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: 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.