Parents may be in a fog when children come home from hospital

Parents caring for children discharged from the hospital face many stressors and can feel they are "in a fog" that may make it harder for them to process important information, according to a new study.

"We had ideas about what experiences these families faced as they tried to settle back into their home routine after hospitalization, but we certainly learned a great deal more about the specifics," said lead author Dr. Lauren G. Solan of the University of Rochester Medical Center.

"This allowed us to paint a much clearer picture about what a hospital to home transition looks like from the family perspective and identify some of the main challenges families face as they try to have a smooth transition home," Solan told Reuters Health by email.

The researchers surveyed adult caregivers of children under age 18 who had been discharged from Cincinnati Children's Hospital Medical Center. The caregivers were recruited for the study while the child was hospitalized and returned to the hospital for a focus group 30 days after the child was discharged.

Moderators held the 90-minute sessions in conference rooms and asked about aspects of the inpatient experience, discharge processes, and health system and family factors.

In the end the researchers analyzed answers from 53 female and eight male adult caregivers.

Many reported feeling "in a fog" due to sleep deprivation and worry during the transition from hospital to home, which may have prevented them from appropriately processing information that may be critical to caring for their child, the researchers reported in Pediatrics.

"This is important because, often, we as health care providers give families lots of instructions at the time of discharge," Solan said.

"Other sources of stress included the sometimes complicated care plans their child was discharged home on, if their child did not recover from their illness as quickly as expected or worsened, missing days from work and/or school, and knowing the right person to call with questions after discharge," Solan said.

"Empathy seems all the more important as a result of these findings," she said.

Some people expressed desire for health providers to follow-up after discharge either by phone or home nurse visit to check up on their child.

Pamela F. Cipriano, president of the American Nurses Association, told Reuters Health by email that doctors and nurses can help family members prepare to take their child home by asking them to repeat back critical information to assess their understanding and retention, and by correcting misinformation or expanding with greater clarity.

Cipriano, who was not part of the new study, added that it's important that preparations be done with enough time to allow "for a calm discussion without distraction."

"These sorts of interventions may be key to making the transition easier for families and are interventions we're currently testing," Solan said. "Some of the other ways to make the transition easier, including allowing caregivers time off from work/school to care for their ill child, are much more challenging to address."

SOURCE: Pediatrics, online November 30, 2015.