Social Support for Mothers of Mentally Ill Children

描述(由申请人提供)：这项拨款申请是为了响应国家护理研究所的计划公告#PA-00-138，远程保健干预措施，以改善临床护理。拟议的远程保健护理干预措施有可能改善母亲的心理功能，降低卫生保健利用率。本研究的主要目的是测试和比较基于网络的社会支持干预和电话社会支持干预对5至12岁严重精神病儿童的母亲的压力、应对和情绪的有效性，这些母亲已经住院并从精神病院出院。这项研究的第二个目的是测试父母应对方式、情绪和感知压力的变化对儿童精神障碍的非计划或紧急接触医疗保健提供者的数量的影响。支持这项研究的理论模型基于拉撒路的压力和应对概念，包括作为前置因素的儿童疾病、社会支持、感知到的压力、应对和情绪状态。基于网络的干预包括信息页面、用于异步聊天的公告栏、每周聊天室，以及向在孩子所在病房工作的护士发送电子邮件的能力。PI将作为基于网络的社会支持干预的护士监督员。采用实验设计，180名受试者将被随机分配到3组中的一组：干预、电话护理或标准护理。将有225名母亲参加，以管理自然减员。网络干预和电话社会支持将持续6个月。将使用以15人为一组的小组随机化，以确保父母队列始终使用网站干预。标准化工具将在基线、干预完成后6个月和9个月进行管理。数据将使用多元统计进行分析。 这项研究的结果将提供数据，以改善母亲和家庭在精神疾病儿童住院时的心理健康，并减少紧急医疗保健的使用。美国精神病学协会报告称，有1200万美国儿童患有某种形式的精神疾病。当孩子因精神疾病需要住院时，他们会受到严重的干扰。幼儿患有严重的精神疾病，往往会导致母亲在孩子一生中处于压力时期。反过来，母亲的压力会对孩子的功能产生负面影响。如果干预成功，实施最有效的提供社会支持的方法将相对容易，因为大多数设有儿童精神科的医院都有一个网站，可以链接社会支持的内容，也可以由单位工作人员通过电话提供社会支持。

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.