Miles M S, Carter M C, Hennessey J, Eberly T W, Riddle I
University of North Carolina, Chapel Hill.
Matern Child Nurs J. 1989 Fall;18(3):207-19.
This study was designed to evaluate a theoretical framework, based on stress theory, which identifies potential sources of stress in parents of children hospitalized in an intensive care unit (ICU). The framework suggests that personal, situational, and ICU environmental stress stimuli interactively impact on the overall parental stress response. Multiple regression techniques were used to evaluate the interaction of personal family factors, situational stimuli, and ICU environmental stressors and to assess their impact upon the overall parental stress response. Data were collected from 510 parents of children hospitalized in one of five midwestern ICUs. Instruments used were the Parental Stressor Scale: Pediatric ICU (Carter & Miles, 1984), the State-Trait Anxiety Scale (Spielberger, Gorsuch, & Luschene, 1970), the Review of Life Experiences Scale (Hurst, Jenkins, & Rose, 1978), and a personal-experiential questionnaire. Results indicate that a number of personal and situational variables were predictive of higher stress. In addition two aspects of the ICU environment contributed the most variance to the overall stress of parents: alterations in the parental role and the child's behavioral and emotional responses. In evaluating the full framework, one personal variable (Trait Anxiety); two situational variables (perception of severity and type of admission); and three ICU environmental dimensions, (parental role alteration, the child's behavior and emotional response, and the child's appearance) significantly predicted stress (State Anxiety). The findings support the theoretical framework underlying this study as a useful model for studying and evaluating parental stress during a child's admission to an ICU. Results also suggest that additional personal family and situational factors, such as uncertainty, may need to be added to the model to more fully predict parental stress responses.
本研究旨在评估一个基于压力理论的理论框架，该框架确定了在重症监护病房（ICU）住院儿童的父母的潜在压力源。该框架表明，个人、情境和ICU环境压力刺激会相互作用，影响父母的整体压力反应。多元回归技术被用于评估个人家庭因素、情境刺激和ICU环境压力源之间的相互作用，并评估它们对父母整体压力反应的影响。数据收集自美国中西部五个ICU之一中住院儿童的510名父母。使用的工具包括《父母压力源量表：儿科ICU》（卡特和迈尔斯，1984年）、《状态-特质焦虑量表》（斯皮尔伯格、戈尔苏奇和卢申，1970年）、《生活经历量表》（赫斯特、詹金斯和罗斯，1978年）以及一份个人经历问卷。结果表明，一些个人和情境变量可预测更高的压力。此外，ICU环境的两个方面对父母的整体压力影响最大：父母角色的改变以及孩子的行为和情绪反应。在评估整个框架时，一个个人变量（特质焦虑）、两个情境变量（对病情严重程度和入院类型的认知）以及三个ICU环境维度（父母角色改变、孩子的行为和情绪反应以及孩子的外表）显著预测了压力（状态焦虑）。这些发现支持了本研究的理论框架，该框架是研究和评估孩子入住ICU期间父母压力的有用模型。结果还表明，可能需要在模型中加入其他个人家庭和情境因素，如不确定性，以更全面地预测父母的压力反应。
