Development of a screening measure of stress for parents of children hospitalised in a Paediatric Intensive Care Unit

Abstract

Background: Having a child admitted to intensive care is a highly stressful experience for parents; however there is a lack of screening instruments of parental stress in that context, which would be useful for both, research and clinical purposes.

Objectives: (1) To validate a brief measure of parental stress based on the Parental Stressor Scale: Paediatric Intensive Care Unit (PSS:PICU), (2) to study which environmental factors of the PICU are more stressful in a sample of Spanish parents, and (3) to study which variables are related to higher levels of stress among this group.

Method: 196 Spanish parents completed the Abbreviated PSS: PICU (A-PSS:PICU) and a general stress scale (the Perceived Stress Scale) upon their child's discharge to test the convergent validity of the tool. Three months later, they were assessed anxiety and depression using the Hospital Anxiety and Depression Scale, and posttraumatic stress with the Davidson Trauma Scale in order to test the predictive validity of the A-PSS:PICU.

Results: Two factors emerged from Confirmatory Factor Analyses, (1) stress due to child's condition and (2) stress related to PICU's staff. The A-PSS:PICU showed adequate reliability and convergent and predictive validity. The most stressful aspects were the behaviours and emotional responses of their child and the loss of their parental role. Age, gender, child's condition, length of admission, spiritual beliefs, and mechanical ventilation were associated to parental stress scores.

Conclusion: The A-PSS:PICU is a reliable and valid measure. Parental stress should be screened during a child's PICU admission to identify parents at risk of post-discharge distress.

Keywords: Assessment of stress; PICU; Paediatric Intensive Care Unit; Parental stress; Psychometric properties.