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. 2018 Apr;141(4):e20172127.
doi: 10.1542/peds.2017-2127.

Parental Adverse Childhood Experiences and Resilience on Coping After Discharge

Anita N Shah  1   2 , Andrew F Beck  3   2   4 , Heidi J Sucharew  2   5 , Stacey Litman  6 , Cory Pfefferman  3   2 , Julianne Haney  7 , Samir S Shah  3   2   8 , Jeffrey M Simmons  3   2   9 , Katherine A Auger  3   2   9 ; H2O Study Group
Collaborators, Affiliations

Parental Adverse Childhood Experiences and Resilience on Coping After Discharge

Anita N Shah et al. Pediatrics. 2018 Apr.

Abstract

Background and objectives: Adults with a history of adverse childhood experiences (ACEs) (eg, abuse) have suboptimal health outcomes. Resilience may blunt this effect. The effect of parental ACEs (and resilience) on coping with challenges involving their children (eg, hospitalization) is unclear. We sought to quantify ACE and resilience scores for parents of hospitalized children and evaluate their associations to parental coping after discharge.

Methods: We conducted a prospective cohort study at a children's hospital (August 2015-May 2016). Eligible participants were English-speaking parents of children hospitalized on the Hospital Medicine or Complex Services team. The ACE questionnaire measured the responding parent's past adversity (ACE range: 0-10; ≥4 ACEs = high adversity). The Brief Resilience Scale (BRS) was used to measure their resilience (range: 1-5; higher is better). The primary outcome was measured by using the Post-Discharge Coping Difficulty Scale via a phone call 14 days post-discharge (range: 0-100; higher is worse). Associations were assessed by using multivariable linear regression, adjusting for parent- and patient-level covariates.

Results: A total of 671 (81% of eligible parents) responded. Respondents were primarily women (90%), employed (66%), and had at least a high school degree (65%); 60% of children were white, 54% were publicly insured. Sixty-four percent of parents reported ≥1 ACE; 19% had ≥4 ACEs. The mean Brief Resilience Scale score for parents was 3.95. In adjusted analyses, higher ACEs and lower resilience were significantly associated with more difficulty coping after discharge.

Conclusions: More parental adversity and less resilience are associated with parental coping difficulties after discharge, representing potentially important levers for transition-focused interventions.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
The frequency of positive responses to each included ACE question posed in descending order (n = 671).
FIGURE 2
FIGURE 2
Boxplots of BRS by ACE risk category. ACE categories include the following: low (0 ACEs), moderate (1–3 ACEs), and high (≥4 ACEs). With increasing ACE risk, the BRS median score decreases (Kruskal-Wallis P = .005).
See this image and copyright information in PMC

References

    1. Shonkoff JP, Garner AS; Committee on Psychosocial Aspects of Child and Family Health; Committee on Early Childhood, Adoption, and Dependent Care; Section on Developmental and Behavioral Pediatrics . The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129(1). Available at: www.pediatrics.org/cgi/content/full/129/1/e232 - PubMed
    1. Felitti VJ, Anda RF, Nordenberg D, et al. . Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. Am J Prev Med. 1998;14(4):245–258 - PubMed
    1. Johnson SB, Riley AW, Granger DA, Riis J. The science of early life toxic stress for pediatric practice and advocacy. Pediatrics. 2013;131(2):319–327 - PMC - PubMed
    1. Garner AS, Shonkoff JP; Committee on Psychosocial Aspects of Child and Family Health; Committee on Early Childhood, Adoption, and Dependent Care; Section on Developmental and Behavioral Pediatrics . Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics. 2012;129(1). Available at: www.pediatrics.org/cgi/content/full/129/1/e224 - PubMed
    1. Randell KA, O’Malley D, Dowd MD. Association of parental adverse childhood experiences and current child adversity. JAMA Pediatr. 2015;169(8):786–787 - PubMed

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