The influence of illness severity and family resources on maternal uncertainty during critical pediatric hospitalization

BACKGROUND: Psychological management of parents during a child's critical illness is a challenge to intensive care nurses because of the uncertainty that accompanies hospitalization. OBJECTIVE: To explore the relationships among illness severity, family resources, and maternal uncertainty during the initial stage of a child's hospitalization in a pediatric intensive care unit for a life-threatening illness. METHODS: A convenience sample of 40 mothers rated perceptions of uncertainty (using Mishel's Uncertainty of Illness Scale: Parent Child Form), family cohesion (using Olson's Family Adaptability and Cohesion Evaluation Scale), and social support (using Norbeck's Social Support Questionnaire). Illness severity was estimated with the Pediatric Risk of Mortality Scale. RESULTS: Results showed a positive association between illness severity and maternal uncertainty and a negative association between family cohesion and maternal uncertainty. Severity of illness contributed less to maternal uncertainty than did family cohesion. CONCLUSIONS: Family relationships are important factors to consider when clinicians estimate the effect on parents of their child's critical illness, particularly when uncertainty over their child's outcome may lead to parental stress that can interfere with coping and child management.