Research

What factors play into parental stress and anxiety during their child’s PICU admission and follow-up? 

To understand the complexities of parental stress and anxiety, Zaina Alzawad, PhD, MANP, M.Ed., RN, Nurse Scientist at Stanford Health Care’s Office of Research Patient Care Services, and her dedicated team, have recently concluded a pilot study, the results of which have now been published in the Journal of Pediatric Health Care in January 2024. This insightful research aimed to dissect the various pre-existing and peri-traumatic elements contributing to the emotional turmoil parents face during and after their child's stay in the Pediatric Intensive Care Unit (PICU).

Key findings:

• Income's Role: A significant correlation was found between a family's income level and the anxiety experienced during a child's PICU admission. Particularly, middle-income parents reported heightened anxiety, with low-income families similarly affected.
• Influence of Parental Attributes: Factors such as the parents' age, racial background, and personal history of adverse childhood experiences (ACEs) were notably linked to increased stress levels. Especially vulnerable were younger parents and those with a history of ACEs.
• Racial Considerations and Limitations: Although a connection between race and parental stress was observed, the study's limited diversity in participants calls for a cautious interpretation of these findings.
• Post-PICU Concerns: Upon follow-up, parents' anxiety predominantly centered around the fear of their child falling ill again. Moreover, the type of diagnosis—specifically respiratory and cardiac issues—was a major anxiety trigger.
• Educational Influence: The level of parental education also played a role in stress perception, with those holding vocational degrees reporting higher stress compared to their more educated counterparts.

Despite the study’s limitations, including its small  sample size, focus on a single tertiary care center, and the fact that none of the models yielded statistically significant results,  the study underscores the need for healthcare professionals to be particularly supportive of parents grappling with economic hardships or a history of Aces.

Conclusion:

Dr. Alzawad and her team advocate for expanded research to encompass a more diverse participant pool across various healthcare environments. This approach aims to foster a deeper understanding of the dynamics at play and to explore additional factors that might influence parental stress and anxiety in the PICU setting.

This study not only highlights the multifaceted nature of parental anxiety and stress but also serves as a call to action for healthcare providers to adopt a more empathetic and tailored approach to support families during these challenging times.

Link to Study

Written by: Briana Williams

Developing Nurses and Interdisciplinary Teams in Caring Science

Developing Nurses and Interdisciplinary Teams in Caring Science

Aubrey L. Florom-Smith, PhD, RN, AFASMA, Nurse Scientist at Stanford Health Care’s Office of Research Patient Care Services, with colleagues Tina Cartwright, DNP, RN, NPD-BC, NEA-BC, and Peggy Jenkins, PhD, RN, CNE, recently published the article, Developing Nurses and Interdisciplinary Teams in Caring Science in The Journal of Nursing Administration’s February 2024 publication.

During the COVID-19 pandemic in 2020, healthcare workers across more than 100 US hospitals reported experiencing elevated levels of  burnout, stress, workload, fear of infections, and symptoms of anxiety and depression. This period also saw a notable increase in turnover rates within healthcare positions in 2021, exacerbating the challenges of managing the health crisis brought on by the pandemic.

Dr. Florom-Smith and the authors have highlighted the significance of reducing compassion fatigue, burnout, and turnover rates, noting their association with enhanced teamwork, patient experiences, and overall organizational outcomes.

To address this widespread issue, Dr. Florom-Smith and colleagues evaluated the impact of a caring science program on interdisciplinary healthcare professionals in 2022 over a 3-month period. The program involved three sessions and was rooted in caring science, utilizing theory-guided frameworks such as Watson's Caring Science, Rays’ Theory of Bureaucratic Caring, and Rogers’ Diffusion of Innovations Theory.

The evaluation aimed to assess participants' self-reported levels of caring, compassion satisfaction, and their intent to leave at an academic-affiliated community hospital.

Key findings:

Evaluation of participants was conducted before the program, after its completion, and 60 days thereafter, utilizing Watson Caritas measures. Results revealed a statistically significant increase in compassion satisfaction, reflecting an enhanced sense of fulfillment in helping and caring for others among participants.

While not statistically significant, there was observed increase in self-caring, leader caring, and coworker caring. Notably, the goal of achieving zero turnover among program participants was met during the evaluation period.

Conclusion:

The findings suggest that while the caring science intervention proved beneficial for participants, achieving broader organizational goals such as reducing turnover and improving the well-being of nurses and interdisciplinary teams necessitates addressing foundational issues in tandem with implementing caring science-based programs. The authors encourage future studies with the implementation of caring science interventions at the organizational level to create a caring environment while integrating education and enculturation to further develop an evidence-based solution.

Link to the article

Written by: Cynthia Cortez, MSN, RN

Office of Research Patient Care Services Publishes in JAMA