A Diaz-Caneja1, J Gledhill, T Weaver, S Nadel, E Garralda. 1. The Academic Unit of Child and Adolescent Psychiatry, Imperial College, St. Mary's Hospital, Norfolk Place, London, W2 1PG, UK. adiazcaneja@hotmail.com
Abstract
AIMS: To compare the experiences of parents and children during inpatient admission to either a paediatric intensive care unit (PICU) or a general paediatric ward (GPW) with a specific focus on identifying factors which may influence psychological outcome. METHODS: Semi-structured qualitative interviews of 20 parents whose children had been admitted to hospital. Cases were sampled purposively to ensure representation of both groups (PICU and GPW admissions). Interviews were tape recorded, transcribed and subjected to a thematic analysis. RESULTS: The experiences of parents were explored with regard to illness onset, admission to PICU or GPW and the discharge period. In the PICU group, the sources of stress differed according to the stage: at onset, they were mainly related to their child's illness; during admission, concerns were focused on their child's appearance; finally, on discharge, possible relapse of the illness, impact of the admission on the child and family and the lack of clear follow-up were the central themes. In the GPW group, parents reported similar themes but with lower levels of associated stress. Both groups identified good communication with the medical team and opportunities for participation as helpful in reducing stress. CONCLUSIONS: Admission to hospital is stressful for parents particularly if the child is admitted to PICU. Hospital staff should enhance communication with parents and maximise opportunities for parental participation in the child's treatment. Such interventions may reduce parents' experience of stress during the admission and have the potential to improve psychological outcome.
AIMS: To compare the experiences of parents and children during inpatient admission to either a paediatric intensive care unit (PICU) or a general paediatric ward (GPW) with a specific focus on identifying factors which may influence psychological outcome. METHODS: Semi-structured qualitative interviews of 20 parents whose children had been admitted to hospital. Cases were sampled purposively to ensure representation of both groups (PICU and GPW admissions). Interviews were tape recorded, transcribed and subjected to a thematic analysis. RESULTS: The experiences of parents were explored with regard to illness onset, admission to PICU or GPW and the discharge period. In the PICU group, the sources of stress differed according to the stage: at onset, they were mainly related to their child's illness; during admission, concerns were focused on their child's appearance; finally, on discharge, possible relapse of the illness, impact of the admission on the child and family and the lack of clear follow-up were the central themes. In the GPW group, parents reported similar themes but with lower levels of associated stress. Both groups identified good communication with the medical team and opportunities for participation as helpful in reducing stress. CONCLUSIONS: Admission to hospital is stressful for parents particularly if the child is admitted to PICU. Hospital staff should enhance communication with parents and maximise opportunities for parental participation in the child's treatment. Such interventions may reduce parents' experience of stress during the admission and have the potential to improve psychological outcome.
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