Parent Coping Support Interventions During Acute Pediatric Hospitalizations: A Meta-Analysis

Doupnik, S. K.; Hill, D.; Palakshappa, D.; Worsley, D.; Bae, H.; Shaik, A.; Qiu, M. K.; Marsac, M.; Feudtner, C.

Pediatrics. 2017 Aug 19; 140(3)

Abstract

CONTEXT: Parents may experience psychological distress when a child is acutely hospitalized, which can negatively affect child outcomes. Interventions designed to support parents' coping have the potential to mitigate this distress. OBJECTIVE: To describe interventions designed to provide coping support to parents of hospitalized children and conduct a meta-analysis of coping support intervention outcomes (parent anxiety, depression, and stress). DATA SOURCES: We searched Pubmed, Embase, PsycINFO, Psychiatry Online, and Cumulative Index to Nursing and Allied Health Literature from 1985 to 2016 for English-language articles including the concepts "pediatric," "hospitalization," "parents," and "coping support intervention." STUDY SELECTION: Two authors reviewed titles and abstracts to identify studies meeting inclusion criteria and reviewed full text if a determination was not possible using the title and abstract. References of studies meeting inclusion criteria were reviewed to identify additional articles for inclusion. DATA EXTRACTION: Two authors abstracted data and assessed risk of bias by using a structured instrument. RESULTS: Initial searches yielded 3450 abstracts for possible inclusion. Thirty-two studies met criteria for inclusion in the systematic review and 12 studies met criteria for inclusion in the meta-analysis. The most commonly measured outcomes were parent depression, anxiety, and stress symptoms. In meta-analysis, combined intervention effects significantly reduced parent anxiety and stress but not depression. Heterogeneity among included studies was high. LIMITATIONS: Most included studies were conducted at single centers with small sample sizes. CONCLUSIONS: Coping support interventions can alleviate parents' psychological distress during children's hospitalization. More evidence is needed to determine if such interventions benefit children.

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