Elsevier

Journal of Pediatric Nursing

Volume 68, January–February 2023, Pages 87-92
Journal of Pediatric Nursing

Identifying parent anxiety and family distress of critically ill children in response to changes in hospital visitation policies during the COVID-19 pandemic

https://doi.org/10.1016/j.pedn.2022.10.008Get rights and content

Highlights

  • A child's admission to a pediatric intensive care unit (PICU) is one of the most stressful and anxiety-provoking situations for parents.

  • Restricting parent presence interrupts the social and emotional relationship and offers less time for bonding..

  • Coronavirus-19 (COVID-19) forced hospitals to make abrupt changes to existing visitation policies.

  • This research provides context for support of careful development and implementation of hospital visitation policies.

Abstract

Purpose

This research study describes parent anxiety and family distress among three study groups of varying restrictions in parent presence for children in the PICU during a pandemic.

Design and methods

A retrospective study was conducted to describe differences in parent anxiety and family distress for parents of children hospitalized before and during the COVID-19 pandemic. Participants fell into three study groups based on the dates of the child's hospital stay and the level of parent and family presence or restriction they experienced. Participants were asked to complete a survey that included basic demographic information along with utilization of the GAD-7 and FDI measures. The data were assessed using descriptive statistics, Fisher's exact test, and the Kruskal-Wallis test.

Results

A total of 82 parents of children hospitalized during the specified times in the PICU participated. There was a statistically significant difference among the three cohorts in diagnoses (respiratory, cardiovascular, and medical-surgical), p ≤0.001. A larger percentage of children of the study participants were hospitalized with respiratory illnesses (62.5%) in the unrestricted study group when compared to the other study groups with higher patient acuity. There was also a statistical significance among the three study groups regarding whether the second parent was able to visit the child during the PICU admission (p = 0.007).

Conclusions

Our study suggests that restricting parent and visitor presence does not increase parent anxiety or family distress during a child's admission to the PICU. The literature widely supports that having a critically ill child is undoubtedly stressful for parents and families, but the most significant causation for the anxiety and stress remains unknown and is likely multifactorial.

Clinical and research implications

Parents who experienced rigid restrictions in parent and visitor presence did not have increased anxiety. Other impactful variables such as a child's mortality risk and the uncertainty of outcome may have impacted anxiety for parents whose children were critically ill. Further research is needed to understand which stressors are most significant, during a critically ill child's hospitalization, from a parent's perspective. Limiting staff and patient exposure to persons who may have contagious illness (restricting parent and family presence) may not in itself lead to increased anxiety and distress for parents and families. This study may provide context for careful development of hospital visitation policies to ensure balance between patient and family centered care and protection from infectious disease.

Keywords

Parent anxiety
Family distress
Parent presence
Visitor restrictions
Critically ill children
COVID-19 pandemic

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