Trajectory of Parenting Confidence among Parents of Infants with Complex Chronic Conditions

意义：医疗保健的技术进步提高了生存率和患病率， 患有复杂慢性病的婴儿（I-CCC）。I-CCC被定义为患有以下疾病的婴儿： 由于复杂的慢性病，他们的医疗需求增加，通常需要专门的 护理，严重的功能限制和高医疗保健利用率。I-CCC的父母开发 在医院环境中的育儿技巧和信心，并预计将掌握 复杂的治疗方案，导航多种医疗保健，康复和社会服务 系统.有效育儿的一个主要贡献者是他们的育儿信心（PC），这是 被定义为父母对他们成功养育子女的能力的信念或判断 作用父母教养能力与有效的父母教养行为密切相关，并支持父母的能力 管理与拥有I-CCC相关的业务需求。自信的父母 更强的授权意识，并感知复杂的业务需求管理 压力更小几个重要的背景因素，如以家庭为中心的护理，家庭 功能，和婴儿发育的复杂性被假设为促进PC的发展。 了解个人电脑的发展是至关重要的考虑到激烈的竞争， 父母的要求与婴儿诊断为CCC。 目的：本研究的目的是探讨父母养育信心的发展， 时间和环境因素对I-CCC父母PC发育的影响。 方法：采用纵向多方法探索性设计， PC和情境因素对PC发展的影响。研究的主要重点将是 报告三个时间点PC的稳定性和变化，并确定 影响发展格局的因素。家长自我报告措施将收集在 婴儿CCC诊断、出院和出院后3个月。定性访谈将 在出院后3个月进行，以进一步了解家长对PC的看法。 父母自我报告的措施将被用来收集数据的PC，家庭功能和家庭 中心护理实践。图表审查和父母报告将用于收集婴儿数据。 总结：自信的父母更有效地应对育儿挑战，更有能力应对 这反过来又会对婴儿的健康和发育产生积极的影响。然而， 有限的知识PC轨迹和如何突出的因素有助于成功的 培养父母的自信心。这项研究将是第一个确定信心的研究之一 发展轨迹和影响发展的突出背景因素。

Significance: Technological advances in health care have increased the survival rates and prevalence of infants with complex chronic conditions (I-CCC). I-CCCs are defined as those infants with increased caregiving needs due to their complex chronic condition, often requiring specialized care, significant functional limitations, and high healthcare utilization. Parents of I-CCCs develop parenting skills and confidence within the hospital environment and are expected to master complex treatment regimens, navigate multiple healthcare, rehabilitative and social service systems. A major contributor to effective parenting is their parenting confidence (PC), which is defined as a parent's belief or judgment about their ability to be successful in their parenting role. PC is strongly correlated with effective parenting behaviors, and supports a parents' ability to manage caregiving demands associated with having an I-CCC. Confident parents have a greater sense of empowerment and perceive the management of complex caregiving demands as less stressful. Several important contextual factors such as family centered care, family functioning, and infant caregiving complexity are hypothesized to foster the development of PC. Understanding the development of PC is critically important given the intense caregiving demands of parents with an infant diagnosed with a CCC. Purpose: The purpose of the proposed study is to examine the development of parenting confidence over time and the influence of contextual factors on PC development among parents of I-CCCs. Methods: A longitudinal multi-method exploratory design will be conducted to examine the trajectories of PC and effects of contextual factors on PC development. The primary focus of the study will be to report stability and variation in PC across three time points and identify how contextual factors influence the pattern of development. Parent self-report measures will be collected at infant's diagnosis of CCC, discharge, and 3 months post-discharge. Qualitative interviews will be conducted at 3 months post-discharge to further understand parents' perceptions of PC. Parent self-report measures will be used to collect data on PC, family functioning, and family centered care practices. Chart review and parent report will be used to collect infant data. Summary: Confident parents respond more effectively to parenting challenges, feel more equipped to meet their child's needs, which in turn positively impacts infant health and development. Yet, we have limited knowledge about PC trajectories and how salient factors contribute to the successful development of parenting confidence. This study will be one of the first to identify confidence trajectories and the salient contextual factors influencing development.