Parent uncertainty, self-care, and adjustment outcomes in the pediatric inpatient rehabilitation setting

Children admitted for inpatient rehabilitation have complex medical needs that typically require intensive medical care and therapies. The psychosocial adjustment process for parents of children admitted for inpatient rehabilitation may be particularly difficult given the demands of extended hospitalization; however, limited data exists to characterize parent psychosocial adjustment in this unique context. Thus, the present study aimed to assess parent distress during a child's admission for inpatient rehabilitation, as well as factors which may impact parent adjustment. Thirty parents completed measures 4-10 days following admission to a pediatric rehabilitation hospital in a Midwestern city. Measures of depression, anxiety, posttraumatic stress, parent perceived uncertainty in illness/medical condition, and parent perceived success at engaging in self-care were completed. Parents reported high levels of psychological distress, with a substantial subset of parents reporting clinically concerning levels of depressive (36%), anxious (44.8%), and posttraumatic stress symptoms (41.4%). Overall, 57% of parents reported clinically concerning symptoms in at least one area of adjustment. Higher levels of uncertainty were associated with higher levels of posttraumatic stress symptoms (p < .05). Lower reported success in self-care and managing difficult emotions was associated with higher levels of depressive symptoms and posttraumatic stress symptoms (p < .05). This study is among the first to document parent adjustment during a child's admission for inpatient rehabilitation. Parents reported clinically concerning rates of depressive, anxious, and posttraumatic stress symptoms, indicating a clear need for psychosocial intervention. Further, given the elevated risk for child adjustment difficulties associated with parent adjustment difficulties (Bakula et al., 2019), these results are especially concerning. These data point to several areas of assessment and potential intervention, especially in addressing illness-related uncertainty and helping parents to improve self-care