The Study Of Illness Uncertainty,Family Hardiness And Resilience In Parents With Severely Ill Children

Objective:To investigate the level of illness uncertainty,family hardiness and resilience in parents with severely ill children,analyze the present situation and its influencing factors,as well as explore the correlation among parents’ illness uncertainty,family hardiness and resilience,so as to provide evidence-based basis for family intervention of severely ill children.Methods:A multi-center cross-sectional survey was conducted in 315 parents of severely ill children in pediatric intensive care units from 4 Grade A tertiary specialized hospitals or general hospitals in Fujian Province.All respondents were investigated using General demographic data,the Pediatric Critical Illness Score,the Parent’s Perception Uncertainty Scale(PPUS),the Family Hardiness Index(FHI)and the Conner-Davidson Resilience Scale(CD-RISC).The data were analyzed with descriptive statistical methods,t-test,One-Way ANOVA,chi-square test,Mann-Whitney U rank sum test,Spearman correlation and Binary logistic regression.A structural equation model of family hardiness in mediating resilience and illness uncertainty was built with Amos26.0 software.Data analyses were performed with SPSS 25.0,and p values < 0.05 were considered statistically significant.Results:1.Descriptive analysis(1)The total mean score of parents’ illness uncertainty for their children was(89.22 ±13.88)points,where 264(83.81%)were in the middle level.The mean score of total items was(2.88±0.45)points.Regarding the dimensions,the total scores of ambiguity(40.00±8.03)points and the average score of item(3.08±0.62)points were the highest,followed by that of complexity(23.18±4.62),lack of information(13.41±2.85),unpredictability(12.63±2.24).(2)The total mean score of family hardiness was(42.92±8.08)points,and the total item average score was(2.15±0.40)points.Regarding the dimensions,the score for commitment was(21.45±4.37)points,for control was(11.10±3.68)points and for challenge was(10.37±2.15)points.(3)The total mean score of resilience was(63.38 ±15.89)points,and the total item average score was(2.54±0.64)points.With respect to dimension,the score for tenacity was(32.35±9.29)points,for strength was(21.49±5.34)points,and for optimism was(9.55±2.65)points.2.Influencing factors analysis(1)The univariate analysis showed that the level of illness uncertainity was statistically different among family residence,number of offspring,family hardiness and resilience(P<0.05).(2)The binary logistic regression analysis showed that family residence,number of offspring,family hardiness and resilience were the main factors that affected the level of illness uncertainty of parents with severely ill children(P<0.05);the OR for family residence were 2.38(95%CI 1.132～5.012),the OR for number of offspring was 2.130(95%CI 1.181～3.841),the OR for family hardiness was 0.935(95%CI 0.888～0.985)and the OR for resilience was 0.954(95%CI 0.931～0.978),respectively.3.Correlation analysisFor severely ill children in Pediatric Intensive Care Unit,the total score and each dimension of their partents’ illness uncertainty were negatively correlated with family hardiness and resilience(P<0.01).However,the total score and each dimension of resilience were positively correlated with family hardiness(P<0.01).4.Mediating effect analysisResilience had both direct and indirect effects on illness uncertainty.Family hardiness could partly moderate the relation between resilience and illness uncertainty of parents.Conclusion:1.It suggested that the parents of severely ill children were generally at a medium level of illness uncertainty,and the level of family hardiness and resilience was relatively low.2.Family residence,number of offspring,family hardiness and resilience influence illness uncertainty of parents.3.Family hardiness was closely related with family residence,marriage status,age of children and the score of Pediatric Critical Illness.4.Relationship with children,residence,job,monthly family income,gender and age of children affected the level of resilience.5.Illness uncertainty had significant negative correlations with family hardiness and resilience.Significant positive correlation exists between resilience and family hardiness.6.Family hardiness partly mediate the relation between resilience and illness uncertainty.