Anita N Shah1,2, Andrew F Beck3,2,4, Heidi J Sucharew2,5, Stacey Litman6, Cory Pfefferman3,2, Julianne Haney7, Samir S Shah3,2,8, Jeffrey M Simmons3,2,9, Katherine A Auger3,2,9. 1. Divisions of Hospital Medicine, anita.shah@cchmc.org. 2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and. 3. Divisions of Hospital Medicine. 4. General and Community Pediatrics. 5. Biostatistics and Epidemiology. 6. Social Services, and. 7. College of Arts and Sciences, University of Dayton, Dayton, Ohio. 8. Infectious Diseases and. 9. James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Abstract
BACKGROUND AND OBJECTIVES: Adults with a history of adverse childhood experiences (ACEs) (eg, abuse) have suboptimal health outcomes. Resilience may blunt this effect. The effect of parental ACEs (and resilience) on coping with challenges involving their children (eg, hospitalization) is unclear. We sought to quantify ACE and resilience scores for parents of hospitalized children and evaluate their associations to parental coping after discharge. METHODS: We conducted a prospective cohort study at a children's hospital (August 2015-May 2016). Eligible participants were English-speaking parents of children hospitalized on the Hospital Medicine or Complex Services team. The ACE questionnaire measured the responding parent's past adversity (ACE range: 0-10; ≥4 ACEs = high adversity). The Brief Resilience Scale (BRS) was used to measure their resilience (range: 1-5; higher is better). The primary outcome was measured by using the Post-Discharge Coping Difficulty Scale via a phone call 14 days post-discharge (range: 0-100; higher is worse). Associations were assessed by using multivariable linear regression, adjusting for parent- and patient-level covariates. RESULTS: A total of 671 (81% of eligible parents) responded. Respondents were primarily women (90%), employed (66%), and had at least a high school degree (65%); 60% of children were white, 54% were publicly insured. Sixty-four percent of parents reported ≥1 ACE; 19% had ≥4 ACEs. The mean Brief Resilience Scale score for parents was 3.95. In adjusted analyses, higher ACEs and lower resilience were significantly associated with more difficulty coping after discharge. CONCLUSIONS: More parental adversity and less resilience are associated with parental coping difficulties after discharge, representing potentially important levers for transition-focused interventions.
BACKGROUND AND OBJECTIVES: Adults with a history of adverse childhood experiences (ACEs) (eg, abuse) have suboptimal health outcomes. Resilience may blunt this effect. The effect of parental ACEs (and resilience) on coping with challenges involving their children (eg, hospitalization) is unclear. We sought to quantify ACE and resilience scores for parents of hospitalized children and evaluate their associations to parental coping after discharge. METHODS: We conducted a prospective cohort study at a children's hospital (August 2015-May 2016). Eligible participants were English-speaking parents of children hospitalized on the Hospital Medicine or Complex Services team. The ACE questionnaire measured the responding parent's past adversity (ACE range: 0-10; ≥4 ACEs = high adversity). The Brief Resilience Scale (BRS) was used to measure their resilience (range: 1-5; higher is better). The primary outcome was measured by using the Post-Discharge Coping Difficulty Scale via a phone call 14 days post-discharge (range: 0-100; higher is worse). Associations were assessed by using multivariable linear regression, adjusting for parent- and patient-level covariates. RESULTS: A total of 671 (81% of eligible parents) responded. Respondents were primarily women (90%), employed (66%), and had at least a high school degree (65%); 60% of children were white, 54% were publicly insured. Sixty-four percent of parents reported ≥1 ACE; 19% had ≥4 ACEs. The mean Brief Resilience Scale score for parents was 3.95. In adjusted analyses, higher ACEs and lower resilience were significantly associated with more difficulty coping after discharge. CONCLUSIONS: More parental adversity and less resilience are associated with parental coping difficulties after discharge, representing potentially important levers for transition-focused interventions.
Authors: Katherine A Auger; Emily L Mueller; Steven H Weinberg; Catherine S Forster; Anita Shah; Christine Wolski; Grant Mussman; Anna J Ipsaro; Matthew M Davis Journal: J Pediatr Date: 2015-12-30 Impact factor: 4.406
Authors: Eyal Cohen; Erzsébet Horváth-Puhó; Joel G Ray; Lars Pedersen; Nancy Adler; Anne Gulbech Ording; Paul H Wise; Arnold Milstein; Henrik Toft Sørensen Journal: JAMA Date: 2016-12-20 Impact factor: 56.272
Authors: Heather L Tubbs-Cooley; Rita H Pickler; Jeffrey M Simmons; Katherine A Auger; Andrew F Beck; Hadley S Sauers-Ford; Heidi Sucharew; Lauren G Solan; Christine M White; Susan N Sherman; Angela M Statile; Samir S Shah Journal: J Adv Nurs Date: 2016-01-28 Impact factor: 3.187
Authors: Anita N Shah; Katherine A Auger; Heidi J Sucharew; Colleen Mangeot; Kelsey Childress; Julianne Haney; Samir S Shah; Jeffrey M Simmons; Andrew F Beck Journal: J Hosp Med Date: 2020-11 Impact factor: 2.960
Authors: Jessica Vervoort-Schel; Gabriëlle Mercera; Inge Wissink; Emmelie Mink; Peer van der Helm; Ramón Lindauer; Xavier Moonen Journal: Int J Environ Res Public Health Date: 2018-09-28 Impact factor: 3.390