Evolution of parental stress and coping processes: a framework for critical care practice.

Crisis theory, stress and coping theory, and research on parental stress and coping during pediatric critical care experiences are integrated into a conceptual framework for understanding, assessing, and ultimately intervening to reduce parental stress and bolster coping. Within this framework, cognitive appraisal of stress, coping and person and situation factors are discussed as important determinants of parents' adaptation to this stressful situation. The nurse's ability to respond to the evolving nature of parental stress and coping processes over the course of the experience enhances the use of the framework in designing coping interventions.