Factors Associated With Posttraumatic Growth In Parents Of Children Who Have Undergone Surgery For Congenital Disease

Objective:The aim was to explore the role of emotional intelligence, social support, self-efficacy, posttraumatic stress symptoms (PTSS) and resilience in the experience of posttraumatic growth (PTG) for parents of children who have undergone surgery for congenital disease at pediatric surgery department in China.Methods:A questionnaire survey was carried out in208parents of children who have undergone surgery for congenital disease at pediatric surgery department in China during hospitalization. PTG was measured by the Posttraumatic Growth Inventory (PTGI), emotional intelligence by33-item Emotional Intelligence Scale (EIS), social support by the Perceived Social Support Scale (PSSS), self-efficacy by the General Self-Efficacy Scale (GSES), resilience by the10-item Connor-Davidson Resilience Scale (CD-RISC10) and PTSS by the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Hierarchical multiple regression analyses were used to explore the best predictors. The Statistic Package for the Social Sciences (SPSS version17.0) was used for analyses. Demographic variables were analyzed using descriptive statics. Two-tailed Pearson correlations and one-way analyses of variance (ANOVAs) were used to examine the relationship between PTG and demographic and other factors. Predictors of PTG were evaluated using a hierarchical regression analysis, with order of entry of variables. Path analysis, using AMOS16.0, was performed to examine parents’PTG path.Results:1.54.3%parents reported some degree of PTG, with a mean PTGI total score of M=52.44, SD=20.20, range=1-95. The highest scores were found for personal strength.2. One-way ANOVAs revealed significant differences in PTG based on demographic variables such as age groups, education level of parents. Meanwhile, PTG was significantly correlated with parents’age, r=-0.14, P<0.05.3. Parents met the criteria of PTSD symptoms reported higher level of growth compared with those who failed to meet the criteria (P<0.001). Furthermore, the correlation analysis showed that there were significantly positive relations between PTSS and PTG, as well as the PTG subscales (r=0.15-0.29, P<0.05, P<0.01).4. PTG was significantly and positively related to emotional intelligence, resilience and self-efficacy (total P<0.05). Further, there was no significant relationship between the perceived social support and PTG. But the subscales "friends support"and "other support" of PSSS was significantly related to PTG, respectively.5. Hierarchical multiple regression analyses indicated that34%variance of PTG was explained by emotional intelligence and self-efficacy. Moreover, after entering the resilience and PTSS factors, the sum of variance increased by8%(P<0.001). Resilience and PTSS were the partial mediation of the relationship between emotional intelligence and PTG; the full mediation of the relationship between self-efficacy and PTG. The PTSS had moderating effect to the relationship of perceived social support and PTG.6. Path analysis posited that PTSS and resilience could mediate between emotional intelligence, perceived social support and self-efficacy on the one hand and growth on the other. The exogenous variables were emotional intelligence, perceived social support and self-efficacy; the mediating variables were PTSS and resilience; the dependent variable was growth. This analysis yielded good adjusted goodness of fit:χ2=2.366, df-2,χ2/df=1.183; P=0.306; CFI=0.999; GFI=0.996; AGFI=0.960; RMSEA=0.030. Conclusions:1. Parents of children who have undergone surgery for congenital disease at dediatric surgery department had certain level of PTG, with a positive rate of54.3%.2. There were significantly differences in education level of the parents. Parents with order age had higher level of PTG and parents with moderate education level had the highest level of growth.3. Factors, such as personal resources (emotional intelligence, self-efficacy), environmental resources (perceived social support) all predicted the PTG. Resilience and PTSD symptoms were the mediators of the predictors and PTG.