Parental stress and coping strategies during pediatric hospitalization: a descriptive study at the University Hospital of Salamanca

Parental stress and coping strategies during pediatric hospitalization: a descriptive study at the University Hospital of Salamanca | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Parental stress and coping strategies during pediatric hospitalization: a descriptive study at the University Hospital of Salamanca Jonathan Adalia Rodriguez, Ana María Ullán Fuente This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7401799/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Child hospitalization generates significant psychological distress in parents, who may experience stress, anxiety, and feelings of helplessness. Nursing support can play a key role in facilitating coping and family adaptation. Objective To identify levels of stress and coping strategies used by parents during their child’s hospitalization in pediatric units at the University Hospital of Salamanca, and to analyze the influence of nursing interventions on this process. Methods A descriptive, quantitative, cross-sectional study was conducted between December 2023 and May 2024. Data were collected through an ad hoc self-administered questionnaire including the Parental Stressor Scale: Infant Hospitalization (PSS:IH) and the Coping Strategies Inventory. Participants were parents of children under 14 years hospitalized ≥ 48 hours. Sociodemographic, clinical, stress, coping, and nursing support variables were analyzed using descriptive and inferential statistics (SPSS v28). Results A total of 84 parents were included (62.7% women; mean age 36.1 years; mean number of children 1.65). The mean parental stress level was moderate (x̄=2.77). The most stressful items were: child on mechanical ventilation (75.6%), presence of tubes/catheters (73.6%), child in pain (72.6%), and alarms from monitors/equipment (71.8%). Mothers showed higher stress related to disruption of parental role (p = 0.05). The most frequent coping strategies were wishful thinking (x̄=22) and problem-solving (x̄=20.3). Nursing information and support were positively correlated with the use of problem-solving (rho = 0.779; p = 0.003) and social support (rho = 0.631; p = 0.005). Conclusions Parental stress during pediatric hospitalization is mainly associated with invasive procedures and medical devices. Nursing interventions focused on communication and emotional support foster adaptive coping strategies and facilitate family adjustment. Background Hospitalization of a child is a stressful experience for parents, often associated with anxiety, depression, and vulnerability ( 1 , 2 ). This situation disrupts family routines and is intensified by exposure to invasive procedures and medical devices. In Castilla y León, Spain, 52,080 children under 14 years were hospitalized in 2023, of whom 35% were admitted to neonatal units and 64.7% to pediatric units; 3.32% and 8.11% respectively required intensive care ( 3 ). Previous studies highlight that professional support and adequate information can reduce parental stress and enhance the use of adaptive coping strategies ( 4 , 5 ). Nurses play a central role in this process, as they are the professionals most frequently in contact with the child and family, integrating physical, psychological, and social care ( 6 – 9 ). Parental coping depends on several factors, including communication with healthcare providers, disruption of parental role, and the quality of information received ( 10 – 13 ). Nursing interventions can therefore promote psychological adaptation by providing support and effective communication. The aim of this study was to identify parental stress levels and coping strategies during pediatric hospitalization at the University Hospital of Salamanca, and to explore the role of nursing interventions in this process. Methods Design Descriptive, quantitative, cross-sectional study. Setting and period Pediatric hospitalization units at the University Hospital of Salamanca, from December 2023 to May 2024. Participants : Parents of children under 14 years hospitalized for ≥ 48 hours. Inclusion criteria: Spanish language comprehension and informed consent. Sampling was non-probabilistic, by convenience. Instruments : Parental Stressor Scale: Infant Hospitalization (PSS:IH) , Spanish validated version ( 14 ), consisting of 36 items in 7 subscales. Coping Strategies Inventory (CSI) , Spanish adaptation by Cano ( 15 ), 40 items in 8 subscales. Ad hoc sociodemographic and clinical questionnaire. Variables: Independent: parental age, sex, role, number of children; child’s age, reason for admission, previous hospitalizations, unit. Dependent: parental stress level, coping strategies, perceived nursing information and support. Analysis Means and standard deviations for quantitative variables; frequencies and percentages for categorical variables. Hypothesis testing and correlations (Pearson/Spearman depending on normality; Shapiro-Wilk, Levene tests). Significance threshold p < 0.05. Analyses performed using SPSS v28. Ethical considerations : This study was conducted in accordance with the principles of the Declaration of Helsinki . Ethical approval was obtained from the Research Ethics Committee of the University of Salamanca (CEIm: 2023/04/1271-TD) . Written informed consent was obtained from all participants. Funding Statement: This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Results Of 96 parents recruited, 84 met inclusion criteria. Most were women (62.7%), with a mean age of 36.1 years and mean 1.65 children. Main reasons for admission were respiratory pathology (34.6%), infectious disease (11.5%), and prematurity (10.3%). The mean child age was 3.3±4.7 years; 87% were under 8 years. Mean hospital stay was 9.4 days. Mean parental stress level was moderate (x̄=2.77). Most stressful items: mechanical ventilation (75.6%), tubes/catheters (73.6%), child in pain (72.6%), monitor/equipment alarms (71.8%). Significant correlation between stress related to communication with healthcare staff and child age (rho=0.309; p=0.02). “The differences are summarized in Table 1 .” Mothers showed higher stress linked to disruption of parental role (p=0.05). Most frequent coping strategies: wishful thinking (x̄=22), problem-solving (x̄=20.3), cognitive restructuring (x̄=16). “Detailed correlations are shown in Table 2 .” Fewer children were associated with greater use of problem-solving (rho=-0.331; p=0.045). Nursing information and support correlated with problem-solving (rho=0.779; p=0.003) and social support (rho=0.631; p=0.005). Discussion This study found moderate parental stress levels, consistent with previous reports (16,17). “A machine is breathing for my child” was the most stressful item, in line with earlier findings (18–20). Although not statistically significant in this sample, duration of hospitalization has been linked to parental stress in other studies, with higher levels reported during the first 7–15 days (21,22). Coping strategies most commonly used were problem-solving and cognitive restructuring, both problem-focused, consistent with prior research (23–25). Nursing support and communication were associated with greater use of adaptive strategies, reducing anxiety and facilitating family integration during hospitalization (26–28). Limitations: The study was limited by sample size and descriptive cross-sectional design, which did not allow assessment of changes over time or causality. Conflicts of Interest: The authors declare no conflict of interest. Conclusions Parental stress during pediatric hospitalization is mainly driven by invasive procedures and the use of medical devices. Disruption of the parental role is an additional stressor, particularly for mothers. Nursing interventions focusing on communication and emotional support promote the use of adaptive coping strategies, such as problem-solving and social support, thereby improving the family’s adaptation process. Validated instruments to assess family coping could be integrated into routine practice to guide tailored interventions. Declarations Conflicts of Interest: The authors declare no conflict of interest. Funding Statement: This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author Contribution Jonathan Adalia Rodriguez: Conceptualization, Methodology, Investigation, Writing – original draft.Ana María Ullán de la Fuente: Supervision, Writing – review & editing. Data Availability https://gredos.usal.es/handle/10366/164979 References Oxley R. Parents’ experiences of their child’s admission to paediatric intensive care. Nurs Child Young People [Internet]. 2015 [cited 2023 Nov 22];27(4):16–21. Available from: https://journals.rcni.com/nursing-children-and-young-people/parents-experiences-of-their-childs-admission-to-paediatric-intensive-care-ncyp.27.4.16.e564 Caruso A, Mikulic IA. 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Available from: https://educacion.usal.es/wp-content/uploads/sites/34/2020/03/Humanizacion-del-hospital-pedia%CC%81trico.-Perspectiva-psicosocial-.pdf Ferreira L, Oliveira J, Gonçalves R, Elias T, Medeiros S, Mororó D. Nursing care for families of hospitalized children and adolescents. Rev Enferm UFPE [Internet]. 2019 [cited 2024 Apr 5];413(1):23–31. Available from: https://www.researchgate.net/publication/336345160_Cuidar_de_enfermagem_as_familias_de_criancas_e_adolescentes_hospitalizados McFarland MR, Wehbe-Alamah HB. Leininger’s theory of culture care diversity and universality: an overview with a historical retrospective and a view toward the future. J Transcult Nurs [Internet]. 2019 [cited 2023 Apr 4];30(6):540–557. Available from: https://doi.org/10.1177/1043659619867134 Miguel SN. Parental stress in parents with hospitalized children in the pediatric area of the regional hospital of Ayacucho - 2017 [doctoral thesis]. Universidad Alas Peruanas; 2021. Available from: https://repositorio.uap.edu.pe/handle/20.500.12990/9907 Hidalgo Iza C. Stress and coping in parents of hospitalized children in the pediatric area of the Calderón General Teaching Hospital [Internet]. Quito: UCE; 2017. Available from: https://www.dspace.uce.edu.ec/entities/publication/85d85131-428f-49b0-be9d-f269f490faba Barros I, Lourenço M, Nunes E, Charepe Z. Nursing interventions promoting adaptation of child/adolescent/family to hospitalization. Enferm Glob [Internet]. 2021 [cited 2023 Jan 7];21(1):539–596. Available from: https://dialnet.unirioja.es/servlet/articulo?codigo=7750633 Doupnik SK, Hill D, Palakshappa D, Worsley D, Bae H, Shaik A, et al. Parent coping support interventions during acute pediatric hospitalizations: a meta-analysis. Pediatrics [Internet]. 2017 [cited 2024 Jun 12];140(3):e20164171. Available from: https://doi.org/10.1542/peds.2016-4171 Navarro-Tapia S, Ramírez M, Clavería C, Molina Y. 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Available from: https://pubmed.ncbi.nlm.nih.gov/20500854/ Campello J. Coping styles and adaptation to illness in parents of children with Sanfilippo syndrome: a pilot study [Internet]. Universidad Miguel Hernández; 2016 [cited 2024 Jun 15]. Available from: https://dspace.umh.es/handle/11000/3134 De la Huerta R, Corona J, Méndez J. Assessment of coping styles in primary caregivers of children with cancer. Neurología, Neurocirugía y Psiquiatría [Internet]. 2006 [cited 2024 Apr 8];39(1):46–51. Available from: https://www.medigraphic.com/pdfs/revneuneupsi/nnp-2006/nnp061g.pdf Ball J, Bindler R, Cowen K. Child health nursing: partnership with children and families. 3rd ed. Madrid: Pearson Education; 2014. Barros I, Lourenço M, Nunes E, Charepe Z. Nursing interventions promoting adaptation of the child/adolescent/family to hospitalization. Enfermería Global [Internet]. 2021 [cited 2024 Jun 3];21(1):539-596. Available from: https://dialnet.unirioja.es/servlet/articulo?codigo=7750633 Araújo YBD, Collet N, Moura FMD, Nóbrega RDD. Family knowledge about chronic conditions in childhood. Texto & Contexto-Enfermagem [Internet]. 2009 [cited 2024 Jan 7];18:498-505. Available from: https://www.redalyc.org/pdf/714/71411760013.pdf Aftyka A, Rozalska I, Milanowska J. Is post-traumatic growth possible in the parents of former patients of neonatal intensive care units? Ann Agric Environ Med [Internet]. 2020 [cited 2024 Feb 5];27(1):106-112. Available from: http://dx.doi.org/10.26444/aaem/105800 Lyu QY, Kong SKF, Wong FKY, You LM, Yan J, Zhou XZ, Li XW. Psychometric validation of an instrument to measure family coping during a child's hospitalization for cancer. Cancer Nursing [Internet]. 2017 [cited 2024 May 3];40(3):194–200. Available from: https://doi.org/10.1097/NCC.0000000000000382 Tables Table 1. Mann-Whitney W test between hospitalization units and parental stress levels Hospitalization units Communication subscale Behavior subscale Neonatal ICU / Neonatal Intermediate Ranks = 10 /5 Ranks = 15,50 /8,79 W = 7 / p = 0,023 W = 27,5 / p = 0,013 Pediatric ward/ Neonatal Intermediate Ranks = 23,57 /8,5 Ranks = 29,14 /15,79 W = 31,50 / p = 0,001 W = 111,5 / p = 0,005 Pediatric ICU/ Neonatal Intermediate Ranks = 9,25 /6,57 Ranks = 10,44/ 10,54 W = 18 / p = 0,25 W = 47,5 / p = 0,984 Pediatric ward/ Neonatal ICU Ranks = 21,46/ 18,79 Ranks = 25,23/ 26,45 W = 103,5 / p = 0,604 W = 204/ p = 0,81 Pediatric ward/ Pediatric ICU Ranks = 23,31 /13,81 Ranks = 26,10 /13,75 W = 74,5 / p = 0,046 W = 74/ p = 0,018 Neonatal ICU / Pediatric ICU Ranks = 9,71 /6,50 Ranks = 12,14 /7,06 W = 16 / p = 0,178 W = 20,5 / p = 0,051 Notes: Units were compared in pairs using the mean parental stress level in the communication and staff behavior subscales. A significance level of p < 0.05 was applied. Table 2. Correlations between coping strategies and information and support received by parents Coping strategies Information received Support received Problem solving (rho = 0,779; p = 0,003 ) (rho = 0,634; p = 0,02 ) Social support (rho = 0,631; p = 0,005 ) (r = 0,523; p = 0,018 ) Notes: Correlations between coping strategies and the means of information and support received. Pearson’s r was used for parametric values and Spearman’s rho for non-parametric values, with a significance level of p < 0.05. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7401799","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":527299865,"identity":"c493a1ea-2674-4760-858b-796efe982861","order_by":0,"name":"Jonathan Adalia Rodriguez","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2ElEQVRIiWNgGAWjYBACNoYEhgMSBjY8bOwNQG4BcVoYH1hUpMnx8RwAcg2IsieB2aDizGFjOYkEIrXwseeYSdxsY05sk3xj/OGHAYOcfAMhh/G8MZOc2caW2CadYybZY8BgbHCAkBaJHDNpyTYesBYGHgOGxA2EHAbW8rdNAuiwM8Yf/xgw1M8n6DCJHGMDiTMGxmwSPAbSQFuAYU7QL88KH0hUJMix8aSVScsYSBhuIKRFvj15AzAq//PItx/e/PFNhY08wRBDBxIkqh8Fo2AUjIJRgBUAAM1dN18NZeyJAAAAAElFTkSuQmCC","orcid":"","institution":"University of Salamanca","correspondingAuthor":true,"prefix":"","firstName":"Jonathan","middleName":"Adalia","lastName":"Rodriguez","suffix":""},{"id":527299866,"identity":"3aeabe30-1a9b-4a94-bfd7-20f0dba6deef","order_by":1,"name":"Ana María Ullán Fuente","email":"","orcid":"","institution":"University of Salamanca","correspondingAuthor":false,"prefix":"","firstName":"Ana","middleName":"María Ullán","lastName":"Fuente","suffix":""}],"badges":[],"createdAt":"2025-08-18 16:53:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7401799/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7401799/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93394049,"identity":"06eb89f8-ee0f-4d34-bf15-2e02e5507485","added_by":"auto","created_at":"2025-10-13 11:14:51","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32405,"visible":true,"origin":"","legend":"","description":"","filename":"MainttextBMC.docx","url":"https://assets-eu.researchsquare.com/files/rs-7401799/v1/a9cb37923c27d5cc3c29a5c1.docx"},{"id":93394050,"identity":"e5cba390-676f-438b-808e-684494b6fa9e","added_by":"auto","created_at":"2025-10-13 11:14:51","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":4652,"visible":true,"origin":"","legend":"","description":"","filename":"cd7eed09777e4e729706ef77945731ba.json","url":"https://assets-eu.researchsquare.com/files/rs-7401799/v1/8294b61b539d6dd4225b6d70.json"},{"id":93394391,"identity":"c97e345a-955d-4c32-a847-ce27ba003398","added_by":"auto","created_at":"2025-10-13 11:22:51","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":57447,"visible":true,"origin":"","legend":"","description":"","filename":"cd7eed09777e4e729706ef77945731ba1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7401799/v1/7d2a56a6da2c745adb98a2ec.xml"},{"id":93394054,"identity":"39dc9525-b087-4452-8c13-2854b5847ad0","added_by":"auto","created_at":"2025-10-13 11:14:52","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":57008,"visible":true,"origin":"","legend":"","description":"","filename":"cd7eed09777e4e729706ef77945731ba1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7401799/v1/6d40e1ce3e4a3658845521be.xml"},{"id":93394051,"identity":"a2cc9e9e-85a2-487c-8295-9ec5dad58ba3","added_by":"auto","created_at":"2025-10-13 11:14:51","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":65937,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7401799/v1/ba79da2092ddfc331b049c3d.html"},{"id":94474008,"identity":"c348f770-d7d8-4830-88e3-505b9365f0d6","added_by":"auto","created_at":"2025-10-27 15:46:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":751760,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7401799/v1/b4b08380-8ece-47ec-bf32-ede28ba66b35.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Parental stress and coping strategies during pediatric hospitalization: a descriptive study at the University Hospital of Salamanca","fulltext":[{"header":"Background","content":"\u003cp\u003eHospitalization of a child is a stressful experience for parents, often associated with anxiety, depression, and vulnerability (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This situation disrupts family routines and is intensified by exposure to invasive procedures and medical devices.\u003c/p\u003e\u003cp\u003eIn Castilla y Le\u0026oacute;n, Spain, 52,080 children under 14 years were hospitalized in 2023, of whom 35% were admitted to neonatal units and 64.7% to pediatric units; 3.32% and 8.11% respectively required intensive care (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePrevious studies highlight that professional support and adequate information can reduce parental stress and enhance the use of adaptive coping strategies (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Nurses play a central role in this process, as they are the professionals most frequently in contact with the child and family, integrating physical, psychological, and social care (\u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eParental coping depends on several factors, including communication with healthcare providers, disruption of parental role, and the quality of information received (\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Nursing interventions can therefore promote psychological adaptation by providing support and effective communication.\u003c/p\u003e\u003cp\u003eThe aim of this study was to identify parental stress levels and coping strategies during pediatric hospitalization at the University Hospital of Salamanca, and to explore the role of nursing interventions in this process.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eDesign\u003c/strong\u003e\u003cp\u003eDescriptive, quantitative, cross-sectional study.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eSetting and period\u003c/strong\u003e\u003cp\u003ePediatric hospitalization units at the University Hospital of Salamanca, from December 2023 to May 2024.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eParticipants\u003c/b\u003e: Parents of children under 14 years hospitalized for \u0026ge;\u0026thinsp;48 hours. Inclusion criteria: Spanish language comprehension and informed consent. Sampling was non-probabilistic, by convenience.\u003c/p\u003e\u003cp\u003e\u003cb\u003eInstruments\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eParental Stressor Scale: Infant Hospitalization (PSS:IH)\u003c/b\u003e, Spanish validated version (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), consisting of 36 items in 7 subscales.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eCoping Strategies Inventory (CSI)\u003c/b\u003e, Spanish adaptation by Cano (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), 40 items in 8 subscales.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eAd hoc sociodemographic and clinical questionnaire.\u003c/b\u003e\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eVariables:\u003c/h2\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eIndependent: parental age, sex, role, number of children; child\u0026rsquo;s age, reason for admission, previous hospitalizations, unit.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eDependent: parental stress level, coping strategies, perceived nursing information and support.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAnalysis\u003c/strong\u003e\u003cp\u003eMeans and standard deviations for quantitative variables; frequencies and percentages for categorical variables. Hypothesis testing and correlations (Pearson/Spearman depending on normality; Shapiro-Wilk, Levene tests). Significance threshold p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Analyses performed using SPSS v28.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthical considerations\u003c/b\u003e: This study was conducted \u003cb\u003ein accordance with the principles of the Declaration of Helsinki\u003c/b\u003e. Ethical approval was obtained from the \u003cb\u003eResearch Ethics Committee of the University of Salamanca (CEIm: 2023/04/1271-TD)\u003c/b\u003e. Written informed consent was obtained from all participants.\u003c/p\u003e\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement:\u0026nbsp;\u003c/strong\u003eThis study \u003cstrong\u003edid not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/strong\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOf 96 parents recruited, 84 met inclusion criteria. Most were women (62.7%), with a mean age of 36.1 years and mean 1.65 children.\u003c/p\u003e\n\u003cp\u003eMain reasons for admission were respiratory pathology (34.6%), infectious disease (11.5%), and prematurity (10.3%). The mean child age was 3.3\u0026plusmn;4.7 years; 87% were under 8 years. Mean hospital stay was 9.4 days.\u003c/p\u003e\n\u003cp\u003eMean parental stress level was moderate (x̄=2.77). Most stressful items: mechanical ventilation (75.6%), tubes/catheters (73.6%), child in pain (72.6%), monitor/equipment alarms (71.8%). Significant correlation between stress related to communication with healthcare staff and child age (rho=0.309; p=0.02).\u0026nbsp;\u0026ldquo;The differences are summarized in \u003cstrong\u003eTable 1\u003c/strong\u003e.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eMothers showed higher stress linked to disruption of parental role (p=0.05). Most frequent coping strategies: wishful thinking (x̄=22), problem-solving (x̄=20.3), cognitive restructuring (x̄=16).\u0026nbsp;\u0026ldquo;Detailed correlations are shown in \u003cstrong\u003eTable 2\u003c/strong\u003e.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFewer children were associated with greater use of problem-solving (rho=-0.331; p=0.045). Nursing information and support correlated with problem-solving (rho=0.779; p=0.003) and social support (rho=0.631; p=0.005).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study found moderate parental stress levels, consistent with previous reports (16,17). \u0026ldquo;A machine is breathing for my child\u0026rdquo; was the most stressful item, in line with earlier findings (18\u0026ndash;20).\u003c/p\u003e\n\u003cp\u003eAlthough not statistically significant in this sample, duration of hospitalization has been linked to parental stress in other studies, with higher levels reported during the first 7\u0026ndash;15 days (21,22).\u003c/p\u003e\n\u003cp\u003eCoping strategies most commonly used were problem-solving and cognitive restructuring, both problem-focused, consistent with prior research (23\u0026ndash;25).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNursing support and communication were associated with greater use of adaptive strategies, reducing anxiety and facilitating family integration during hospitalization (26\u0026ndash;28).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations:\u003c/strong\u003e The study was limited by sample size and descriptive cross-sectional design, which did not allow assessment of changes over time or causality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u0026nbsp;\u003c/strong\u003eThe authors declare no conflict of interest.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eParental stress during pediatric hospitalization is mainly driven by invasive procedures and the use of medical devices. Disruption of the parental role is an additional stressor, particularly for mothers.\u003c/p\u003e\n\u003cp\u003eNursing interventions focusing on communication and emotional support promote the use of adaptive coping strategies, such as problem-solving and social support, thereby improving the family\u0026rsquo;s adaptation process.\u003c/p\u003e\n\u003cp\u003eValidated instruments to assess family coping could be integrated into routine practice to guide tailored interventions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\u003ch2\u003eFunding Statement:\u003c/h2\u003e\u003cp\u003eThis study \u003cb\u003edid not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/b\u003e\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJonathan Adalia Rodriguez: Conceptualization, Methodology, Investigation, Writing \u0026ndash; original draft.Ana Mar\u0026iacute;a Ull\u0026aacute;n de la Fuente: Supervision, Writing \u0026ndash; review \u0026amp; editing.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003ehttps://gredos.usal.es/handle/10366/164979\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOxley R. 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Available from: https://dspace.umh.es/handle/11000/3134\u003c/li\u003e\n\u003cli\u003eDe la Huerta R, Corona J, M\u0026eacute;ndez J. Assessment of coping styles in primary caregivers of children with cancer. Neurolog\u0026iacute;a, Neurocirug\u0026iacute;a y Psiquiatr\u0026iacute;a [Internet]. 2006 [cited 2024 Apr 8];39(1):46\u0026ndash;51. Available from: https://www.medigraphic.com/pdfs/revneuneupsi/nnp-2006/nnp061g.pdf\u003c/li\u003e\n\u003cli\u003eBall J, Bindler R, Cowen K. \u003cem\u003eChild health nursing: partnership with children and families.\u003c/em\u003e 3rd ed. Madrid: Pearson Education; 2014.\u003c/li\u003e\n\u003cli\u003eBarros I, Louren\u0026ccedil;o M, Nunes E, Charepe Z. Nursing interventions promoting adaptation of the child/adolescent/family to hospitalization. \u003cem\u003eEnfermer\u0026iacute;a Global\u003c/em\u003e [Internet]. 2021 [cited 2024 Jun 3];21(1):539-596. Available from: https://dialnet.unirioja.es/servlet/articulo?codigo=7750633\u003c/li\u003e\n\u003cli\u003eAra\u0026uacute;jo YBD, Collet N, Moura FMD, N\u0026oacute;brega RDD. Family knowledge about chronic conditions in childhood. \u003cem\u003eTexto \u0026amp; Contexto-Enfermagem\u003c/em\u003e [Internet]. 2009 [cited 2024 Jan 7];18:498-505. Available from: https://www.redalyc.org/pdf/714/71411760013.pdf\u003c/li\u003e\n\u003cli\u003eAftyka A, Rozalska I, Milanowska J. Is post-traumatic growth possible in the parents of former patients of neonatal intensive care units? \u003cem\u003eAnn Agric Environ Med\u003c/em\u003e [Internet]. 2020 [cited 2024 Feb 5];27(1):106-112. Available from: http://dx.doi.org/10.26444/aaem/105800\u003c/li\u003e\n\u003cli\u003eLyu QY, Kong SKF, Wong FKY, You LM, Yan J, Zhou XZ, Li XW. Psychometric validation of an instrument to measure family coping during a child\u0026apos;s hospitalization for cancer. \u003cem\u003eCancer Nursing\u003c/em\u003e [Internet]. 2017 [cited 2024 May 3];40(3):194\u0026ndash;200. Available from: https://doi.org/10.1097/NCC.0000000000000382\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Mann-Whitney W test between hospitalization units and parental stress levels\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse;border: none;width: 567px;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:windowtext 1.0pt;border-left: windowtext 1.0pt;border-bottom:black 1.5pt;border-right:black 1.0pt;border-style:solid;background:#DEEAF6;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eHospitalization units\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;background:#DEEAF6;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eCommunication subscale\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid black 1.5pt;border-right:solid windowtext 1.0pt;background:#DEEAF6;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cstrong\u003e\u003cspan style=\"color:black;\"\u003eBehavior subscale\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:141.5pt;border-top:none;border-left: solid black 1.5pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003eNeonatal ICU / Neonatal Intermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eRanks = \u003cstrong\u003e\u003cspan style=\"color:#538135;\"\u003e10\u003c/span\u003e\u003c/strong\u003e/5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.5pt;background:white;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks =\u0026nbsp;\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#538135;'\u003e15,50\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003e/8,79\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eW = 7 / p = \u003cspan style=\"color:red;\"\u003e0,023\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.5pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eW = 27,5 / p = \u003cspan style=\"color:red;\"\u003e0,013\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:141.5pt;border-top:none;border-left: solid black 1.5pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003ePediatric ward/ Neonatal Intermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eRanks = \u003cstrong\u003e\u003cspan style=\"color:#538135;\"\u003e23,57\u003c/span\u003e\u003c/strong\u003e/8,5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.5pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eRanks = \u003cstrong\u003e\u003cspan style=\"color:#538135;\"\u003e29,14\u003c/span\u003e\u003c/strong\u003e/15,79\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eW = 31,50 / p = \u003cspan style=\"color:red;\"\u003e0,001\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.5pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eW = 111,5 / p = \u003cspan style=\"color:red;\"\u003e0,005\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:141.5pt;border-top:none;border-left: solid black 1.5pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003ePediatric ICU/ Neonatal Intermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks =\u0026nbsp;\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#3A7C22;'\u003e9,25\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003e/6,57\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.5pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks = 10,44/\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#3A7C22;'\u003e10,54\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eW = 18 / p = 0,25\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.5pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eW = 47,5 / p = 0,984\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:141.5pt;border-top:none;border-left: solid black 1.5pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003ePediatric ward/ Neonatal ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks =\u0026nbsp;\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#3A7C22;'\u003e21,46/\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003e18,79\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.5pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks = 25,23/\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#3A7C22;'\u003e26,45\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eW = 103,5 / p = 0,604\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.5pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eW = 204/ p = 0,81\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:141.5pt;border-top:none;border-left: solid black 1.5pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003ePediatric ward/ Pediatric ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eRanks = \u003cstrong\u003e\u003cspan style=\"color:#538135;\"\u003e23,31\u003c/span\u003e\u003c/strong\u003e/13,81\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.5pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eRanks = \u003cstrong\u003e\u003cspan style=\"color:#538135;\"\u003e26,10\u003c/span\u003e\u003c/strong\u003e/13,75\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eW = 74,5 / p = \u003cspan style=\"color:red;\"\u003e0,046\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.5pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eW = 74/ p = \u003cspan style=\"color:red;\"\u003e0,018\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:141.5pt;border-top:none;border-left: solid black 1.5pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003eNeonatal ICU / Pediatric ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks =\u0026nbsp;\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#3A7C22;'\u003e9,71\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003e/6,50\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.5pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eRanks =\u0026nbsp;\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:#3A7C22;'\u003e12,14\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003e/7,06\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.0pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eW = 16 / p = 0,178\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:141.5pt;border-top:none;border-left:none;border-bottom:solid black 1.5pt;border-right:solid black 1.5pt;background:#EDEDED;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;color:black;'\u003eW = 20,5 / p = 0,051\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNotes: Units were compared in pairs using the mean parental stress level in the communication and staff behavior subscales. A significance level of p \u0026lt; 0.05 was applied.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Correlations between coping strategies and information and support received by parents\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse;border: none;width: 573px;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:121.15pt;border-top:windowtext;border-left:windowtext;border-bottom:black;border-right:black;border-style:solid;border-width:1.0pt;background:#DAE8F8;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cstrong\u003e\u003cspan style=\"font-family: Aptos;color:black;\"\u003eCoping strategies\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:157.3pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;background:#DAE8F8;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cstrong\u003e\u003cspan style=\"font-family: Aptos;color:black;\"\u003eInformation received\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:150.55pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid black 1.0pt;border-right:solid windowtext 1.0pt;background:#DAE8F8;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cstrong\u003e\u003cspan style=\"font-family: Aptos;color:black;\"\u003eSupport received\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:121.15pt;border-top:none;border-left:solid windowtext 1.0pt;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003e\u003cspan style=\"font-family:Aptos;\"\u003eProblem solving\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:157.3pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e(rho = 0,779; p = \u003cspan style=\"color:red;\"\u003e0,003\u003c/span\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:150.55pt;border-top:none;border-left:none;border-bottom:solid black 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e(rho = 0,634; p = \u003cspan style=\"color:red;\"\u003e0,02\u003c/span\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:121.15pt;border-top:none;border-left:solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:normal;font-size:16px;font-family:\"Aptos\",sans-serif;'\u003e\u003cspan style=\"font-family:Aptos;\"\u003eSocial support\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:157.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid black 1.0pt;padding:0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e(rho = 0,631; p = \u003cspan style=\"color:red;\"\u003e0,005\u003c/span\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:150.55pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 5.25pt 0cm 5.25pt;height:15.0pt;\"\u003e\n \u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;line-height:150%;font-size:16px;font-family:\"Aptos\",sans-serif;text-align:center;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e(r = 0,523; p = \u003cspan style=\"color:red;\"\u003e0,018\u003c/span\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNotes: Correlations between coping strategies and the means of information and support received. Pearson\u0026rsquo;s r was used for parametric values and Spearman\u0026rsquo;s rho for non-parametric values, with a significance level of p \u0026lt; 0.05.\u003c/em\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7401799/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7401799/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003e Child hospitalization generates significant psychological distress in parents, who may experience stress, anxiety, and feelings of helplessness. Nursing support can play a key role in facilitating coping and family adaptation.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo identify levels of stress and coping strategies used by parents during their child\u0026rsquo;s hospitalization in pediatric units at the University Hospital of Salamanca, and to analyze the influence of nursing interventions on this process.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA descriptive, quantitative, cross-sectional study was conducted between December 2023 and May 2024. Data were collected through an ad hoc self-administered questionnaire including the Parental Stressor Scale: Infant Hospitalization (PSS:IH) and the Coping Strategies Inventory. Participants were parents of children under 14 years hospitalized\u0026thinsp;\u0026ge;\u0026thinsp;48 hours. Sociodemographic, clinical, stress, coping, and nursing support variables were analyzed using descriptive and inferential statistics (SPSS v28).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 84 parents were included (62.7% women; mean age 36.1 years; mean number of children 1.65). The mean parental stress level was moderate (x̄=2.77). The most stressful items were: child on mechanical ventilation (75.6%), presence of tubes/catheters (73.6%), child in pain (72.6%), and alarms from monitors/equipment (71.8%). Mothers showed higher stress related to disruption of parental role (p\u0026thinsp;=\u0026thinsp;0.05). The most frequent coping strategies were wishful thinking (x̄=22) and problem-solving (x̄=20.3). Nursing information and support were positively correlated with the use of problem-solving (rho\u0026thinsp;=\u0026thinsp;0.779; p\u0026thinsp;=\u0026thinsp;0.003) and social support (rho\u0026thinsp;=\u0026thinsp;0.631; p\u0026thinsp;=\u0026thinsp;0.005).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eParental stress during pediatric hospitalization is mainly associated with invasive procedures and medical devices. Nursing interventions focused on communication and emotional support foster adaptive coping strategies and facilitate family adjustment.\u003c/p\u003e","manuscriptTitle":"Parental stress and coping strategies during pediatric hospitalization: a descriptive study at the University Hospital of Salamanca","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-13 11:14:47","doi":"10.21203/rs.3.rs-7401799/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"570ba1fd-2867-4954-a17e-764a950e8523","owner":[],"postedDate":"October 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-27T14:30:01+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-13 11:14:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7401799","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7401799","identity":"rs-7401799","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}