Document Type : Original Article


1 Malagnino Associated Medical Clinic Rome

2 Department of Endodontics University “Gabriele D’Annunzio”, Chiety, Italy


BACKGROUND: The pediatric hospital is an environment with a high level of stress for most parents.
Parents experience high levels of stress if their children are hospitalized due to the fear for the loss
of their child’s life.
OBJECTIVE: The objective of this study was to evaluate stress factors in parents of hospitalized
MATERIALS AND METHODS: This study was conducted from January to July 2019 at the General
Pediatrics Department of Fieri Regional Hospital. The study sample was composed of 200 parents,
of which 86 (43.3%) were males and 114 (56.7%) were females. The parents chosen as our sample
had their children hospitalized for at least 5 days.
RESULTS: Our results showed that 80% of the sample was stressed out by waiting at the hospital,
whereas 42% of them felt stressed also by their child’s oral problems. Parents of hospitalized
children (83%) felt stressed about the painful techniques applied to their children. Nearly 65% of
them were stressed out by the hospital environment; child's sleep bruxism was considered another
stressor by 39% of the sample.
CONCLUSION: This study claims that parents of hospitalized children experience stress from different
stressors such as dental visits, waiting for the diagnosis, and sleep bruxism. There are other factors
which do not influence parental stress including residence, divorced parents, and  hospital conditions.


1. Côa TF, Pettengill MA. The vulnerability experienced by the
family of childrenhospitalized in a pediatric intensive care unit.
Rev Esc Enferm USP 2011;45:825‑32.
2. Schatkoski AM, Wegner W, Algeri S, Pedro EN. Safety and
protection for hospitalized children: Literature review. Rev Lat
Am Enfermagem 2009;17:410‑6.
3. Meltzer LJ, Steinmiller E, Simms S, Grossman M, Complex Care
Consultation Team, Li Y. Staff engagement during complex
pediatric medical care: The role of patient, family, and treatment
variables. Patient Educ Couns 2009;74:77‑83.
4. Commodari E. Children staying in hospital: A research on
psychological stress of caregivers. Ital J Pediatr 2010;36:40.
5. Pires MP, Pedreira Mda L, Peterlini MA. Safe pediatric surgery:
Development and validation of preoperative interventions
checklist. Rev Lat Am Enfermagem 2013;21:1080‑7.
6. Bilgin A, Wolke D. Maternal sensitivity in parenting preterm
children: A meta‑analysis. Pediatrics 2015;136:e177‑93.
7. Franck LS, Ferguson D, Fryda S, Rubin N. The child and family
hospital experience: Is it influenced by family accommodation?
Med Care Res Rev 2015;72:419‑37.
8. Meyer EC, Snelling LK, Myren‑Manbeck LK. Pediatric intensive
care: The parents’ experience. AACN Clin Issues 1998;9:64‑74.
9. Popp JM, Robinson JL, Britner PA, Blank TO. Parent adaptation
and family functioning in relation to narratives of children with
chronic illness. J Pediatr Nurs 2014;29:58‑64.
10. Am J Dis Child. La Clare LH. The Impact of Childhood Chronic
Illness on the Family: Psychosocial Adjustment of Siblings. Sophia,
The St. Catherine University Repository Website; 2013. Available
11. Anthony KK, Gil KM, Schanberg LE. Brief report: Parental
perceptions of child vulnerability in children with chronic illness.
J Pediatr Psychol 2003;28:185‑90.
12. Coull A, Cahman SF. Kid s stuff: Features and factors driving
children hospital design. Health Fac Manage 2004;17 (6):38‑44.
13. Brehaut JC, Garner RE, Miller AR, Lach LM, Klassen AF,
Rosenbaum PL, et al. Changes over time in the health of caregivers
of children with health problems: Growth‑curve findings from a
10‑year Canadian population‑based study. Am J Public Health
14. Brehaut JC, Kohen DE, Garner RE, Miller AR, Lach LM,
Klassen AF, et al. Health among caregivers of children with health
problems: Findings from a Canadian population‑based study. Am
J Public Health 2009;99:1254‑62.
15. Shaw RJ, Bernard RS, Storfer‑Isser A, Rhine W, Horwitz SM.
Parental coping in the neonatal intensive care unit. J Clin Psychol
Med Settings 2013;20:135‑42.
16. McNary A. Consent to treatment of minors. Innov Clin Neurosci
17. Ferguson KT, Cassells RC, MacAllister JW, Evans GW. The
physical environment and child development: An international
review. Int J Psychol 2013;48:437‑68.
18. Mackler JS, Kelleher RT, Shanahan L, Calkins SD, Keane SP,
O’Brien M, et al. Parenting stress, parental reactions, and
externalizing behavior from ages 4 to 10. J Marriage Fam
19. Lutz KF, Burnson C, Hane A, Samuelson A, Maleck S,
Poehlmann J, et al. Parenting stress, social support, and
mother‑child interactions in families of multiple and singleton
preterm toddlers. Fam Relat 2012;61:642‑56.
20. Doupnik SK, Hill D, Palakshappa D, Worsley D, Bae H,
Shaik A. Parent coping support interventions during acute
pediatric hospitalizations: A meta‑analysis. Pediatrics 2017;140.
pii: e20164171.
21. Balluffi A, Kassam‑Adams N, Kazak A, Tucker M, Dominguez T,
Helfaer M, et al. Traumatic stress in parents of children admitted
to the pediatric intensive care unit. Pediatr Crit Care Med
22. Ryan‑Wenger NA, Sharrer VW, Campbell KK. Changes
in children’s stressors over the past 30 years. Pediatr Nurs
2005;31:282‑8, 291.
23. Hill C, Knafl KA, Santacroce SJ. Family‑centered care from
the perspective of parents of children cared for in a pediatric
intensive care unit: An integrative review. J Pediatr Nurs 2017.
pii: S0882‑5963 (17) 30531‑6.
24. Crowell AJ, Keluskar J, Gorecki A. Parenting behavior and the
development of children with autism spectrum disorder. Compr
Psychiatry 2019;90:21‑9.
25. Shields L. A review of the literature from developed and
developing countries relating to the effects of hospitalization on
children and parents. Int Nurs Rev 2001;48:29‑37.
26. Lerwick JL. Minimizing pediatric healthcare‑induced anxiety and
trauma. World J Clin Pediatr 2016;5:143‑50.
27. Hallström I, Elander G. Decision‑making during hospitalization:
Parents’ and children’s involvement. J Clin Nurs 2004;13:367‑75.
28. PalermoTM, Valrie CR, Karlson CW. Family and parent influences
on pediatric chronic pain: A developmental perspective. Am
Psychol 2014;69:142‑52.
29. Grosik C, Snyder D, Cleary GM, Breckenridge DM, Tidwell B.
Identification of internal and external stressors in parents of
newborns in intensive care. Perm J 2013;17:36‑41.
30. Golics CJ, Basra MK, Finlay AY, Salek S. The impact of disease
on family members: A critical aspect of medical care. J R Soc Med
31. Feizi A, Najmi B, Salesi A, Chorami M, Hoveidafar R. Parenting
stress among mothers of children with different physical, mental,
and psychological problems. J Res Med Sci 2014;19:145‑52.
32. Chang Y, Fine MA. Modeling parenting stress trajectories among
low‑income young mothers across the child’s second and third years: Factors accounting for stability and change. J Fam Psychol
33. Haskett ME, Smith Scott S, Sabourin Ward C. Subgroups of
physically abusive parents based on cluster analysis of parenting
behavior and affect. Am J Orthopsychiatry 2004;74:436‑47.
34. McPherson AV, Lewis KM, Lynn AE, Haskett ME, Behrend TS.
Predictors of parenting stress for abusive and nonabusive
mothers. J Child Fam Stud 2009;18:61‑9.
35. Luthar SS. Poverty and Children’s Adjustment. Thousand Oaks,
CA: Sage; 1999.
36. McLoyd VC. Socioeconomic disadvantage and child development.
Am Psychol 1998;53:185‑204.
37. Lamontagne LL, Hepworth JT, SalisburyMH, Riley LP. Optimism,
anxiety, and coping in parents of children hospitalized for spinal
surgery. Appl Nurs Res 2003;16:228‑35.
38. McIntosh BJ, Stern M, Ferguson KS. Optimism, coping
and psychological distress: Maternal reactions to NICU
hospitalization. Child Health Care 2004;33:59‑76.
39. Wijnberg‑Williams BJ, KampsWA, Klip EC, Hoekstra‑Weebers JE.
Psychological adjustment of parents of pediatric cancer patients
revisited: Five years later. Psychooncology 2006;15:1‑8.
40. Wray J, Sensky T. Psychological functioning in parents of children
undergoing elective cardiac surgery. Cardiol Young 2004;14:131‑9.
41. Wise AE, Delahanty DL. Parental factors associated with child
post‑traumatic stress following injury: A consideration of
intervention targets. Front Psychol 2017;8:1412.
42. Woodman AC, Mawdsley HP, Hauser‑Cram P. Parenting
stress and child behavior problems within families of children
with developmental disabilities: Transactional relations across
15 years. Res Dev Disabil 2015;36C: 264‑76.
43. Bluth K, Roberson PN, Billen RM, Sams JM. A stress model for
couples parenting children with autism spectrum disorders and
the introduction of a mindfulness intervention. J Fam Theory Rev
44. Neece CL. Mindfulness‑based stress reduction for parents of
young children with developmental delays: Implications for
parental mental health and child behavior problems. J Appl Res
Intellect Disabil 2014;27:174‑86.