Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Departments of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Pain Symptom Manage. 2019 Aug;58(2):190-197. doi: 10.1016/j.jpainsymman.2019.04.018. Epub 2019 Apr 23.
Parents of seriously ill children hold personal beliefs about what they should do to be good parents. How these beliefs change over time is unknown.
The objectives of this study were to describe the pattern of Good-Parent Beliefs over time, and determine whether parents' hopeful patterns of thinking, affect, and perceived child's health are associated with changes in beliefs at 12 and 24 months.
Our longitudinal sample included 124 parents of 100 children hospitalized with serious illness. We used latent transition models to classify parents into groups with similar Good-Parent Beliefs during the baseline and follow-up periods and modeled the change in good-parent beliefs over time as a function of covariates using generalized linear mixed models.
Two parent belief profiles emerged from the latent transition model: Loved ("Making sure my child feels loved," n = 61 at baseline) and Informed ("Making informed decisions," n = 63 at baseline). At 12 months, 21 parents (20.4%) had moved into the Loved group and no parents transitioned to the Informed group. By 24 months, eight parents transitioned to the Loved group and four to the Informed group (13.04%). Transition into the Loved group was associated with parents' baseline degree of hopeful thinking and positive perceptions of child's health at baseline.
Some parents change their parenting priorities over time. Hopeful patterns of thinking and perception of child health appear to predict change. Clinicians should regularly reevaluate Good-Parent Beliefs over time to promote priority-congruent dialogue.
重病患儿的父母对自己应如何做个好父母持有个人信念。这些信念随时间的变化尚不清楚。
本研究的目的是描述好父母信念随时间的变化模式，并确定父母充满希望的思维、情绪和对孩子健康的感知模式是否与 12 个月和 24 个月时信念的变化相关。
我们的纵向样本包括 124 名患有重病住院儿童的父母。我们使用潜在转变模型将父母分为基线和随访期间具有相似好父母信念的组，并使用广义线性混合模型将好父母信念随时间的变化作为协变量的函数进行建模。
潜在转变模型得出了两种父母信念特征：关爱型（“确保孩子感受到爱”，n=61 人，基线）和知情型（“做出知情决策”，n=63 人，基线）。在 12 个月时，有 21 名父母（20.4%）转变为关爱型组，没有父母转变为知情型组。到 24 个月时，有 8 名父母转变为关爱型组，4 名父母转变为知情型组（13.04%）。转变为关爱型组与父母基线时的乐观程度和对孩子健康的积极看法有关。
一些父母随时间改变其育儿优先事项。充满希望的思维模式和对孩子健康的感知似乎可以预测变化。临床医生应定期重新评估好父母信念随时间的变化，以促进与优先事项一致的对话。
