert scale as low (1–2.9), moderate (3–3.9), and high (4–5), respectively.Statistical Analysis Used:Simple descriptive statistics method with frequency, percentage, mean, and standard deviation was used as applicable.Results:NICU environment is moderate to highly stressful for mothers. The mean score for each domain of PSS: NICU was as follows: sights and sounds, 2.60 (±0.43); looks and behavior, 3.47 (±0.31); and parental role alteration, 3.94 (±0.24), respectively. Maternal stress level remained high irrespective of age at delivery, educational level, occupation, mode of delivery, and number of living children.Conclusions:Mothers of NICU-admitted babies are under significant stress, which needs to be identified early along with care of the sick neonate, so as to give a holistic care to the family.

Comparison of maternal stress and psychiatric morbidity among mothers of children having psychiatric disorders and those of typically developing children.

Introduction:Motherhood is regarded to be stressful, but when the child has a psychiatric illness, the mother is affected more than the father since she is the primary caregiver. She gets affected not only emotionally but also psychologically. Increasing severity of stress in mothers may lead to negative outcome on a child's care.Aims:The aim of this study was to evaluate the stress levels in mothers of children diagnosed with psychiatric disorder and to study the association between children having a psychiatric disorder and the psychiatric morbidity in their mothers.Materials and Methods:This was a case–control study with a total of 150 participants, in which 75 consecutive mothers of children were diagnosed with any psychiatric illness using ICD-10 criteria and compared to 75 mothers of typically developing children. The study was approved by the Institutional Ethics Committee. The Parental Stress Scale and the Mini-International Neuropsychiatric Interview-Plus questionnaire were used for assessments.Results:The study showed statistically significant stress scores (49.54) in mothers having children diagnosed with psychiatric illnesses as compared to scores (30.98) in mothers of normally developing children. Psychiatric morbidity in cases (n = 58; 77.3%) was statistically significant as compared to controls (n = 23; 30.6%). Depression and anxiety were among the most common psychiatric morbidities evaluated, and the highest was for mothers having children with severe mental retardation.Conclusion:In all children with psychiatric disorders, mothers have to be screened for psychiatric morbidity to prevent, detect, and manage it at the earliest.

Maternal stress of cases in pediatric intensive care unit in Tertiary hospital Bangalore

Background: Pediatric intensive care unit (PICU) is a highly stressful environment to most parents specifically mothers who are very sensitive. Knowledge of their stress helps us to plan counselling strategies for the suffering parents. The objectives were to identify common maternal stress factors during their childs critical illness and to examine the relationship of different variables with the stress. Methods: It was a prospective observational study done in PICU of a tertiary care medical college hospital in Bangalore. One hundred mothers of children (1 month to 15 years) admitted to PICU for at least 24 hours were interviewed using the Parental Stress Scale (PSS: PICU), which rates 22 factors on a scale from 1 to 5. The demographic and clinical characteristics of children were also recorded and analysed statistically. Results: The average parental stress score was 3.5. Parents of children who got admitted in PICU for the first time were more stressed The main causes of extremely stressful situations were the sight of other sick children in PICU sight of monitors & equipment in PICU, their child being unresponsive, crisis in other children in the PICU.. Younger mother were more stressed than older mother, irrespective of the illness and clinical status. Age of the child, sex, socioeconomic status, urban/rural, did not vary stress levels, all had similar stress level (score>3). Among the procedures, majority (52%) parents felt intravenous cannulation as more stressful followed by blood sampling (43%). Conclusions: For a mother, first PICU admission were more stressful. Socioeconomic status, age of children and residence did not affect level of stress. Many of these stress factors can be resolved and remedial steps can be undertaken to relieve these stressors.

Stress and coping strategies for parenting children with hearing impairment and autism.

Objectives:To determine the level of stress experienced and coping strategies used by parents of hearing impaired and autistic children.Methods:Using non-probability convenience sampling this cross sectional study recruited n =200 parents of hearing impaired (HI) and 100 parents of autistic children, of either gender, aged 20 to 60 years. Samples were recruited from Special Education Institutes of Islamabad and Rawalpindi, over a period of six months, from October 2018 to March 2019 and conducted at Isra Institute of Rehabilitation Sciences, Islamabad. Basic demographical sheet, Parental Stress Scale and Coping Strategies Inventory were used for data collection. Statistical analysis was done using SPSS 21.Results:In parents of hearing impaired the mean parental stress score was 47.44±12.85 and commonest coping strategy was problem focused engagement (26.03) followed by problem focused dis-engagement (24.25). In the autistic group the mean parental stress score was 48.92+11.22 with problem focused engagement being the most frequently used strategy (27.4) followed by emotion focused strategy.Conclusion:Different level of stress experienced by parents of autistic and hearing impaired children which is statistically significant and they employed different coping strategies.

Psychological Stress among Parents of Hearing Impaired versus Intellectually Disabled Pakistani Children

Background: Parents of special children face physical, psychological and social impact of their child’s disability, including hopelessness and depression. This study is important as it will help professionals plan and provide effective coping strategies so parents could have a positive perception and behavior for disabilities (like hearing impaired and intellectual disability) in their children. The objective of this study was to analyze level of psychological stress among parents of children with hearing impaired (HI) versus intellectual disability (ID) and relationship between disability and psychological stress.Material and Methods: This cross-sectional study comprised of parents (n = 200) of 100 HI and 100 ID children, of both genders, aged 1 to 16 years. These were recruited by non-probability convenience sampling after taking consent from special education centers of Punjab (Pakistan), over a period of six months from May 2017 to October 2017. After collecting demographic details, quantitative assessment of parental stress was done using Parental Stress Scale (PSS). Statistical analysis was carried out using SPSS v21.Results: The sample population (n=200) consisted of 32.5% male and 67.5% female respondents, with a mean age of 41.23 ± 6.7 years. The mean of total parental psychological stress score was 61.85 ± 17.1 with significant association between disabilities (HI and ID) and psychological stress (p&lt;0.01). In HI group, moderate psychological stress was seen (n=53, 26.5%), while in ID group, profound level of psychological stress was noted in majority (n=70, 35%) of participants.Conclusions: Parents of both HI and ID children showed psychological stress, however, parents of ID children suffered higher level of stress.

NIVEL DE ESTRÉS EN PADRES DE NIÑOS HOSPITALIZADOS EN UNIDADES CRÍTICAS PEDIÁTRICAS Y NEONATALES

Introduction: Illness and hospitalization are critical events for a child. It is common that the whole family experiences a stress reaction while the child is seriously ill or hospitalized. Objective: The purpose of this research is to determine the stress level in parents whose children have been hospitalized in neonatal and pediatric critical care units, and how this relates to the socio-demographic characteristics of the parent and/or child. Materials and Methods: Quantitative, descriptive correlational and cross-sectional study, using a sample of 41 suitable parents, who were present in May 2017 in the pediatric and neonatal critical care units of a hospital located in the Nuble Region, Chile. A characterization questionnaire and the Spanish version of the Parental Stress Scale adapted by Polaino-Lorente and Ochoa were applied. The data were processed using SPSS 15.0, performing Student’s t and one-way ANOVA tests. Results: According to the overall stress score, 48.8% classified the level as extremely stressful; 29.3% as very stressful; 12.2% as moderately stressful and the rest as little and not stressful at all. Stress in parents is higher during the child’s first week of hospitalization, both in areas of communication with the health professionals and the alteration of the parental role. Conclusion: Stress in parents with a hospitalized child in critical care units can be extreme, being higher during the child’s first week of hospitalization.

Relationship Between Parental Stress and their Attitudes Towards Cochlear Implantation Outcomes in Children Referred to Besat Cochlear Implant Center in Hamadan 2018

PurposeThis study aimed to investigate the relationship between parental stress and their attitudes towards post-cochlear implantation outcomes in children referred to Besat cochlear implant center in Hamadan during 2018. Design and methodsIn this descriptive cross-sectional study, 100 parents of children with cochlear implantation were selected from Besat cochlear implant center in Hamadan through census method from April to October 2018. The data were collected using a demographic characteristic questionnaire, parental stress scale developed by Berry and Jones, and Parental Attitudes of Various Aspects of Cochlear Implantation. The data were analyzed using SPSS software (version 16) through correlation coefficient, one-way ANOVA, and t-test. P-value <0.05 was considered statistically significant. ResultsThe results of this study indicated that parental stress negatively correlated with their attitudes towards the outcomes of cochlear implantation (r = −0.420), including the aspects of communication (r = −0.462), educational (r = −0.398), and social skills (r = −0.445), as well as services provided by the health care centers (r = −0.277), and the efficiencies of cochlear implantation center (r = −0.118) (P < 0.05). ConclusionAccording to the results, parents with more positive attitudes towards the areas of communication, educational, and social skills, as well as services provided by the health care centers, and the efficiencies of cochlear implantation center experienced lower levels of stress. Practice implicationsNurses can measure the stress and attitudes towards cochlear implantation outcomes in children to accurately assess the needs of the family in order to improve their nursing process and advance the child's rehabilitation program.

Stressors of parents of infants undergoing neonatal surgery for major non-cardiac congenital anomalies in a surgical neonatal intensive care unit.

As more babies survive major neonatal surgery, the quality of life of the whole family is a major focus of health care. While there is evidence suggesting that parents of babies admitted to neonatal intensive care units (NICUs) experience high levels of stress, little is known about stressors in parents whose infants also require neonatal surgery. This study identified fathers' and mothers' stressors in a surgical NICU. Parents of infants admitted for general surgery to the NICU at a tertiary children's hospital from February 2014 to September 2015 were eligible for enrolment. Parents completed the Parental Stressor Scale: NICU to measure levels of stress related to three subscales: sights and sounds, infant appearance and parental role alteration, using a 5-point Likert scale. Data for 111 parents (57% mothers) showed parental role alteration as the greatest stressor for parents (M = 2.98, standard deviation (SD) = 0.89), particularly for mothers, followed by infant appearance (M = 2.84, SD = 0.95). Both fathers and mothers rated feeling helpless (M = 4.1, SD = 1.0), unable to protect their baby (M = 4.1, SD = 0.9) and seeing their baby in pain (M = 3.9, SD = 1.2) the most common, most stressful experiences and highest contributors to overall stress in the surgical NICU environment. Parental role alteration is the greatest stressor for parents in the surgical NICU. Reducing stress for parents of infants undergoing neonatal surgery requires management of the infant's pain and strategies to support parents in their role in the NICU.