Perception Of Illness Severity And Worry About Infant Health In Mothers Of Hospitalized Medically Fragile Infants

2.50
Hdl Handle:
http://hdl.handle.net/10755/166082
Category:
Abstract
Type:
Presentation
Title:
Perception Of Illness Severity And Worry About Infant Health In Mothers Of Hospitalized Medically Fragile Infants
Author(s):
Docherty, Sharron
Author Details:
Sharron Docherty, MScN, University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA, (updated February 2015) email: doche002@mc.duke.edu
Abstract:
A major source of stress for parents of critically ill infants is concern about the severity of the infant's illness. This concern is heightened when the infant is "medically fragile". Parents worry about whether the baby will live or die, the efficacy of treatment measures, the potential length of hospitalization, and the long-term prognosis. Maternal perception of severity may or may not be related to the actual illness severity. The purpose of this study was to explore perception of severity and degree of worry perceived by mothers of medically fragile infants with differing health problems and to explore predictors of mother's level of worry. The social-ecological systems-theory perspective of human development and the Parental ICU Stress Model provided the framework. Subjects were 79 mothers of medically fragile infants, defined as infants diagnosed with a serious-life threatening health problem within the first 2 months of life as the result of sequelae of prematurity, a serious birth defect, or chronic disease. The mothers and their infants were part of a larger longitudinal study. There were 56 preterms (70.9%) and 23full term infants (29.1%) with a variety of chronic health problems. The mean age of the mother s was 26 and more than half had high school education. There were 40 Caucasian mothers, 28 African American mothers, and 11 mothers from other ethnic backgrounds. Data were collected using the Parental Perception of Severity Scale, the Child Health Worry Scale, and the Parental Stressor Scale: Infant Hospitalization. Technological dependence and other infant health variables were collected from the medical record. There were no differences in perceived severity or worry about the child's health between mothers of infants with different chronic health diagnoses. Significant reductions in perception of severity from admission to the data collection point were found only in mothers with infants in the chronic lung disease, gastrointestinal disease, and other disease categories. Hierarchical regression exploring predictors of maternal worry indicated that mother's age and educational level, and maternal stress related to the infant's appearance and behavior predicted 55% of the variance in maternal worry. Findings suggested that older mothers and mothers with a lower educational level need addition interventions to help them with worries related to their child's health status. In addition, stress related to their infant's appearance and behavior appeared to impact on worry about the child's health status suggesting the need for intervention with mothers of medically fragile infants which focus on understanding and coping with their child's appearance and behavior during hospitalization. 8117 perceptions of maternal role and strategies used by mothers of critically ill children: a grounded theory investigation Louise M. Niemer The majority of literature relative to parents of critically ill children has focused largely on identifying parental stressors, and parents' self-identified needs relative to the pediatric intensive care experience. In general, stressors and needs are affiliated closely parental role issues. However, specific issues related to the parental role have not received attention. Hence, the purpose of this study was to investigate the (1) perceived role of mothers with critically ill children, (2) factors impacting upon their role, and (3) strategies employed my mothers to accomplish their role. A grounded theory design was selected. This approach is based upon symbolic interactionism which asserts that the actions of individuals are derived from their understanding of the meanings symbolized by the actions of others. Thus, interactions proceed in a reciprocal symbolic way. Data were collected through guided informal interviews with twelve mothers from a large metropolitan university-based medical center in the mid-eastern United States. A core variable of "being there" readily and consistently emerged as mothers' perceived role. Being there was constituted by (1) emotionally sustaining the child, (2) monitoring information and attributes of the care situation, (3) enabling and facilitating the child's care, and (4) protecting the child. Factors which adversely affected being there involved elements which precluded mothers' presence in the critical care unit. These included (1) unit policies and practices, and (2) mothers' inability to remain calm for their children. Factors which facilitated being there entailed (1) thoughtful and caring nurses and physicians, and (2) being appraised of the child's status and progress, and of anticipated events. A core process variable of "securing presence" was identified. To secure presence, mother's (1) acquiesced to the rules and policies set forth by unit staff/policy, (2) disregarded their own needs, and (3) derived strength through prayer, and the support and encouragement of others, usually husbands. The results of this study have provided a clearer understanding of mothers' perceived role and actions relative to their critically ill child. Theoretically, the results have strong implications for the therapeutic nursing encounter, the unity and interrelatedness within family systems, and family-centered nursing (which is commonly espoused philosophy within many pediatric acute care facilities). The education of nurses in the arena of therapeutic nursing actions, and the integral nature of families is likewise informed by these results. Implications for practice include evaluation of the purpose and outcome of policies and practices which restrict parents presence with their critically ill child, and developing policies and interventions which advance the maternal role. In this study, husbands, mother's of other children, and close family members played a crucial supportive role for mothers'. Examination of the role that others play is recommended for future research. An investigation that seeks to identify nurses' perceptions of proper parental role and how they strategize to influence this could provide a clearer understanding of interactions from the "other side of the fence".
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePerception Of Illness Severity And Worry About Infant Health In Mothers Of Hospitalized Medically Fragile Infantsen_GB
dc.contributor.authorDocherty, Sharronen_US
dc.author.detailsSharron Docherty, MScN, University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, USA, (updated February 2015) email: doche002@mc.duke.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166082-
dc.description.abstractA major source of stress for parents of critically ill infants is concern about the severity of the infant's illness. This concern is heightened when the infant is "medically fragile". Parents worry about whether the baby will live or die, the efficacy of treatment measures, the potential length of hospitalization, and the long-term prognosis. Maternal perception of severity may or may not be related to the actual illness severity. The purpose of this study was to explore perception of severity and degree of worry perceived by mothers of medically fragile infants with differing health problems and to explore predictors of mother's level of worry. The social-ecological systems-theory perspective of human development and the Parental ICU Stress Model provided the framework. Subjects were 79 mothers of medically fragile infants, defined as infants diagnosed with a serious-life threatening health problem within the first 2 months of life as the result of sequelae of prematurity, a serious birth defect, or chronic disease. The mothers and their infants were part of a larger longitudinal study. There were 56 preterms (70.9%) and 23full term infants (29.1%) with a variety of chronic health problems. The mean age of the mother s was 26 and more than half had high school education. There were 40 Caucasian mothers, 28 African American mothers, and 11 mothers from other ethnic backgrounds. Data were collected using the Parental Perception of Severity Scale, the Child Health Worry Scale, and the Parental Stressor Scale: Infant Hospitalization. Technological dependence and other infant health variables were collected from the medical record. There were no differences in perceived severity or worry about the child's health between mothers of infants with different chronic health diagnoses. Significant reductions in perception of severity from admission to the data collection point were found only in mothers with infants in the chronic lung disease, gastrointestinal disease, and other disease categories. Hierarchical regression exploring predictors of maternal worry indicated that mother's age and educational level, and maternal stress related to the infant's appearance and behavior predicted 55% of the variance in maternal worry. Findings suggested that older mothers and mothers with a lower educational level need addition interventions to help them with worries related to their child's health status. In addition, stress related to their infant's appearance and behavior appeared to impact on worry about the child's health status suggesting the need for intervention with mothers of medically fragile infants which focus on understanding and coping with their child's appearance and behavior during hospitalization. 8117 perceptions of maternal role and strategies used by mothers of critically ill children: a grounded theory investigation Louise M. Niemer The majority of literature relative to parents of critically ill children has focused largely on identifying parental stressors, and parents' self-identified needs relative to the pediatric intensive care experience. In general, stressors and needs are affiliated closely parental role issues. However, specific issues related to the parental role have not received attention. Hence, the purpose of this study was to investigate the (1) perceived role of mothers with critically ill children, (2) factors impacting upon their role, and (3) strategies employed my mothers to accomplish their role. A grounded theory design was selected. This approach is based upon symbolic interactionism which asserts that the actions of individuals are derived from their understanding of the meanings symbolized by the actions of others. Thus, interactions proceed in a reciprocal symbolic way. Data were collected through guided informal interviews with twelve mothers from a large metropolitan university-based medical center in the mid-eastern United States. A core variable of "being there" readily and consistently emerged as mothers' perceived role. Being there was constituted by (1) emotionally sustaining the child, (2) monitoring information and attributes of the care situation, (3) enabling and facilitating the child's care, and (4) protecting the child. Factors which adversely affected being there involved elements which precluded mothers' presence in the critical care unit. These included (1) unit policies and practices, and (2) mothers' inability to remain calm for their children. Factors which facilitated being there entailed (1) thoughtful and caring nurses and physicians, and (2) being appraised of the child's status and progress, and of anticipated events. A core process variable of "securing presence" was identified. To secure presence, mother's (1) acquiesced to the rules and policies set forth by unit staff/policy, (2) disregarded their own needs, and (3) derived strength through prayer, and the support and encouragement of others, usually husbands. The results of this study have provided a clearer understanding of mothers' perceived role and actions relative to their critically ill child. Theoretically, the results have strong implications for the therapeutic nursing encounter, the unity and interrelatedness within family systems, and family-centered nursing (which is commonly espoused philosophy within many pediatric acute care facilities). The education of nurses in the arena of therapeutic nursing actions, and the integral nature of families is likewise informed by these results. Implications for practice include evaluation of the purpose and outcome of policies and practices which restrict parents presence with their critically ill child, and developing policies and interventions which advance the maternal role. In this study, husbands, mother's of other children, and close family members played a crucial supportive role for mothers'. Examination of the role that others play is recommended for future research. An investigation that seeks to identify nurses' perceptions of proper parental role and how they strategize to influence this could provide a clearer understanding of interactions from the "other side of the fence".en_GB
dc.date.available2011-10-27T14:39:50Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:39:50Z-
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.