Is parental anxiety and coping associated with girls' distress during a VCUG?
2011
Purpose: We investigated the relationship between parental anxiety/coping strategies and girls' distress during VCUGs.
“Trends indicated that parents who reported increased anxiety rated their children as experiencing increased distress.”
“Contrary to expectations, parent anxiety scores on the STAI completed prior to the VCUG were not significantly related to parent self-rated or staff-rated parent anxiety recorded after the VCUG (r Z 0.09 and 0.02), or to ratings of children’s procedural distress (r Z 0.11, 0.01 and 0.11 respectively). However, parents with lower STAI scores did report using more emotion-focused and problem-focused coping strategies to manage their children’s emotional distress caused by common stressors (r Z 0.37 and 0.40 respectively, p < 0.05).”
“The analyses showed that the correlations between parent and medical staff ratings, and child self-report of procedural distress, were all statistically significant. There was a high correlation between the parent and staff ratings of the child’s distress and a lesser correlation between the children’s self-report and the parent/staff perceptions.”
“A strong trend was found in the correlations that showed that parents who reported experiencing greater distress during the VCUG also reported that their children experienced greater procedural distress(r Z 0.27, p < 0.07). A similar trend was also found between medical staff ratings of parental anxiety and staff-rated child distress (r Z 0.28, p < 0.07).”
“Analyses of the relationship between parent coping reactions to children’s distress due to common stressors and children’s distress ratings during the VCUG revealed that the children of parents who reported using more emotion-focused and problem-focused coping strategies to manage children’s emotional distress were rated by medical staff as experiencing less procedural distress (r Z 0.30 and 0.33 respectively, p < 0.05).”
“Also, increased parent use of emotion-focused and problem-focused coping was significantly related to the parents being rated by medical staff as less anxious during the procedure (r Z 0.40 and 0.31 respectively, p < 0.05) though surprisingly the parents themselves did notreport feeling less anxious (r Z 0.6 and 0.17 respectively).”
“Also, parents’ emotion-focused and problem-focused coping was not significantly related to children’s self-rated procedural distress (r Z 0.08 and 0.03 respectively).”
“[S]ome children may feel very distressed but do not express that behavior overtly for the adults to observed, hence the lack of high correlations between the child and adult-perceived distress scales.”
“Surprising[ly] to us, neither age nor number of prior studies was useful as a predictor of post-procedure reported distress. This is, however, consistent with data reported by Volk Kernstock et al., who evaluated 31 children aged 2-8 years who had undergone first time and repeated studies.”
“Alternatively, the experience of watching your child undergo a VCUG (or wondering about the results) may be so significant that it affects even parents not prone to anxiety.”
“Further, although the act of catheterization likely causes the most acute pain, voiding while supine without normal privacy is also often stressful to toilet-trained children.”
“Another potential benefit of teaching coping strategies is long term. Children and their parents will likely experience many stressful, unpleasant situations. The strategies they are taught to be able to cope during a VCUG will likely be beneficial in other circumstancesin the future.”
“The failure to find significant relationships between parent coping and child self-rated distresswas unexpected…It may be that the sense of relief that some children experience immediately after completing the VCUG (which is when the child ratings were obtained) is so great that it might actually cloud their recollection of the distress they experienced during the procedure. To better address the question of perceived versus experienced distress, it would be useful in future work to examine the relations between child self-rated distress and behavioral indicators of child distress.”