Parent and Family Functioning after a Preschooler's Head Trauma: 6 Months Post-Discharge

Tuesday, 8 July 2008: 8:50 AM
JoAnne M. Youngblut, PhD, RN, FAAN , College of Nursing & Health Sciences, Florida International University, Miami, FL
Dorothy Brooten, PhD, RN, FAAN , College of Nursing & Health Sciences, Florida International University, Miami, FL

Learning Objective 1: 1. describe effects of a preschooler’s head trauma on their mothers and families 6 months after hospital discharge.

Learning Objective 2: 2. describe implications of the study’s findings for clinical practice and future research.

Aims: Investigate effects of a preschool child's head trauma on mothers' mental health, mother-child relationship, and family functioning 6 months after the child's hospital discharge.

Methods: Sample - 89 mothers of previously healthy preschool children hospitalized with head injury – event where head trauma was possible, at least one physical finding suggesting head injury. Exclusion criteria – severe cognitive deficits prior to injury, suspected child abuse, child being evaluated with brain death criteria, parent(s) hospitalized or died in injury event. 51% of the mothers were white, 33% Black, 16% Hispanic; 67% were partnered. 53% of the children were hospitalized initially in the PICU. Most sustained only head injury, and 40% experienced loss of consciousness at the scene. Half of the head injuries were serious (19%) or severe (30%). Based on Family Resiliency Model, mothers completed Mental Health Inventory (MHI), Parenting Stress Index, FACES II, Multidimensional Scale of Perceived Social Support at 6 months post-discharge and perceived injury severity, Parental Stressor Scale: PICU, MHI (baseline) at 24-48 hours after hospital admission. Injury severity scale was completed through chart review.

Results: Mothers' mental health, mother-child relationship, and family functioning did not differ between the PICU group and the general care unit group (t-tests). Bivariate correlations indicated that greater maternal stress (PSS:PICU) in the hospital, lower baseline mental health, longer hospital stays, and greater injury severity were related to decreased psychological wellbeing for mothers at 6 months post-discharge. Mothers' greater psychological distress in the hospital was related to greater parenting stress and psychological distress, and lower family cohesion at 6 months post-discharge. Continuing social support was related to great family cohesion and adaptability, less distress and greater wellbeing at 6 months.

Conclusions: Baseline mental health and ongoing social support had important influences on mother, mother-child, and family outcomes at 6 months.

Funding: NINR #R01 NR04430.