Resources, Workload, and Care Coordination Hours Predict Depressive Symptoms in Parents of Children with Medical Complexity

Abstract

Category/Date

Clinical Research Podium Presentations: Current Topics in Pediatric Research. Presented at NAPNAP's 45^th National Conference on Pediatric Health Care, March 14, 2024.

Background

Parents of children with medical complexity (CMC) experience social hardships, financial strain, and demanding care. Research examining their mental health is limited.

Aims

This study examined relationships among financial resources, social support, parents’ workload and capacity to care for their CMC, and how these impact parental depressive symptoms, particularly when workload exceeds capacity.

Methods

A cross-sectional, correlational design was used in a national sample of 106 parents of CMC, recruited using social media after IRB approval. Pearson's correlation and multiple regression were used to examine relationships using well-validated, reliable instruments.

Results

Parent participants were white (84.9%), college educated (37.7%) mothers (98.1%), ranging from 23 to 47 years, residing in 40 of 50 states. CMC averaged 33.78 months of age, with 40.6% having 2-5 chronic conditions. CMC required an average of 8.57 weekly care coordination hours. Nearly 62% of parents reported clinically significant depressive symptoms. Higher financial resources were associated with lower workload (r = - 0.47, p <.001), higher capacity (r = .54, p < .001), and lower depressive symptom scores (r = - 0.56, p < .001). When workload exceeded capacity, it predicted parental depressive symptoms (Adj. R2 = .203, F (1, 104) = 27.714, p = < .001). The number of weekly hours parents coordinate care (β = .38, SE= .16, p = <.001) significantly contributed to depressive symptoms. Together social support, financial resources, workload, and capacity explained 32.4% of the variance in depressive symptoms, with financial resources being the strongest predictor.

Conclusions

In this sample of parents with CMC, depressive symptoms were common, and were associated with inadequate financial resources, high workload, and high care coordination hours. Results emphasize the importance of care coordination support and screening for depressive symptoms. Future research will include diverse samples and health literacy as a proxy for capacity.