Factors associated with the mental health of parents during and after their child's hospitalisation: an international longitudinal prospective cohort study.

BACKGROUND

A child's hospitalisation may have long-term influences on parental mental health, which can affect child health.

OBJECTIVE

To describe the prevalence of and examine factors associated with parents' depression and anxiety symptoms over time.

METHODS

This prospective cohort study in 14 countries measured parent mental health during their child's hospitalisation, at discharge and 3 months postdischarge (2023-2024). We included parents ≥18 years staying at a Ronald McDonald House® during their child's hospitalisation. Exposures were parent, family and child psychosocial and health factors and hospital experiences. Outcomes were parental depression and anxiety symptoms. We used mixed-effects logistic regression.

FINDINGS: 3350 parents, including 2594 (78.6%) mothers, 616 (18.1%) fathers and 131 (3.3%) other caregivers, participated during hospitalisation; 1751 (52%) at discharge, and 2395 (71%) postdischarge. Prevalence of depression and anxiety symptoms was high during hospitalisation (49.7% and 69.0%, respectively) and decreased modestly at discharge (44.6% and 59.5%, respectively), and postdischarge (42.8% and 59.2%, respectively). Over time, probabilities of depression symptoms decreased among those with high, moderate and low levels of social support (50%, 27%, 5%, respectively), and self-care (29%, 27% and 22%, respectively). Probabilities of depression symptoms decreased among those with high or moderate perceived levels of family-centred care (high: 20% decrease; moderate: 11% decrease, compared with low). In contrast, probabilities of depression symptoms increased among those with high or moderate levels of unmet basic needs (high: 18% increase; moderate: 8% increase, compared with low) and poorer ratings of their child's health (high: 68% increase; moderate: 32% increase, compared with low (healthier)). These trends were similar for anxiety symptoms.

CONCLUSIONS

Prevalence of depression and anxiety symptoms is high among parents and only decreases modestly postdischarge.

CLINICAL IMPLICATIONS: Routine screening and ongoing services may lower the risk of prolonged parental mental health symptoms, but more research is needed.