Social Support for Mothers of Mentally Ill Children

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DESCRIPTION (provided by applicant): This grant application is being submitted in response to the National Institute Nursing Research's Program Announcement # PA-00-138, Telehealth Interventions to Improve Clinical Nursing Care. The proposed telehealth nursing interventions have the potential to improve the psychological functioning of mothers and decrease health care utilization. The primary aim of this study is to test and compare the effectiveness of a web-based social support intervention and a telephone social support intervention on stress, coping, and mood for mothers of seriously mentally ill children, ages 5 through 12, who have been hospitalized and discharged from a psychiatric unit. A secondary aim of the study is to test the effects of changes in parental coping, mood, and perceived stress on the number of unscheduled or emergency contacts with health care providers for the child's mental disorder. The theoretical model girding the study is based on Lazarus' concept of stress and coping and includes the child's illness as an antecedent, social support, perceived stress, coping and mood states. The web-based intervention consists of informational pages, a bulletin board for asynchronous chatting, a weekly chat room, and the ability to E-mail a nurse working on their child's unit. The PI will serve as nurse monitor for the web-based social support intervention. Using an experimental design, 180 subjects will be randomly assigned to one of 3 groups: intervention, telephone attention or standard care. 225 mothers will be enrolled to manage attrition. The web-based intervention and telephone social support will last for 6 months. Group randomization will be used, based on groups of 15, to ensure a cohort of parents are using the web site intervention at all times. Standardized instruments will be administered at baseline, 6 months after the intervention is completed, and 9 months. Data will be analyzed using multivariate statistics. Results of the study will provide data to improve the psychological health of mothers and families when a child with a mental illness is hospitalized as well as to decrease emergency health care use. The American Psychiatric Association reports that 12 million American children suffer from some form of mental illness. When children need to be hospitalized for mental illness, they are seriously disturbed. The serious mental illness of a young child often results in periods of stress for mothers throughout the child's life. In turn, mothers who are stressed can negatively affect the child's functioning. If the intervention is successful, it would be relatively easy to implement the most effect method of providing social support since most hospitals that have child psychiatry units have a web site to which the social support content could be linked and phone delivered social support could also be provided by unit staff.