2.50
Hdl Handle:
http://hdl.handle.net/10755/157966
Type:
Presentation
Title:
Explanatory Effects of the Cope Program on Critically Ill Children/Mothers
Abstract:
Explanatory Effects of the Cope Program on Critically Ill Children/Mothers
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Melnyk, Bernadette, PhD, CPNP, NPP, FAAN, FNAP
P.I. Institution Name:Arizona State University College of Nursing
Title:Professor
Contact Address:PO Box 872602, Tempe, AZ, 85287-2602, USA
Contact Telephone:480-965-6431
Co-Authors:Hugh Crean, Nancy Feinstein, Linda Alpert-Gillis
Background: Young, critically ill children are more at high-risk for negative mental health outcomes than matched hospitalized children who do not require intensive care. Parents of these children also are at risk for the development of PTSD, depression and anxiety disorders. Despite these adverse effects, there has been little research conducted to systematically evaluate and explain the effects of interventions aimed at improving psychosocial outcomes for critically ill children and their parents. Purpose: The objective of this study, conducted on data obtained from a randomized clinical trial that tested the effects of an educational-behavioral intervention program (COPE) on the mental health/coping outcomes on critically ill children and their mothers, was to test a theoretically-driven model that explained the process through which the COPE program exerted its positive outcomes. Johnson and Leventhal's self-regulation theory and Carver and Scheier's control theory guided the development of the explanatory model. It was hypothesized that the COPE program would positively affect post-hospital child adjustment through maternal beliefs about their children's responses and their role as well as mothers' stated anxiety and the level of support that they provided to their children during hospitalization. Sample: The sample was comprised of 174 mothers and their 2- to 7-year-old children who were unexpectedly hospitalized in the pediatric intensive care units (PICUs) of two children's hospitals. The final sample of 163 mothers ranged in age from 18 to 52 years with a mean of 31.2 years. The mean age of the children was 50.3 months. Major reasons for hospitalization were respiratory problems and accidental trauma. Subject enrollment and follow-up assessments at 3, 6, and 12 months after hospitalization occurred between 1998 and 2002. Methods: Structural equation modeling tested the explanatory model with the AMOS 4.0 statistical package. Goodness of fit of the model was assessed using the associated chi-square, the root mean square error of approximation and the comparative fit index. Variables tested in the model included maternal beliefs, state anxiety, and maternal participation in their children's care as well as child adjustment, which was assessed with the Behavioral Assessment System for Children (BASC) (Parent Form) by Reynolds and Kamphaus. Findings: The standardized coefficients and the goodness-of-fit indices suggested that this model provided a reasonable fit to the data. Specifically, the COPE intervention strengthened maternal beliefs in their children's behavioral responses to hospitalization and their role in helping their children to cope with the stressful event which, in turn, reduced maternal state anxiety. A reduction in maternal anxiety led to better child adjustment. In addition, COPE was associated with a higher level of global support provided by mothers to their children during hospitalization, which led to better post-hospital child adjustment. Conclusions: Implementing the COPE program in PICUs throughout the country could avert mental health problems in this high risk population and reduce family burden and costs associated with a child's critical care hospitalization.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleExplanatory Effects of the Cope Program on Critically Ill Children/Mothersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157966-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Explanatory Effects of the Cope Program on Critically Ill Children/Mothers</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Melnyk, Bernadette, PhD, CPNP, NPP, FAAN, FNAP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Arizona State University College of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">PO Box 872602, Tempe, AZ, 85287-2602, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">480-965-6431</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bernadette.melnyk@asu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Hugh Crean, Nancy Feinstein, Linda Alpert-Gillis</td></tr><tr><td colspan="2" class="item-abstract">Background: Young, critically ill children are more at high-risk for negative mental health outcomes than matched hospitalized children who do not require intensive care. Parents of these children also are at risk for the development of PTSD, depression and anxiety disorders. Despite these adverse effects, there has been little research conducted to systematically evaluate and explain the effects of interventions aimed at improving psychosocial outcomes for critically ill children and their parents. Purpose: The objective of this study, conducted on data obtained from a randomized clinical trial that tested the effects of an educational-behavioral intervention program (COPE) on the mental health/coping outcomes on critically ill children and their mothers, was to test a theoretically-driven model that explained the process through which the COPE program exerted its positive outcomes. Johnson and Leventhal's self-regulation theory and Carver and Scheier's control theory guided the development of the explanatory model. It was hypothesized that the COPE program would positively affect post-hospital child adjustment through maternal beliefs about their children's responses and their role as well as mothers' stated anxiety and the level of support that they provided to their children during hospitalization. Sample: The sample was comprised of 174 mothers and their 2- to 7-year-old children who were unexpectedly hospitalized in the pediatric intensive care units (PICUs) of two children's hospitals. The final sample of 163 mothers ranged in age from 18 to 52 years with a mean of 31.2 years. The mean age of the children was 50.3 months. Major reasons for hospitalization were respiratory problems and accidental trauma. Subject enrollment and follow-up assessments at 3, 6, and 12 months after hospitalization occurred between 1998 and 2002. Methods: Structural equation modeling tested the explanatory model with the AMOS 4.0 statistical package. Goodness of fit of the model was assessed using the associated chi-square, the root mean square error of approximation and the comparative fit index. Variables tested in the model included maternal beliefs, state anxiety, and maternal participation in their children's care as well as child adjustment, which was assessed with the Behavioral Assessment System for Children (BASC) (Parent Form) by Reynolds and Kamphaus. Findings: The standardized coefficients and the goodness-of-fit indices suggested that this model provided a reasonable fit to the data. Specifically, the COPE intervention strengthened maternal beliefs in their children's behavioral responses to hospitalization and their role in helping their children to cope with the stressful event which, in turn, reduced maternal state anxiety. A reduction in maternal anxiety led to better child adjustment. In addition, COPE was associated with a higher level of global support provided by mothers to their children during hospitalization, which led to better post-hospital child adjustment. Conclusions: Implementing the COPE program in PICUs throughout the country could avert mental health problems in this high risk population and reduce family burden and costs associated with a child's critical care hospitalization.</td></tr></table>en_GB
dc.date.available2011-10-26T20:22:40Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:22:40Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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