Parental stress: a study from a pediatric intensive care unit in Mangalore

Binoop Sampath Kumar, K. Shreedhara Avabratha


Background: Pediatric intensive care unit (PICU) is a highly stressful environment to most parents. Knowledge of stress allows us to plan counselling strategies for the suffering parents. The objectives were to identify common parental stressors during their child’s critical illness and to examine the relationship of demographic variables with their stress.
Methods: It was a prospective observational study done in PICU of a tertiary care medical college hospital in Mangalore. One hundred parents of children (1 month to 15 years) admitted to PICU for at least 24 hours were interviewed using the Parental Stress Scale (PSS: PICU), which rates 22 factors on a scale from 1 (not stressful) to 5 (extremely stressful). The demographic and clinical characteristics of children were also recorded and analysed statistically.
Results: The average parental stress score was 3.5. The main causes of extremely stressful situations were the sight of their child being unresponsive, sight of monitors & equipment in PICU, other sick children in PICU, crises in other children in the PICU. Parents of children who got admitted in PICU for the first time were more stressed. Younger parents were more stressed than older parents, irrespective of the illness and clinical status. Age of the child, sex, socioeconomic status, urban/rural, father/mother did not vary stress levels, all had similar stress level (score>3). Among the procedures, majority (52%) parents felt intravenous cannulation as more stressful followed by blood sampling (43%).
Conclusions: Young parents and first PICU admission were more stressful. Socioeconomic status, residential area and age of children did not affect level of stress. Many of these stress factors can be looked into and remedial steps can be taken to relieve some of these stressors.


Parental stress, Pediatric intensive care unit, Demographic factors

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Balluffi A, Kassam-Adams N, Kazak A, Tucker M, Dominguez T, Helfaer M. Traumatic stress in parents of children admitted to the pediatric intensive care unit. Pediatr Crit Care Med. 2004;5:547-53.

Meyer E, Snelling L, Myren-Manbeck L. Pediatric intensive care: the parent's experience. AACN Clin Issues: Adv Pract Acute Crit Care. 1998;9(1):64-74.

Fisher MD. Identified needs of parents in a pediatric intensive care unit. Crit Care Nurs. 1994;14:82-90.

Miles MS, Carter MC. Coping strategies used by parents during their child’s hospitalization in an intensive care unit. Child Health Care. 1985;14:14-21.

LaMontagne LL, Pawlak R. Stress and coping of parents and children in a pediatric intensive care unit. Heart Lung. 1990;19:416-21.

Miles MS, Carter MC, Spicher C, Hassanein RS. Maternal and paternal stress reactions when a child is hospitalized in a pediatric intensive care unit. Issues Compr Pediatr Nurs. 1984;7:333-42.

Aamir M, Mittal K, Kaushik JS, Kashyap H, Kaur G. Predictors of stress among parents in pediatric intensive care unit: a prospective observational study. Indian J Pediatr. 2014;81(11):1167-70.

Pooni PA, Singh D, Bains HS, Misra BP, Soni RK. Parental stress in a paediatric intensive care unit in Punjab, India. J Paediatr Child Health. 2013;49:204-9.

Carter MC, Miles MS. The parental stressor scale: pediatric intensive care unit. Matern Child Nurs J. 1989;18:187-98.

Kumar N, Gupta N, Kishore J. Kuppuswamy’s socioeconomic scale: updating income ranges for

Kumar BS et al. Int J Contemp Pediatr. 2015 Nov;2(4):401-405

International Journal of Contemporary Pediatrics | October-December 2015 | Vol 2 | Issue 4 Page 405

the year 2012. Indian J Public Health. 2012;56(1):103-4.

Kasper JW, Nyamathi AM. Parents of children in the pediatric intensive care unit: what are their needs? Heart Lung. 1988;17:574-81.

Nizam M, Norzila MZ. Stress among parents with acutely ill children. Med J Malaysia. 2001;56:428-34.

Needle JS, O’Riordan M, Smith PG. Parental anxiety and medical comprehension within 24 hours of a child's admission to the pediatric intensive care unit. Pediatr Crit Care Med. 2009 Nov;10(6):668-74.

Graves JK, Ware ME. Parents’ and health professionals’ perceptions concerning parental stress during a child’s hospitalization. Child Health Care. 1990;19:37-42.

Haines C, Perger C, Nagy S. A comparison of stressors experienced by parents of intubated and non-intubated children. J Adv Nurs. 1995;21:350-5.

Eberly TW, Miles MS, Carter MC, Hennessey J, Riddle I. Parental stress after the unexpected admission of a child to the intensive care unit. CCQ. 1985;8:57-65.

Miles MS, Mathes M. Preparation of parents for the ICU experience: what are we missing? Child Health Care. 1991;20:132-7.

Scott LD. Perceived needs of parents of critically ill children. J Soc Pediatr Nurs. 1998;3:4-13.

Board R, Ryan-Wenger N. Stressors and stress symptoms of mothers with children in the PICU. J Pediatr Nurs. 2003;18(3):195-202.

Rei RM, Fong C. The Spanish version of the parental stressor scale: pediatric intensive care unit. J Pediatr Nurs. 1996;11(1):3-9.