From Bedside Vigilance to Empowered Parent: a Descriptive Qualitative Study of Maternal Involvement in the Pediatric Intensive Care Unit

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2025 Mar 13

PMID 40074985

Authors

Selecia Gwee Lee En

Pei Fen Poh

Qian Wen Sng

Shuen Hwee

Jamie Qiao Xin Ng

Shefaly Shorey

Affiliations

Soon will be listed here.

Abstract

To explore the experiences of mothers of children hospitalized in the Pediatric Intensive Care Unit (PICU) and the factors influencing their involvement in Singapore.Convenience sampling was used to recruit mothers of children aged 0 to 18 years old hospitalized in a PICU for at least 48 h from a public tertiary hospital in Singapore from September to November 2023. Semi-structured interviews were conducted with 13 mothers in person until data saturation was achieved. Thereafter, data were analyzed using thematic analysis. Four themes and thirteen subthemes were identified. The themes were: (1) Emotional roller-coaster, (2) Redefining mother's duties, (3) Collaborating with the healthcare team, (4) Barriers to Maternal Involvement. Conclusions: Mothers felt hopeless and anxious during their child's hospitalization but rarely showed outward signs of emotional distress. Mothers were motivated to be involved in caregiving activities by their desire to reclaim their maternal role. Mothers worked closely together with the healthcare providers. However, maternal involvement was limited by their fear of causing more harm, inconducive spaces, and balancing their sick child and other siblings at home. These findings provide a nuanced insight into maternal experiences and can help to inform enhanced family-centered care hospital policies. Triangulation of findings from PICU healthcare providers and other caregivers such as fathers and siblings is needed to holistically understand the support needs of such families. Practice implications: PICU healthcare providers need to pay greater attention to maternal emotional well-being. After more research on families with children in PICU, hospitals could seek to implement family-centred psychosocial support programs for parents and siblings.

References

Ames K, Rennick J, Baillargeon S . A qualitative interpretive study exploring parents' perception of the parental role in the paediatric intensive care unit. Intensive Crit Care Nurs. 2011; 27(3):143-50. DOI: 10.1016/j.iccn.2011.03.004. View

Colville G, Darkins J, Hesketh J, Bennett V, Alcock J, Noyes J . The impact on parents of a child's admission to intensive care: integration of qualitative findings from a cross-sectional study. Intensive Crit Care Nurs. 2008; 25(2):72-9. DOI: 10.1016/j.iccn.2008.10.002. View

Dahav P, Sjostrom-Strand A . Parents' experiences of their child being admitted to a paediatric intensive care unit: a qualitative study-like being in another world. Scand J Caring Sci. 2017; 32(1):363-370. DOI: 10.1111/scs.12470. View

Engstrom A, Dicksson E, Contreras P . The desire of parents to be involved and present. Nurs Crit Care. 2014; 20(6):322-30. DOI: 10.1111/nicc.12103. View

Penk J, Loke Y, Waloff K, Frank L, Stockwell D, Spaeder M . Unplanned admissions to a pediatric cardiac critical care unit: a review of 2 years' experience. Pediatr Crit Care Med. 2015; 16(2):155-60. DOI: 10.1097/PCC.0000000000000316. View

Broden E, Deatrick J, Ulrich C, Curley M . Defining a "Good Death" in the Pediatric Intensive Care Unit. Am J Crit Care. 2020; 29(2):111-121. PMC: 11288184. DOI: 10.4037/ajcc2020466. View

Wool J, Irving S, Meghani S, Ulrich C . Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review. J Fam Nurs. 2021; 27(2):154-167. DOI: 10.1177/1074840720975869. View

Krefting L . Rigor in qualitative research: the assessment of trustworthiness. Am J Occup Ther. 1991; 45(3):214-22. DOI: 10.5014/ajot.45.3.214. View

Ji J, Yang L, Yang H, Jiang Y, Tang P, Lu Q . Parental experience of transition from a paediatric intensive care unit to a general ward: A qualitative study. J Nurs Manag. 2022; 30(7):3578-3588. DOI: 10.1111/jonm.13716. View

10.

Baker S, Gledhill J . Systematic Review of Interventions to Reduce Psychiatric Morbidity in Parents and Children After PICU Admissions. Pediatr Crit Care Med. 2017; 18(4):343-348. DOI: 10.1097/PCC.0000000000001096. View

11.

Kircanski K, Lieberman M, Craske M . Feelings into words: contributions of language to exposure therapy. Psychol Sci. 2012; 23(10):1086-91. PMC: 4721564. DOI: 10.1177/0956797612443830. View

12.

Meert K, Thurston C, Briller S . The spiritual needs of parents at the time of their child's death in the pediatric intensive care unit and during bereavement: a qualitative study. Pediatr Crit Care Med. 2005; 6(4):420-7. DOI: 10.1097/01.PCC.0000163679.87749.CA. View

13.

Foster M, Whitehead L, Maybee P, Cullens V . The parents', hospitalized child's, and health care providers' perceptions and experiences of family centered care within a pediatric critical care setting: a metasynthesis of qualitative research. J Fam Nurs. 2013; 19(4):431-68. DOI: 10.1177/1074840713496317. View

14.

Morawska A, Calam R, Fraser J . Parenting interventions for childhood chronic illness: a review and recommendations for intervention design and delivery. J Child Health Care. 2014; 19(1):5-17. DOI: 10.1177/1367493513496664. View

15.

Macdonald M, Liben S, Carnevale F, Cohen S . An office or a bedroom? Challenges for family-centered care in the pediatric intensive care unit. J Child Health Care. 2012; 16(3):237-49. DOI: 10.1177/1367493511430678. View

16.

Richards C, Starks H, OConnor M, Doorenbos A . Elements of Family-Centered Care in the Pediatric Intensive Care Unit: An Integrative Review. J Hosp Palliat Nurs. 2017; 19(3):238-246. PMC: 5421392. DOI: 10.1097/NJH.0000000000000335. View

17.

Noyes J . Barriers that delay children and young people who are dependent on mechanical ventilators from being discharged from hospital. J Clin Nurs. 2002; 11(1):2-11. DOI: 10.1046/j.1365-2702.2002.00565.x. View

18.

Falkenburg J, Tibboel D, Ganzevoort R, Gischler S, Dijk M . The Importance of Parental Connectedness and Relationships With Healthcare Professionals in End-of-Life Care in the PICU. Pediatr Crit Care Med. 2018; 19(3):e157-e163. DOI: 10.1097/PCC.0000000000001440. View

19.

Baird J, Rehm R, Hinds P, Baggott C, Davies B . Do You Know My Child? Continuity of Nursing Care in the Pediatric Intensive Care Unit. Nurs Res. 2016; 65(2):142-50. PMC: 4780357. DOI: 10.1097/NNR.0000000000000135. View

20.

Moss K, Healy K, Ziviani J, Newcombe P, Cobham V, McCutcheon H . Trauma-informed care in practice: Observed use of psychosocial care practices with children and families in a large pediatric hospital. Psychol Serv. 2019; 16(1):16-28. DOI: 10.1037/ser0000270. View