COPING WITH CRITICALLY ILL CHILDREN--AN INTERVENTION

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DESCRIPTION (Adapted from the Investigator's Abstract): Critically ill children are at risk for short- and long-term negative behavioral, academic and emotional outcomes. There also have been recent reports in the literature that children who experience life-threatening illnesses and their parents are at high risk for the development of post-traumatic stress disorder. Numerous studies have demonstrated the positive effects of including parents in the psychological preparation of their children for planned, minor surgeries and procedures. However, it is not known whether similar approaches would be valuable for children experiencing serious illnesses and their parents. For this reason and the fact that there is a paucity of experimental studies with critically ill children and their parents, clinicians and researchers have emphasized the urgent need to develop and evaluate interventions to enhance coping outcomes in this population. The major objective of this research is to improve coping outcomes, both psychological and functional, in critically ill young children and their mothers during and following hospitalization. A theoretically driven, parent-focused, nursing intervention program that integrates informational and behavioral components will be utilized. The primary aim of this study is to evaluate the short- and long-term effects of an experimental intervention program (COPE: Creating Opportunities for Parent Empowerment) on the process and outcomes of maternal and child coping with critical illness. The secondary aim is to examine a proposed model developed to explain the effects of the COPE intervention program on the process and outcomes of maternal and child coping through use of self-regulation theory, control theory and the emotional contagion hypothesis. One hundred eighty-four mothers with two- to six-year old, critically ill children will be randomly assigned to a control or experimental group at each of two study sites. A variety of valid and reliable measures, including self-report and non-biased observation ratings, will assess the effects of the intervention program during and at 1, 3, and 6 months following hospitalization.