Original Article

Reducing Maternal Stress in Pediatric Hospitalization during the COVID-19 Pandemic by Improving Family-Centered Care with Bedside Telehealth: A Pilot Randomized Clinical Trial

Abstract

Objective: Stress and anxiety in the mother as one of the most important members of the child's health can delay recovery and prolong hospitalization of the child. However, families feel very anxious or stressed because of the limitations imposed by COVID-19; therefore, it is important for physicians and nurses who work with children and families to recognize and reduce family stress. This study aimed to investigate the effect of implementing an educational-supportive program on improving family-centered care with bedside telehealth.

Method: In this clinical trial, 40 parents with hospitalized children were selected and randomly assigned to control and intervention groups. The intervention group received a supportive training program, including teaching parental roles and supportive methods for the child and mother during the illness, while nurse counseling and support role was performed virtually as part of the intervention. After the virtual and visual implementation of the training, the father established online video communication with the child and the mother as the primary caregiver. Data collection tools were a demographic questionnaire and Stress Response Inventory (SRI) completed by the mother before and after seven days of intervention. The control group received routine care.

Results: After the intervention, mothers in the intervention group showed significantly lower levels of stress than before the intervention (P < 0.05). Stress level of mothers in the control group did not demonstrate significant difference before and after the intervention (P > 0.05). Also, a comparison of mothers' stress scores post-intervention showed significant difference between the two groups (P < 0.05).

Conclusion: Planning and maintaining family integrity during the COVID-19 pandemic along with educating and supporting fathers through the supportive role of spouses can reduce stress of mothers with hospitalized children.

1. Commodari E. Children staying in hospital: a research on psychological stress of caregivers. Ital J Pediatr. 2010;36:40.
2. Namnabati M, Abdeyazdan Z, Okhovat F. Stress Decrease in Mothers of Children, Discharged from Pediatric Surgical Units: A Four-staged Follow up Care Program Implementation. Journal of Pediatrics, Perinatology and Child Health. 2019; 3:083-9. DOI:10.26502/JPPCH.74050018
3. Daneshvar Ameri Z, Taghavi Larijani T, Kazem Nejad A, Jafari S. The Effectiveness of Partners’ Learning Method on Anxiety and Stress in Mothers of Children with Cystic Fibrosis. Iran Journal of Nursing. 2017;30(108):23-32.
4. Zeinali J, Mirhaghjou SN, Mirzaei M, Alhani F, Kazem Nezhad Leili E, Dehghani M. The effect of family centered care on meeting parental information needs of‎ hospitalized children. Journal of holistic nursing and midwifery. 2012;22(1):30-7.
5. Valizadeh F, Ghasemi S. Medical Staff Attitude toward Parents' Participation in the Care of their Hospitalized Children. Journal of Hayat. 2008;14(1):69-76.
6. Ghaderi S, Alaee Karahrudi F, Yousefi Chaijan P, Nasiri Oscui N. Fathersʼ participation in the care of hospitalized child in pediatric intensive care unit on fathersʼ stress and coping strategies. Journal of Arak University of Medical Sciences. 2014;16(10):61-9.
7. Hart JL, Turnbull AE, Oppenheim IM, Courtright KR. Family-Centered Care During the COVID-19 Era. J Pain Symptom Manage. 2020;60(2):e93-e7.
8. Dokken D, Ahmann E. Resources and Support to Maintain the'Essence'of Patient-and Family-Centered Care during COVID-19. Pediatric nursing. 2020;46(3):154-5.
9. de Cock ESA, Henrichs J, Klimstra TA, Janneke BMMA, Vreeswijk C, Meeus WHJ, et al. Longitudinal Associations Between Parental Bonding, Parenting Stress, and Executive Functioning in Toddlerhood. J Child Fam Stud. 2017;26(6):1723-33.
10. Bostanabad MA, Areshtanab HN, Balila M, Jafarabadi MA, Ravanbakhsh K. Effect of a supportive-training intervention on mother-infant attachment. Iranian Journal of Pediatrics. 2017;27(6): e10565.
11. Matricardi S, Agostino R, Fedeli C, Montirosso R. Mothers are not fathers: differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta Paediatr. 2013;102(1):8-14.
12. Schmeer K. Father absence due to migration and child illness in rural Mexico. Soc Sci Med. 2009;69(8):1281-6.
13. Nomaguchi K, Brown SL, Leyman TM. Fathers' Participation in Parenting and Maternal Parenting Stress: Variation by Relationship Status. J Fam Issues. 2017;38(8):1132-56.
14. Kress V, Steudte-Schmiedgen S, Kopp M, Förster A, Altus C, Schier C, et al. The Impact of Parental Role Distributions, Work Participation, and Stress Factors on Family Health-Related Outcomes: Study Protocol of the Prospective Multi-Method Cohort "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Front Psychol. 2019;10:1273.
15. Coyne I, Murphy M, Costello T, O'Neill C, Donnellan C. A survey of nurses' practices and perceptions of family-centered care in Ireland. J Fam Nurs. 2013;19(4):469-88.
16. Coats H, Bourget E, Starks H, Lindhorst T, Saiki-Craighill S, Curtis JR, et al. Nurses' Reflections on Benefits and Challenges of Implementing Family-Centered Care in Pediatric Intensive Care Units. Am J Crit Care. 2018;27(1):52-8.
17. Koh KB, Park JK, Kim CH, Cho S. Development of the stress response inventory and its application in clinical practice. Psychosomatic medicine. 2001;63(4):668-78.
18. Hein S, Bick J, Issa G, Aoude L, Maalouf C, Awar A, et al. Maternal perceptions of father involvement among refugee and disadvantaged families in Beirut, Lebanon. PLoS One. 2020;15(3):e0229670.
19. Gabbie S, Man K, Morgan G, Maity S. The development of a family liaison team to improve communication between intensive care unit patients and their families during the COVID-19 pandemic. Arch Dis Child Educ Pract Ed. 2021;106(6):367-9.
20. Jabraeili M, Arshadi M, Namdar H, Ghojazadeh M, Jafarpour Z, Najafi F. Correlation of perceived nursing support with stress and self-confidence among the mothers of infants with congenital gastrointestinal anomalies. Nursing and Midwifery Studies. 2018;7(4):163-7.
21. Gilson KM, Davis E, Gains J, Brunton S, Williams K, Reddihough D. Experiences and barriers to accessing mental health support in mothers of children with a disability. Child Care Health Dev. 2021;47(5):697-704.
22. Zablotsky B, Bradshaw CP, Stuart EA. The association between mental health, stress, and coping supports in mothers of children with autism spectrum disorders. J Autism Dev Disord. 2013;43(6):1380-93.
23. Yuan R, Xu QH, Xia CC, Lou CY, Xie Z, Ge QM, et al. Psychological status of parents of hospitalized children during the COVID-19 epidemic in China. Psychiatry Res. 2020;288:112953.
24. Hemdi A, Daley D. The Effectiveness of a Psychoeducation Intervention delivered via WhatsApp for mothers of children with Autism Spectrum Disorder (ASD) in the Kingdom of Saudi Arabia: A randomized controlled trial. Child Care Health Dev. 2017;43(6):933-41.
25. Castel S, Creveuil C, Beunard A, Blaizot X, Proia N, Guillois B. Effects of an intervention program on maternal and paternal parenting stress after preterm birth: A randomized trial. Early Hum Dev. 2016;103:17-25.
26. Hoffenkamp HN, Tooten A, Hall RA, Braeken J, Eliëns MP, Vingerhoets AJ, et al. Effectiveness of hospital-based video interaction guidance on parental interactive behavior, bonding, and stress after preterm birth: A randomized controlled trial. J Consult Clin Psychol. 2015;83(2):416-29.
27. Bendixen RM, Elder JH, Donaldson S, Kairalla JA, Valcante G, Ferdig RE. Effects of a father-based in-home intervention on perceived stress and family dynamics in parents of children with autism. Am J Occup Ther. 2011;65(6):679-87.
Files
IssueVol 17 No 4 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v17i4.10684
Keywords
COVID-19 Fathers Hospitalization Mothers Pediatrics Stress

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Khaksar S, Maroufi M, Kalhor F. Reducing Maternal Stress in Pediatric Hospitalization during the COVID-19 Pandemic by Improving Family-Centered Care with Bedside Telehealth: A Pilot Randomized Clinical Trial. Iran J Psychiatry. 2022;17(4):361-368.