Posttraumatic growth in parents after a child's admission to intensive care: Maybe Nietzsche was right?

Paediatric Psychology Service, St George's Hospital, London, SW17 0QT, UK.
Intensive Care Medicine (Impact Factor: 7.21). 03/2009; 35(5):919-23. DOI: 10.1007/s00134-009-1444-1
Source: PubMed


The aim of this prospective study was to establish the degree to which parents report post-traumatic growth after the intensive care treatment of their child.
Prospective cross-sectional cohort study.
Paediatric Intensive Care Unit (PICU).
A total of 50 parents of children, admitted to PICU for >12 h.
Parents provided stress ratings as their child was discharged from PICU and, 4 months later, completed postal questionnaires rating their anxiety, depression, post-traumatic stress and post-traumatic growth. As much as 44 parents (88%) indicated on the Posttraumatic Growth Inventory (PTGI) [1] that they had experienced a positive change to a great degree as a result of their experiences in PICU. Parents of children who were ventilated (P = 0.024) reported statistically higher post-traumatic growth as did parents of older children (P = 0.032). PTGI scores were positively correlated with post-traumatic stress scores at 4 months (P = 0.021), but on closer inspection this relationship was found to be curvilinear.
Post-traumatic growth emerged as a salient concept for this population. It was more strongly associated with moderate levels of post-traumatic stress, than high or low levels.

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    • "Over the past 20 years, a number of studies have explored the concept of PTG within a broad field of traumas, for example, natural disasters, personal loss, and illness (Weiss and Berger, 2010). However, PTG among parents of children with a life-threatening disease has only rarely been investigated (Colville and Cream, 2009; Michel et al., 2010; Yonemoto et al., 2012; Zebrack et al., 2011). Moreover, research on the psychological consequences for parents in relation to pediatric SCT has almost exclusively focused on negative outcomes. "
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    ABSTRACT: In the current study, we investigated the occurrence of posttraumatic growth (PTG) among parents whose children had had stem cell transplantation (SCT) and survived. Although SCT is well established, it remains stressful and dangerous, and SCT is only performed if there is no other choice of treatment to be considered. A questionnaire batteries including the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian version and the Post-Traumatic Growth Inventory were sent out to a cross-sectional national sample of parents of children who had had SCT six months or more before the study. The response rate was 66% (n = 281). The data were analyzed in relation to parents' appraisal of the event, gender, and perceived social support. The results confirm that SCT in childhood is an event of extreme adversity for the parents. Indications of PTSD were found among an important minority of the parents. Nevertheless, a large proportion of the parents had experienced growth as a consequence of the child's illness. Appreciation of life and personal strength were the domains with the highest scores. Moreover, a higher level of PTG was correlated with a higher level of posttraumatic stress and with an experience of the trauma as more severe. In summary, the study indicates that PTG is a relevant concept for this group of parents.
    Journal of Child Health Care 08/2013; 18(4). DOI:10.1177/1367493513496666 · 0.88 Impact Factor
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    • "Although studies on PTG in bereaved parents and parents of severely ill children are available (e.g. Barakat et al., 2006; Colville and Cream, 2009; Engelkemeyer and Marwit, 2008), this phenomenon has not yet been studied prospectively in parents of children with different chronic diseases. In this study we aimed to assess PTG in a sample of mothers and fathers three years after their child was newly diagnosed with type 1 diabetes or cancer. "
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    ABSTRACT: Posttraumatic growth (PTG) can occur after various types of trauma but has not been studied prospectively in parents of children with chronic diseases. In this study, PTG was assessed in 126 parents of 67 children with type 1 diabetes or cancer three years after diagnosis. Most parents (62.7%) reported at least a moderate degree of PTG. Quality of family relationships, parental psychological distress and child medical characteristics assessed one month after diagnosis, and parents' gender, explained 34 percent of PTG variance. The findings confirm that a severe disease of a child can lead to personal growth in the child's parents.
    Journal of Health Psychology 06/2011; 16(8):1259-67. DOI:10.1177/1359105311405872 · 1.88 Impact Factor
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    • "Fathers (n = 15) reported the ‘tube in my child’ as the highest specific source of stress [33], while mothers’ (n = 31) most important stressors were ‘injections’ and ‘watching the heart rate on the monitor’ [34]. PICU admission remains stressful and may cause post-traumatic stress in both fathers and mothers [35, 36]. "
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    ABSTRACT: To explore parents' experiences during the admission of their children to a pediatric intensive care unit (PICU). Qualitative method using in-depth interviews. Thematic analysis was applied to capture parents' experiences. Thirty-nine mothers and 25 fathers of 41 children admitted to seven of the eight PICUs in university medical centers in The Netherlands were interviewed. Parents were interviewed within 1 month after their child's discharge from a PICU. Thematic analysis identified 1,514 quotations that were coded into 63 subthemes. The subthemes were categorized into six major themes: attitude of the professionals; coordination of care; emotional intensity; information management; environmental factors; parent participation. Most themes had an overarching relationship representing the array of experiences encountered by parents when their child was staying in a PICU. The theme of emotional intensity was in particular associated with all the other themes. The findings provided a range of themes and subthemes describing the complexity of the parental experiences of a PICU admission. The subthemes present a systematic and thematic basis for the development of a quantitative instrument to measure parental experiences and satisfaction with care. The findings of this study have important clinical implications related to the deeper understanding of parental experiences and improving family-centered care.
    Intensive Care Medicine 11/2010; 37(2):319-25. DOI:10.1007/s00134-010-2074-3 · 7.21 Impact Factor
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