Measuring Parental Response Styles to Child Stress in Severe Pediatric Illness: A Validation Study

Abstract

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Background: Pediatric illnesses not only impose physical challenges on affected children, but also profoundly impact their emotional well-being. Understanding how parents respond to their children’s psychological distress during medical experiences is crucial for enhancing the overall support provided to these families. Aim: This study evaluated the internal structure of the Parental Response Styles Questionnaire (PRSQ), designed to differentiate parental responses to psychological distress in children with pediatric illnesses. Methods: A sample of 701 parents of children with medical issues responded to the PRSQ, reporting their different emotional expressions and responses to their children’s expressions of distress during the medical experience. Results: Factor analysis confirmed, in three of the five subsamples, an internal scale structure consisting of four factors: apathy and dysphoria, irritability and rejection, overprotectiveness, and perceived maladjustment. The invariance analyses revealed that congenital heart disease and neurological disorders are more similar in function to each other than pediatric cancer. Parents of children with neurological disorders exhibited a notably insecure pattern of parental responsiveness. Conclusions: In pediatric contexts, parental responses to their children’s emotional distress are significant factors in the process of adaptation. These responses can be measured, differentiated, and, ideally, managed by nurses and other healthcare professionals. The Parental Response Styles Questionnaire (PRSQ) is a promising tool for assessing parental reactions during their children’s treatment, and its structure appears to be particularly robust across diagnoses such as pediatric cancer, congenital heart disease, and neurological disorders.