Readiness for Hospital Discharge, Stress, and Coping in Mothers of Children Undergoing Cardiac Surgeries: A Single-Center Prospective Study

Abstract

Objectives: To examine the relationship between stress, coping, and discharge readiness in mothers of children undergoing congenital heart surgeries. Design: Quantitative descriptive study at three time points: pre surgery (time point I), day of hospital discharge (time point II) and 2 weeks following discharge (time point III). Setting: Tertiary care pediatric hospital in Singapore. Participants: One hundred mothers whose children had undergone congenital heart surgeries. Measurements and Main Results: Data collection included self-reported questionnaires of the Pediatric Inventory for Parents and the Coping Health Inventory for Parents across three time points. Readiness for Hospital Discharge Scale was administered at hospital discharge (time point II). The utilization of health services and support was reported at post discharge (time point III). One-hundred mothers participated in this study between May 2016 and July 2017. Their mean age was 35.8 years (sd = 7.0), and the mean age of their children was 3.7 years (sd = 4.6). There was significant reduction in mean stress difficulty (Pediatric Inventory for Parents) of mothers (F = 4.58; p = 0.013) from time point I to III. No significant changes were found in the overall mean coping score (Coping Health Inventory for Parents) of mothers across time. The mean overall score for the readiness for discharge (Readiness for Hospital Discharge Scale) of mothers at hospital discharge was 207.34 (sd = 29.22). Coping through family integration subscale and communication stress predicted discharge readiness of mothers (adjusted R 2 = 0.11; p = 0.034). Mothers who reported higher overall stress (Pediatric Inventory for Parents) 2 weeks post discharge were more likely to call a friend or family member, visit the emergency department, or have their child readmitted to hospital following hospital discharge. Conclusions: We identified coping by family integration and communication-related stress as predictors of readiness for discharge. Strategies targeted at communication and family integration for discharge preparation may improve caregivers’ readiness for hospital discharge.

Systematic Review of Instruments Assessing Psychosocial Adaptation and Outcomes Among Families of Children With Congenital Heart Disease

“…Ten instruments used to evaluate stress and strain experienced in the parenting role, including in the context of illness were identified across 30 (28%) distinct samples. Seven instruments of parenting stress ( Abidin, 2012 ; Barsella et al, 2021 ; Haverman et al, 2013 ; Östberg et al, 1997 ; Streisand et al, 2001 ; Jantien Vrijmoet-Wiersma et al, 2010 ) were identified across 27 distinct samples ( Barsella et al, 2021 ; Bishop et al, 2019 ; Brosig et al, 2007a ; Carey et al, 2002 ; Caris et al, 2016 ; Chaisom et al, 2010 ; Chang et al, 2020 ; Choi & Lee, 2021 ; De Stasio et al, 2019 ; Ezzat et al, 2016 ; Goldberg et al, 1991 ; Golfenshtein et al, 2017 ; Jackson et al 2020 ; Kaugars et al, 2018 ; Lee et al, 2007 ; Majnemer et al, 2006 ; Medoff-Cooper et al, 2020 ; Mörelius et al, 2002 ; Poh et al, 2020 ; Mussatto et al, 2021 ; Re et al, 2018 ; Sarajuuri et al, 2012 ; Torowicz et al, 2010 ; Uzark & Jones, 2003 ; van der Mheen et al, 2019 ; Visconti et al, 2002 ; Jantien Vrijmoet -Wiersma et al, 2009 ). Most frequently used were the Parenting Stress Index ( Abidin, 2012 ) and the Parenting Stress-Short Form ( Abidin, 2012 ) across 8 and 12 studies, respectively, including Dutch, Korean, Arabic, Chinese, and Thai translations of the Parenting Stress Index-Short Form.…”

“…Instruments explicitly identifying assessment of coping, including coping self-efficacy and coping appraisal, were categorized in this section. The full, modified version, and subscale-only usage of 12 instruments of coping ( Carver, 1997 ; Carver et al, 1989 ; Chesney et al, 2003 ; Endler & Parker, 1994 ; Folkman & Lazarus, 1985 ; Frydenberg & Lewis, 2014 ; Jackson et al, 2017 ; McCubbin et al, 1981 ; Murphy et al, 2017 ; Schreurs, 1993 ; Sira et al, 2014 ) were identified across 19 (17%) studies and 18 samples ( Ahn et al, 2014 ; Berant et al, 2001 , 2003 ; Choi & Lee, 2021 ; Davis 1998 ; Diffin et al, 2016 ; Doherty et al, 2009 ; Hancock et al, 2018 ; Jackson et al, 2020 ; Miller et al, 2021 ; McCusker et al, 2010 ; Mussatto et al, 2021 ; Poh et al 2020 ; Roberts et al, 2021 ; Rychik et al, 2013 ; Sira et al, 2014 ; Spijkerboer et al 2007 ; Svavarsdottir & McCubbin, 1996 ; Utens et al, 2000 ). The most frequently used instrument was the Coping Health Inventory for Parents ( McCubbin et al, 1981 ) in five studies across the USA and Singapore, with two studies ( Jackson et al, 2020 ; Sira et al, 2014 ) using multiple coping instruments.…”

Clown care in the clinical nursing of children: a meta-analysis and systematic review

“…The hospital environment serves as an important stressor for children when seeking a doctor, and the medical and nursing procedures can easily have a negative impact on the experience for children ( 1 ). Even minor surgeries or routine treatments can cause pain and anxiety in children.…”

Families under pressure: A qualitative study of stressors in families of children with congenital heart disease

“…This result has led to a shift in focus from survival to long‐term care issues, such as follow‐up practices and psychosocial consequences. Caring for a child with CHD is stressful, and patients may require multiple interventional therapies, surgical procedures, life‐long medication and nursing interventions (Poh et al., 2020; van der Linde et al., 2011), representing substantial economic and mental pressures on the family (Faraoni et al., 2016; McClung et al., 2018).…”