Trajectory of Parenting Confidence among Parents of Infants with Complex Chronic Conditions

复杂慢性病婴儿父母的育儿信心轨迹

• 批准号: 9324396
• 负责人: Ashlee Jones Vance
• 金额: $ 3.48万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2019-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9324396
• 关键词: Awareness; Belief; Caring; Child; Child Care; Child Development; Child Rearing; Child health care; Childhood; Chronic; Communication; Complex; Data; Decision Making; Development; Diagnosis; Emotional; Environment; Family; Fostering; Growth; Health; Health Personnel; Healthcare; Hospitalization; Hospitals; Infant; Infant Development; Infant Health; Institute of Medicine (U.S.); Intensive Care; Intensive Care Units; Intervention; Interview; Judgment; Knowledge; Link; Longevity; Measures; Mediation; Medical; Medical Records; Methods; Nature; Outcome; Parent-Child Relations; Parents; Patient Self-Report; Pattern; Perception; Philosophy; Population; Population Research; Prevalence; Process; Provider; Rehabilitation therapy; Reporting; Role; Social Work; Strategic Planning; Structure; Subgroup; Survival Rate; System; Testing; Time; Treatment Protocols; Variant; Work; care delivery; caregiving; complex chronic conditions; contextual factors; cost; design; empowerment; health care service utilization; mortality; parental role; prevent; psychological distress; skills; social; therapy development

Significance: Technological advances in health care have increased the survival rates and prevalence of infants with complex chronic conditions (I-CCC). I-CCCs are defined as those infants with increased caregiving needs due to their complex chronic condition, often requiring specialized care, significant functional limitations, and high healthcare utilization. Parents of I-CCCs develop parenting skills and confidence within the hospital environment and are expected to master complex treatment regimens, navigate multiple healthcare, rehabilitative and social service systems. A major contributor to effective parenting is their parenting confidence (PC), which is defined as a parent's belief or judgment about their ability to be successful in their parenting role. PC is strongly correlated with effective parenting behaviors, and supports a parents' ability to manage caregiving demands associated with having an I-CCC. Confident parents have a greater sense of empowerment and perceive the management of complex caregiving demands as less stressful. Several important contextual factors such as family centered care, family functioning, and infant caregiving complexity are hypothesized to foster the development of PC. Understanding the development of PC is critically important given the intense caregiving demands of parents with an infant diagnosed with a CCC. Purpose: The purpose of the proposed study is to examine the development of parenting confidence over time and the influence of contextual factors on PC development among parents of I-CCCs. Methods: A longitudinal multi-method exploratory design will be conducted to examine the trajectories of PC and effects of contextual factors on PC development. The primary focus of the study will be to report stability and variation in PC across three time points and identify how contextual factors influence the pattern of development. Parent self-report measures will be collected at infant's diagnosis of CCC, discharge, and 3 months post-discharge. Qualitative interviews will be conducted at 3 months post-discharge to further understand parents' perceptions of PC. Parent self-report measures will be used to collect data on PC, family functioning, and family centered care practices. Chart review and parent report will be used to collect infant data. Summary: Confident parents respond more effectively to parenting challenges, feel more equipped to meet their child's needs, which in turn positively impacts infant health and development. Yet, we have limited knowledge about PC trajectories and how salient factors contribute to the successful development of parenting confidence. This study will be one of the first to identify confidence trajectories and the salient contextual factors influencing development.

意义：医疗保健的技术进步提高了生存率和普遍性 具有复杂慢性病的婴儿（I-CCC）。 I-CCC被定义为那些婴儿 由于其复杂的慢性状况，增加了护理需求，通常需要专业 护理，大量功能局限性和高度医疗保健利用。 I-CCC的父母发展 育儿技能和医院环境中的信心，并有望掌握 复杂的治疗方案，导航多个医疗保健，康复和社会服务 系统。有效育儿的主要贡献者是他们的育儿信心（PC），即 定义为父母对他们在育儿中取得成功能力的信念或判断 角色。 PC与有效的育儿行为密切相关，并支持父母的能力 管理与拥有I-CCC相关的护理需求。自信的父母有一个 更大的授权和感知复杂的护理需求的管理 压力较小。几个重要的背景因素，例如家庭中心护理，家庭 假设功能和婴儿护理复杂性以促进PC的发展。 考虑到强烈的护理，​​了解PC的开发至关重要 父母患有CCC的父母的需求。 目的：拟议的研究的目的是检查育儿信心的发展 时间和上下文因素对I-CCC父母之间PC开发的影响。 方法：将进行纵向多方法探索设计，以检查 PC和上下文因素对PC开发的影响。该研究的主要重点将是 在三个时间点上报告PC中PC的稳定性和变化，并确定上下文 因素影响发展模式。父母的自我报告措施将在 婴儿诊断为CCC，出院和入院后3个月。定性访谈将 在入院后3个月进行，以进一步了解父母对PC的看法。 父母自我报告措施将用于收集PC上的数据，家庭功能和家庭 中心护理实践。图表审查和父报告将用于收集婴儿数据。 摘要：父母对育儿挑战的反应更有效，感觉更有能力见面 他们的孩子的需求反过来对婴儿的健康和发展产生了积极影响。但是，我们有 关于PC轨迹的知识有限，以及显着因素如何促进成功 发展育儿信心。这项研究将是第一个确定信心的研究之一 轨迹和影响发展的显着上下文因素。