Douglas L Hill1, Jennifer A Faerber1, Yimei Li2, Victoria A Miller1, Karen W Carroll1, Wynne Morrison3, Pamela S Hinds4, Chris Feudtner5. 1. Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. 2. Departments of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 3. Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 4. Department of Nursing Science, Professional Practice, and Quality, Children's National Health System, Washington, DC, USA; Department of Pediatrics, School of Medicine and the Health Sciences, George Washington University, Washington, DC, USA. 5. Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. Electronic address: feudtner@email.chop.edu.
Abstract
CONTEXT: Parents of seriously ill children hold personal beliefs about what they should do to be good parents. How these beliefs change over time is unknown. OBJECTIVES: The objectives of this study were to describe the pattern of Good-Parent Beliefs over time, and determine whether parents' hopeful patterns of thinking, affect, and perceived child's health are associated with changes in beliefs at 12 and 24 months. METHODS: Our longitudinal sample included 124 parents of 100 children hospitalized with serious illness. We used latent transition models to classify parents into groups with similar Good-Parent Beliefs during the baseline and follow-up periods and modeled the change in good-parent beliefs over time as a function of covariates using generalized linear mixed models. RESULTS: Two parent belief profiles emerged from the latent transition model: Loved ("Making sure my child feels loved," n = 61 at baseline) and Informed ("Making informed decisions," n = 63 at baseline). At 12 months, 21 parents (20.4%) had moved into the Loved group and no parents transitioned to the Informed group. By 24 months, eight parents transitioned to the Loved group and four to the Informed group (13.04%). Transition into the Loved group was associated with parents' baseline degree of hopeful thinking and positive perceptions of child's health at baseline. CONCLUSION: Some parents change their parenting priorities over time. Hopeful patterns of thinking and perception of child health appear to predict change. Clinicians should regularly reevaluate Good-Parent Beliefs over time to promote priority-congruent dialogue.
CONTEXT: Parents of seriously ill children hold personal beliefs about what they should do to be good parents. How these beliefs change over time is unknown. OBJECTIVES: The objectives of this study were to describe the pattern of Good-Parent Beliefs over time, and determine whether parents' hopeful patterns of thinking, affect, and perceived child's health are associated with changes in beliefs at 12 and 24 months. METHODS: Our longitudinal sample included 124 parents of 100 children hospitalized with serious illness. We used latent transition models to classify parents into groups with similar Good-Parent Beliefs during the baseline and follow-up periods and modeled the change in good-parent beliefs over time as a function of covariates using generalized linear mixed models. RESULTS: Two parent belief profiles emerged from the latent transition model: Loved ("Making sure my child feels loved," n = 61 at baseline) and Informed ("Making informed decisions," n = 63 at baseline). At 12 months, 21 parents (20.4%) had moved into the Loved group and no parents transitioned to the Informed group. By 24 months, eight parents transitioned to the Loved group and four to the Informed group (13.04%). Transition into the Loved group was associated with parents' baseline degree of hopeful thinking and positive perceptions of child's health at baseline. CONCLUSION: Some parents change their parenting priorities over time. Hopeful patterns of thinking and perception of child health appear to predict change. Clinicians should regularly reevaluate Good-Parent Beliefs over time to promote priority-congruent dialogue.
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