Gaining control: parents' experiences of accommodating children's asthma.

A qualitative study examined parents' experiences of coming to terms with and becoming effective managers of their children's asthma. Grounded theory technique (Strauss & Corbin, 1991) was used to examine the parents' stories. Through this technique, in-depth interviews were conducted with 39 parents and these participants unraveled the process of accommodating their children's severe asthma. The basic social process was one of gaining control. Participants experienced three phases: being out of control, which meant seeking help, "running around," and trying to make sense of the situation; being involved, which meant searching out, trying out new ways and means, and making changes; and being in control, which they described as being able to take charge, make alliances, and become competent in coping with their child's illness. Participants' experiences provide testimony to interventions that nurses can use to help parents through the process of successful asthma management.

Maternal stress and repeated hospitalizations of children who are physically disabled.

A quasi-experimental study (N = 60) found that the degree and nature of the parental stress experienced with repeated hospitalizations of physically disabled children was different from that experienced by a comparison group with nondisabled children. There was more community nurse support among those with lower versus higher stress over repeated hospitalizations. Next, using qualitative methods, parent and nurse groups validated and extended the findings to the issues involved in the chronic and complex source of stress. Thus, implications from research on single, brief hospitalizations of essentially healthy children may not apply to repeatedly hospitalized, disabled children and their parents.

Hazardous secrets and reluctantly taking charge: parenting a child with repeated hospitalizations.

This study developed a grounded theory of the stresses and coping responses of parents to the repeated hospitalization of chronically ill and disabled children. The theoretical sampling spanned four years and included 30 mothers of children who have a chronic illness or disability and 30 mothers of healthy children; 100 parents of disabled children who attended a weekend retreat: six community health nurses; nine mothers of chronically ill and disabled children before, during and after a hospitalization. The resulting mid-range theory identifies the most stressful aspect as "hazardous secrets" which force the parent to "reluctantly take charge" of the situation. "Vigilance", "calling a halt", "exhaustion" and "taking a break" are key constructs in the process. "Trusting parent and professional relationships" emerged only when a professional assisted in revealing secrets.

Stress-point intervention for parents of repeatedly hospitalized children with chronic conditions.

Little is known about how to assist children with chronic conditions and their families cope with repeated hospitalizations. A two-group, pretest-posttest study was done to determine whether a community-based, stress-point nursing intervention for parents could decrease distress and improve child and family functioning. Fifty participants were randomly assigned to intervention or usual care control groups. The intervention focused on specific, parent-verified child and family issues. Three months after hospitalization, intervention parents had better coping and family functioning than those in the usual care group. Intervention parents' anxiety was initially higher and then lower. There were no child behavior differences between the groups after hospitalization. Intervention children had no developmental regression at 2 weeks and better developmental gains 3 months after discharge than the usual care children. Stress-point intervention for families and their children with chronic conditions improved family coping and functioning, and eliminated hospitalization-induced developmental regression.