646 - Experiences of stress and resilience among mothers and fathers during their child’s hospitalization: an international qualitative analysis

Publication Number: 3626.646

Maram M. Kiran, University of California, San Francisco, School of Medicine, Fresno, CA, United States; Renee Mehra, University of California, San Francisco, San Francisco, CA, United States; Linda S.. Franck, University of California, San Francisco, San Francisco, CA, United States

Background: Child hospitalization is a significant parental stressor. However, little is known about the experiences of parents in different countries.

Objective: To explore experiences of stress and resilience among parents of hospitalized children.

Design/Methods: We conducted a longitudinal prospective cohort study among parents in 14 countries staying for >3 nights at a nearby Ronald McDonald House® (n=34) during their child's hospitalization. We analyzed parents' responses to open-ended questions in the hospital discharge survey using the biopsychosocial model of stress, Hatala's resilience model, and a reflexive thematic approach.

Results: Among 1,751 parents surveyed at discharge, 73% wrote in comments about their experiences (81% mothers; 16% fathers). The most common reasons for the child's hospital care were oncology/hematology (26.8%), cardiology (26.4%), and neonatal (20.2%) conditions. We found four themes related to sources of stress for parents during their child's hospitalization: (1) child's health status, (2) parental psychological distress, (3) separated family members' physical and emotional needs, and (4) family socioeconomic barriers to accessing healthcare and staying with their child. Mothers more often shared concerns about the hospital experience, including the child's health status, family separation, and isolation; whereas fathers expressed concerns about taking care of things at home, interpersonal problems, economic barriers, and uncertainty. Parents across all regions described socioeconomic barriers and psychological stress. Parents from Asia-Pacific, Latin America, and the U.S. more often discussed the child's health status. Parents, except those from Europe, often described family separation. Parental resilience emerged across four themes: (1) physical and biological strengths, including housing and food, (2) psychological resourcefulness, including optimism and gratitude, (3) interpersonal and emotional skills, including social support, and (4) spiritual capabilities, including hope and faith. Mothers more often described physical and biological strengths. Parents from Latin America more often discussed faith, and those from Asia-Pacific discussed psychological resourcefulness.

Conclusion(s): Globally, parents described similar experiences of stress and resilience during their child's hospitalization, with variations by parental role and region. These findings highlight the need for developing role and regionally tailored interventions that can target modifiable stressors and strengthen resilience to improve family well-being during their child's hospital stay.

Figure 1. Common sources of stress among parents of hospitalized children (adapted from the biopsychosocial model of stress)


Figure 2. Common sources of resilience among parents of hospitalized children (adapted from Hatala's Model of Resilience)