The uncertainty and parental stress in primary caregiver of children with airway abnormalities

• Main Authors: Ho-shin huei, 何幸慧
• Other Authors: KAI-WEI WANG
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/53649954571052476707

碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 102 === The study aimed to investigate the stress and uncertainty of primary caregivers of children with airway abnormalities using a cross-sectional research design adopted three questionnaires including demographic details of the children with airway abnormalities and their primary caregivers, uncertainty survey and parental stress questionnaire. There were 90 primary caregivers involved in the study and the data were analysed via SPSS version 19.0 using descriptive statistics, pearson’s correlation and Generalized estimation equations (GEE) and hierarchical regression analysis. The results have found that the major three items of the primary caregivers’ uncertainty included “When I have questions, I rely on health care professionals in the hospital” (Mean/SD 4.12/0.70), “I can understand what the health care professionals are saying to me” (Mean/SD 4.06/0.72) and “I can understand each care provided to my child” (Mean/SD 3.99/0.77). The highest three items representing the stress of the primary caregivers included “I feel stressful when my child has short of breath” (Mean/SD 4.36/0.97), “I feel stressful when my child is crying and distressed due to difficult breathing” (Mean/SD 4.38/0.9 6) and “I feel stressful about what I have to go through due to my child’s illness” (Mean/SD 4.19/0.82). There was no statistical significant association between the uncertainty of the primary caregivers and their age, gender, education background, marriage status and income levels. However, during the initial diagnosis phase, the uncertainty of the primary caregivers of children who are older than one year old comparing with children younger than one year old in the three dimensions of lacking information, ambiguity and overall uncertainty were all statistically significant. In the stress of the primary caregivers, there was no association between the stress and the variables of the children themselves, the caregivers’ age, gender and marital status, however there was association between the stress and the variables of lacking employment and income status. The caregivers’ stress relating to family functional items and caregivers’ themselves was statistically significant associated with the child’s age. The study has found that there was association between the caregivers’ overall stress and their uncertainty (r = 0.529, p <0.01). Moreover, the stress items relating to caregivers’ themselves and overall stress were highly correlated (r = 0.965, p <0.01). The results from hierarchical regression refer to that the variable of the child’s age between one to three years old can predict the caregivers’ uncertainty and stress. The predictor of the stress of the primary caregivers in relation to family function is the ambiguity of uncertainty, which after hierarchical regression with adjusted R2 explain 46.2% of the variable of caregivers’ own stress (F=4.468, p <0.001）and explain 19.5% of the variable of the child’s illness and care（F=1.982, p <0.05. Moreover, the variable of ambiguity uncertainty not only explain 30.8% of the stress in relation to family function (F=2.799, p<0.01）and explain 47.2% of the variable of the overall stress of the primary caregivers (F=4.613, p< 0.001). The outcomes of the study can improve the care quality for the primary caregivers of children with airway abnormalities through careful assessment of the caregivers’ uncertainty and stress. To understand the uncertainty and stress of these primary caregivers, appropriate support intervention strategies can be initiated and implemented for the caregivers to effectively relieve their uncertainty and stress in caring for children with respiratory problems. Moreover, the outcomes of the study can provide evidence for continuous nursing education particularly in the area of family adaptation and resilience in dealing with complex care of children with airway abnormalities. Last but not the least, the outcomes of the study can enhance health care policy makings pertinent to care and resources development in terms of both qualitative and quantitative support for families of acute or chronic respiratory care, including developing online support forum, case management and funding institutions for the families.