Parenting Stress Index (cystic fibrosis) Article Summary
Article: An investigation on parenting stress of children with cystic fibrosis
Authors: Grazia Isabella Continisio, Nicola Serra, Assunta Guillari, Maria Teresa Civitella, Angela Sepe, Silvio Simeone,Gianpaolo Gargiulo, Silvia Toscano, Maria Rosaria Esposito, Valeria Raia and Teresa Rea
Test and Measure: Parenting Stress Index (PSI)
Citation: Continisio GI, Serra N, Guillari A, et al. An investigation on parenting stress of children with cystic fibrosis. Ital J Pediatr. 2020;46(1):33. doi:10.1186/s13052-020-0795-7
Summary
Purpose: The purpose of this study was to determine whether the presence of cystic fibrosis in children/adolescents induces a stress pattern in parents, as well as to analyze the severity of stress in parents and identify any other factors and correlations.
Study Population: The study included 47 parents (mother or father) of children diagnosed with cystic fibrosis
Method: Sampling method to obtain participants not reported. Method of administration of outcome measure (PSI-SF) not reported. Method of delivery/determining the Defensive Response (DEF) not reported. After determining parenting stress level, a group of parents with normal stress and a group with suspicious or elevated stress levels were analyzed against each other for comparison with other factors.
Outcome Measures: Parenting Stress Index- Short Form (PSI-SF) Italian version
Intervention: No intervention performed
Results: Researchers found that only 13/47 questionnaires revealed increased stress. They also found a positive association between total stress and children’s clinical severity indicating that as clinical severity increased, stress level increased.
Major Strengths:
- Researchers analyzed the correlation of stress with other factors that are known to be associated with stress (marriage status, education level, employment status, etc)
- All results reported in tables
Major Limitations:
- There was no control condition to compare parenting stress among parents with children without a diagnosis to parents of children diagnosed with cystic fibrosis
- It was not reported how the classifications of stress severity were determined by researchers (guideline percentiles)
- It was not reported how clinical severity of children (low, moderate, severe) was determined (Was it clinically diagnosed or determined by the parents?).
- Conflicting results reported: In the results section, researchers reported that an increased number of siblings represents a predictor of a decrease in parenting stress level. In the discussion section, the researchers reported that a significant correlation was found in that the presence of more children is associated with high parent stress levels.
- A large number of the children of the parents included in the study were “low severity” which could have a factor in the lower than expected parenting stress levels that were reported.
In the conclusion, researchers state that a multidisciplinary care plan would help parents cope with stress but provides no further resources or thoughts on how to do this were suggested/reported.
Overall Conclusion: The conclusion portion of this article made a very important point that chronic disease can increase the stress on a family, and stress management strategies are important for clinicians to discuss with our patients. Improving quality of life for a patient is a main goal for many different professions, and decreasing stress may be a key factor in achieving that. While this article did have many limitations that should be addressed in order to increase the strength of this research, it was effective in drawing the conclusion that the severity of a disease process in a child can be related to the perceived amount of stress by the parents.
2 responses to “Parenting Stress Index (cystic fibrosis) Article Summary”
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Rachel, this summary was very insightful. I enjoy the implications that this outcome measure, PSI-SF, could have in a clinical setting in regards to treating a patient and their family. The stress that a chronic disease diagnosis can place on a family is notable and having a tool to measure the effectiveness of stress management techniques would be useful as a clinician. I agree with your point about the goal of many professions is to improve quality of life for patients and finding ways to decrease stress could be a key component to meditating that factor. I value patient-centered care and the overall patient experience and I believe tracking stress levels and adjunctive management technique would be valuable to treatments. I am curious about how stress severity was determined and classified, which was listed as a limitation for the study, and the implications this could potentially have on health outcomes in younger populations. More information regarding the relationship between parent stress levels/patterns and overall child health prognosis/outcome. Great review!
Becca, you make a great point in response to how stress severity was determined. In regards to stress severity, we all react to stress differently in the same situation. Think about how we all handle stress differently during exam week when we are taking the same exams! You also pose a great point in stress in younger populations, because identifying stress in kids and teaching management techniques is super important. Thanks for your input!