Construction Of A Migration Stress Intervention Program For Parents Of Children With Congenital Heart Disease Transferred Out Of The IC

Objectives:（1）To investigate the current status of relocation stress and the real experience for relocation stress of parents of children with congenital heart disease transferred from the ICU.（2）To construct an intervention program for the relocation stress of parents of children with congenital heart disease transferred out of the ICU,and to provide a basis for reducing the level of parental relocation stress.Methods:（1）The part of the current status and experience of relocation stress:Based on the cognitive behavioral theory,simultaneous triangulation was adopted.Qualitative research and quantitative research were carried out simultaneously and independently.Cross-sectional survey research methods were adopted.224 parents of children with congenital heart disease transferred from the ICU in three tertiary hospitals in Changsha were selected as study subjects during January to September in 2022.The patients who met the criteria were investigated by a general information questionnaire,Family Relocation Stress Scale,and Parental Caring Behaviors Scale.Descriptive analysis,t-test,Single Factor ANOVA,Pearson Correlation Analysis,and multiple linear regression were used to analyze the data.Phenomenological research methods are adopted.21 parents of children with congenital heart disease transferred from ICU in three tertiary hospitals in Changsha were selected as semi-structured interview subjects during January to May in 2022.Semi-structured interviews and data collection were conducted on parents who met the criteria within 24～48 hours after the child was transferred out of ICU.Colaizzi’s seven-step analysis method was used to analyze the data.（2）The part of the construction of the intervention program:Expert meetings,expert consultation,and feasibility verification were used to structure and revise the intervention program.The level of motivation,authority,coordination and concentration of opinions of experts were used to filter items.At the same time,combined with the experts’revisions,the items were revised after full discussion by the research team.8 parents of children with congenital heart disease transferred from the ICU in a tertiary hospital in Changsha were selected as study subjects.The patients who met the criteria were undergone feasibility verification by a general information questionnaire,Family Relocation Stress Scale,Parental Caring Behaviors Scale,Generalized Anxiety Disorder,Subjective Units of Disturbance Scale,and Feedback questionnaire of intervention program.Descriptive analysis was used to analyze the data.Results:（1）The part of the current status and experience of relocation stress:The average score of relocation stress of parents of ICU transfer congenital heart disease patients was（42.80±6.52）;Correlation analysis showed that caregiver behavior was negatively correlated with relocation stress（r=-0.259,P<0.05）,and was negatively correlated with three dimensions（r=-0.225,P<0.05;r=-0.133,P<0.05;r=-0.197,P<0.05）,and the results of multivariate analysis showed that the gender,education level,and caregiver behavior level of parents were independent influencing factors of relocation stress（P<0.05）,which could explain 11.10%of the total variability(F=9.160,R²=0.111,R_adj²=0.099).The content of the interview was summarized into 3 themes,a total of 12 sub-themes,theme 1:experiencing transformation challenges physical and mental feelings,including contradictory concepts and emotional experience,role change and self-sublimation,and prominent physical and mental distress;Theme 2:strong demand for information,including cognitive misunderstanding,lack of understanding of pre-transfer preparation information,lack of post-transfer care knowledge,lack of post-transfer care behavior skills,uncertain long-term recovery status,and information provision methods to be optimized;Theme 3:urgent need for external support,including the need for medical institution resources,the need for peer learning,and the need for family gain.（2）The part of the construction of the intervention program:After two rounds of expert meetings,three rounds of expert consultation,and taking into account parents’suggestions,the final draft of the intervention program was formed.Intervention methods include:three interventions;The duration of the intervention was10～30min;The first intervention method was group meeting and one-to-many guidance,and the migration manual was issued,and the second and third intervention methods were individual meetings and one-to-one guidance;Eleven intervention targets and corresponding interventions.At the same time,the migration manual includes 12 chapters.Conclusions:（1）The relocation stress of parents of children with congenital heart disease transferred from the ICU is moderate.The relocation stress was more severe in the mother,parents with high school education and below,and parents with low levels of caregiver behavior.（2）The intervention program of relocation stress for parents of children with congenital heart disease transferred from the ICU is scientific,applicable,and feasible.