(805) Effect of Pediatric Hospitalization on the Parent-Child Relationship

Introduction: A child’s hospitalization is distressing for the entire family. Studies describe the psychological impact on child survivors and their parents after discharge, but there is limited research investigating the effect of a hospitalization on the parent-child relationship. The objective of this pilot study is to describe parents’ confidence in their ability to effectively manage parenting tasks (including attachment, communication, discipline, involvement, and the overall parent-child relationship) after hospital discharge. We hypothesized that parenting self-efficacy would be lower in parents of recently hospitalized children as compared to population norms.

Methods: This prospective observational study enrolled 2 cohorts: parents of children aged 2-18 years who spent >2 nights in either the PICU or the general pediatric (GP) wards. Parents were contacted by email a minimum of 2 weeks after discharge with a computerized link to complete the validated BASC-3 Parenting Relationship Questionnaire (PRQ). The PRQ provided scaled scores for parenting confidence, attachment, discipline practices, involvement, and relational frustration.

Results: Over an 18-month period, 1186 parents were invited to participate in this study. Response rate was 17% (n=199). 85% of surveys met criteria for validity and are included in analyses (n=169). PICU parents accounted for 49% of responses (n=82). Median response time was 30 (IQR 20-40) days after discharge. Overall, scores for discipline practices were lower in both the PICU and GP cohorts when compared to population norms (median T-scores 37 vs. 50, p< 0.001) and scores for involvement were significantly higher (56 vs. 50, p< 0.001). There was no difference between scores in the PICU vs. GP cohort. There was no difference in confidence, attachment, or relational frustration between the study parents and population norms.

Conclusions: In this cohort, parents of recently hospitalized children report reduced ability to discipline and greater involvement compared to the general population. Further research is needed to determine whether this is sustained over time or resolves as parents adjust to their child’s post-hospitalization needs. Future studies may investigate strategies to enhance parenting support after discharge.