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Biomedical subjects

M S Miles

Publications and source records attributed to M S Miles.

At least 37 records · Page 2Linked to original sources
PubMed1991

Preparation of parents for the ICU experience: what are we missing?

This study examined the stress experienced by parents of children hospitalized in an intensive care unit (ICU) and explored the degree to which parents are prepared for specific aspects of the ICU environment. Twenty-two mothers and 6 fathers of 22 children hospitalized in a pediatric ICU were interviewed using the Parental Stressor Scale: Pediatric Intensive Care Unit, the Parent Preparation questionnaire designed for this study, and a personal-situational questionnaire. A majority of parents (82%) responded that they had been prepared in some manner and considered the preparation adequate. The dimensions of the ICU that were perceived by parents as most stressful were the child's behavior and the child's emotional response, and parental role alterations. The dimensions of the ICU environment that parents were least likely to have been prepared for or receive help with were these same dimensions. When parents were prepared for or helped with aspects of the ICU, they perceived the adequacy of that help as high. The results of this study suggested that an important focus in parental education and support should be on the parent-child relationship, the most stressful aspect of a child's ICU admission for parents.

Adult↗
PubMed1991

The neonatal intensive care unit environment: sources of stress for parents.

Many aspects of neonatal intensive care units (NICUs) are stressful to parents, including prolonged hospitalization, alterations in parenting, exposure to a technical environment, and the appearance of their small, fragile infant. To identify potential NICU stressors for parents, levels of stress these experiences engender, and their relationship to anxiety, parents of infants hospitalized in three NICUs were interviewed using the Parental Stressor Scale: NICU and the State-Trait Anxiety Inventory. Alterations in parental role caused by the infant's illness generated the greatest stress. The second highest areas of stress were the infant's appearance and behavior. State anxiety levels were higher than normative means and significantly related to stress scores.

Adolescent↗
PubMed1989

The Parental Stressor Scale: Pediatric Intensive Care Unit.

This article details the development of an instrument designed to assess the impact of certain environmental stressors in the pediatric intensive care unit (ICU) on parents of hospitalized children. A theoretical framework based on stress theory and developed by the authors provided the framework for this project. This 62-item scale assessing seven dimensions of the PICU environment was developed in three stages. The first phase in the development of the instrument established the sampling domain of the items, supported content validity, conceptualized the dimensions, developed the scaling, and helped support stability over time. In the second phase of the project, the instrument was administered to 165 parents of children recently discharged from four midwestern ICUs to further evaluate reliability and validity. Results of factor analysis, internal consistency reliability, and construct validity analyses were used to revise the instrument. In the third phase of the project, the revised instrument was administered to 510 parents while their children were in one of five pediatric ICUs. Factor analysis provided seven orthogonal, invariant factors. An alpha coefficient of .95 was obtained for the total instrument; subscale coefficients ranged from .72 to .99 providing support for internal consistency and construct validity.

Child, Preschool↗
PubMed1989

The pediatric intensive care unit environment as a source of stress for parents.

Parents of children hospitalized in one of five midwestern pediatric intensive care units (ICU) were interviewed about the stress experienced from aspects of the ICU environment. Subjects were 324 mothers and 186 fathers of 350 children. Data were collected using the Parental Stressor Scale: Pediatric ICU which assesses seven dimensions of the environment: Child's Behavior and Emotions, Child's Appearance, Sights and Sounds, Procedures, Staff Communication, Anomie, and Parental Role Alteration. The dimensions Child's Behavior and Emotions and Parental Role Alteration were found to be the most stressful aspects of the experience. The items from the dimension Child's Behavior and Emotions that were most stressful were seeing my child in pain, seeing the child frightened and sad, and the inability of the child to communicate with the parent. The items from the Parental Role Alteration dimension with the highest stress scores were: feeling unable to protect my child and not knowing how to best help my child. Findings suggest that alterations in the parent-child relationship are more stressful than aspects of the physical environment. In particular, feeling helpless in the parenting role is a great source of stress for parents.

Adaptation, Psychological↗
PubMed1989

Testing a theoretical model: correlates of parental stress responses in the pediatric intensive care unit.

This study was designed to evaluate a theoretical framework, based on stress theory, which identifies potential sources of stress in parents of children hospitalized in an intensive care unit (ICU). The framework suggests that personal, situational, and ICU environmental stress stimuli interactively impact on the overall parental stress response. Multiple regression techniques were used to evaluate the interaction of personal family factors, situational stimuli, and ICU environmental stressors and to assess their impact upon the overall parental stress response. Data were collected from 510 parents of children hospitalized in one of five midwestern ICUs. Instruments used were the Parental Stressor Scale: Pediatric ICU (Carter & Miles, 1984), the State-Trait Anxiety Scale (Spielberger, Gorsuch, & Luschene, 1970), the Review of Life Experiences Scale (Hurst, Jenkins, & Rose, 1978), and a personal-experiential questionnaire. Results indicate that a number of personal and situational variables were predictive of higher stress. In addition two aspects of the ICU environment contributed the most variance to the overall stress of parents: alterations in the parental role and the child's behavioral and emotional responses. In evaluating the full framework, one personal variable (Trait Anxiety); two situational variables (perception of severity and type of admission); and three ICU environmental dimensions, (parental role alteration, the child's behavior and emotional response, and the child's appearance) significantly predicted stress (State Anxiety). The findings support the theoretical framework underlying this study as a useful model for studying and evaluating parental stress during a child's admission to an ICU. Results also suggest that additional personal family and situational factors, such as uncertainty, may need to be added to the model to more fully predict parental stress responses.

Adolescent↗
PubMed1987

Diel and seasonal changes in resting plasma cortisol levels in juvenile Atlantic salmon, Salmo salar L.

Plasma cortisol levels in juvenile Atlantic salmon, Salmo salar L., were higher at night than during the day from September to May, and were higher in the morning than at night from June to August. Mean nocturnal levels increased slightly from August (less than 1.4 ng/ml) to January (18.2 ng/ml), sharply to a peak in March (46.0 ng/ml), and then declined sharply again reaching minimal values in July (less than 1.4 ng/ml). With the exception of a February peak (7.7 ng/ml) mean diurnal levels also increased slightly from a September minimum of (less than 1.4 ng/ml) to April (3.3 ng/ml), then more sharply to plateau from May to July (8.2-11.0 ng/ml), and declined again to September. The data support the hypothesis that rising cortisol levels in spring represent a generalized stress response to behavioral and physiological maladaptation at smolting.

Adaptation, Physiological↗
PubMed1985

Coping strategies used by parents during their child's hospitalization in an intensive care unit.

The purpose of this study was to identify staff behaviors and parental coping patterns helpful to parents during their child's hospitalization in a pediatric intensive care unit. Subjects were 21 mothers and 15 fathers of 27 hospitalized children. The study used a retrospective self-report method in which parents were asked their perception regarding the use and helpfulness of a number of staff behaviors, as well as whether or not these staff behaviors were experienced. A large percentage of the parents in this study perceived health care professionals in the pediatric intensive care units under study as providing, at least minimally, all of the staff behaviors/interventions listed. The staff behavior seen as most important by the largest number of parents was "being permitted to stay with their child as much as possible." In evaluating the overall findings regarding personal coping strategies, it appears that parents most frequently used problem-focused coping strategies and that these strategies were seen as most helpful. Emotion-focused coping was used by a slightly lower percentage of parents than the other categories.

Adaptation, Psychological↗
PubMed1983

Sources of parental stress in pediatric intensive care units.

This study utilized an inductive approach to identify sources of stress experienced by parents when a child is admitted to a pediatric intensive care unit. Based on a thorough review of the literature, clinical observations, and interviews with parents of children recently discharged from a pediatric intensive care unit, 79 items defining eight dimensions of pediatric intensive care stressors were identified. Suggestions are made for intervention strategies that can be utilized in an attempt to minimize parental stress.

Humans↗