Department of Pediatric Hospital Medicine, Children's National Hospital, Washington, DC.
School of Medicine and Health Sciences, The George Washington University, Washington, DC.
Hosp Pediatr. 2022 Jul 1;12(7):673-679. doi: 10.1542/hpeds.2021-006365.
Effective communication between physician and parent promotes a successful alliance with families. The association of parental stress with self-efficacy when communicating during parent-physician interactions is unknown in the context of a pandemic.
Objectives of this study include quantifying and comparing the stress experienced by parents of hospitalized children before and after onset of the COVID-19 pandemic and examining the relationship of stress with self-efficacy in parent-physician communication during interactions throughout hospitalization.
We conducted in-person surveys of parents of children aged 3 months to 17 years hospitalized at a quaternary-level children's hospital, before and after onset of COVID-19. Parents completed 2 validated tools: Parenting Stress Index (PSI-SF) and the Perceived Efficacy in Parent-Physician Interactions (PEPPI), measuring self-efficacy in communicating with physicians. Socioeconomic data were collected. Fisher exact test and t test were used to compare score proportions and means; linear regression was used to evaluate association between PSI-SF and PEPPI with confounder adjustments.
Forty-nine parents were recruited; the majority identified as non-White and female. An inverse relationship was noted between the total stress score and parental self-efficacy, which only attained statistical significance in the post-COVID-19 cohort (P = .02, multivariate P = .044). A significant increase in the mean was observed for subscale scores of Difficult Child (P = .019) and Parent-Child Dysfunctional Interaction after COVID-19 (P = .016).
Elevated parental stress is associated with decreased self-efficacy during parent-physician interactions and it worsened during the pandemic. Future studies should examine the effect of different communication styles on parental stress and self-efficacy during hospitalization.
医生与家长之间有效的沟通有助于建立成功的合作关系。在大流行背景下，父母在与医生互动时交流的压力与自我效能感之间的关联尚不清楚。
本研究的目的包括量化和比较 COVID-19 大流行前后住院儿童父母所经历的压力，并研究压力与住院期间与医生交流时的自我效能之间的关系。
我们对一家四级儿童医院住院的 3 个月至 17 岁儿童的父母进行了面对面调查，分别在 COVID-19 大流行前后进行了调查。父母完成了 2 项经过验证的工具：父母压力指数（PSI-SF）和父母与医生互动的感知效能（PEPPI），用于衡量与医生沟通的自我效能。收集了社会经济数据。使用 Fisher 确切检验和 t 检验比较分数比例和平均值；使用线性回归评估 PSI-SF 和 PEPPI 与混杂因素调整之间的关联。
共招募了 49 名家长；大多数是非裔美国人，女性。总压力评分与父母自我效能之间呈负相关，仅在后 COVID-19 队列中具有统计学意义（P =.02，多元 P =.044）。在 COVID-19 之后，困难儿童（P =.019）和父母-儿童功能失调性互动（P =.016）的子量表评分的平均值均显著增加。
父母的压力升高与父母与医生互动时的自我效能感降低有关，并且在大流行期间恶化。未来的研究应检查不同沟通方式对住院期间父母压力和自我效能的影响。
