Boonchooduang Nonglak, Jidmahawong Ninlapat, Kungsuwan Supakanya, Seetaboot Sukanlaya, Likhitweerawong Narueporn, Louthrenoo Orawan
Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
BMJ Paediatr Open. 2025 Sep 2;9(1):e003669. doi: 10.1136/bmjpo-2025-003669.
To investigate how parental resilience affects children's health-related quality of life (QoL) following hospital discharge, comparing outcomes between paediatric intensive care and general ward admissions.
Prospective cohort study with 2-month follow-up.
Tertiary care hospital in Thailand (February 2021-August 2022).
100 parent-child dyads (58 paediatric intensive care unit (PICU), 42 general ward) with children aged 4-16 years; 95% completed both assessments.
Parental resilience assessed using the Resilience Quotient questionnaire and children's QoL measured using the Paediatric QoL Inventory 4.0.
Cross-lagged analysis revealed that baseline parental resilience significantly predicted child QoL at follow-up (β=0.426, p=0.038), but baseline child QoL did not significantly predict changes in parental resilience. Hierarchical regression identified changes in parental resilience (β=1.090, p<0.01) and baseline child QoL (β=0.524, p<0.01) as key predictors of later QoL. Parents of general ward patients showed greater improvements in resilience and their children demonstrated significant improvements in social functioning (21.67 vs 8.58 points, p=0.005) and total QoL scores (12.06 vs 4.13 points, p=0.038) compared with the PICU group.
Parental resilience is a significant predictor of children's QoL following hospital discharge, with a unidirectional relationship where parental resilience influences subsequent child outcomes. This association persisted after controlling for demographic and clinical factors, suggesting the potential importance of psychological support for parents during their child's hospitalisation regardless of care setting. Longitudinal studies with longer follow-up periods are needed to validate these findings and assess their clinical significance.
探讨父母的心理韧性如何影响出院后儿童的健康相关生活质量（QoL），比较儿科重症监护病房和普通病房收治患儿的结局。
前瞻性队列研究，随访2个月。
泰国的三级护理医院（2021年2月至2022年8月）。
100对亲子（58对来自儿科重症监护病房（PICU），42对来自普通病房），儿童年龄为4至16岁；95%完成了两项评估。
使用心理韧性商数问卷评估父母的心理韧性，使用儿童生活质量量表4.0测量儿童的生活质量。
交叉滞后分析显示，基线时父母的心理韧性显著预测随访时儿童的生活质量（β=0.426，p=0.038），但基线时儿童的生活质量并未显著预测父母心理韧性的变化。分层回归确定父母心理韧性的变化（β=1.090，p<0.01）和基线时儿童的生活质量（β=0.524，p<0.01）是后期生活质量的关键预测因素。与PICU组相比，普通病房患儿的父母心理韧性改善更大，其子女在社会功能（21.67分对8.58分，p=0.005）和总生活质量得分（12.06分对4.13分，p=0.038）方面有显著改善。
父母的心理韧性是出院后儿童生活质量的重要预测因素，存在单向关系，即父母的心理韧性影响随后的儿童结局。在控制了人口统计学和临床因素后，这种关联仍然存在，这表明无论护理环境如何，在孩子住院期间为父母提供心理支持具有潜在的重要性。需要进行更长随访期的纵向研究来验证这些发现并评估其临床意义。
