Perception of uncertainty among parents of children with pneumonia undergoing mechanical ventilation: what should we focus on

Abstract

Background: Parental illness uncertainty significantly impacts the quality of life of caregivers of ill children, particularly for those whose children require mechanical ventilation due to severe pneumonia-a population facing unique clinical and psychological stressors. This study aimed to describe the current status of illness uncertainty and analyze its influencing factors among parents of children with pneumonia undergoing mechanical ventilation.

Methods: A cross-sectional survey design was used. Consecutive sampling was adopted to recruit parents of children with pneumonia receiving mechanical ventilation in the Pediatric Intensive Care Unit (PICU) of a tertiary A-level children's hospital in Jiangsu, China. Data were collected using the Chinese version of the Parental Perception of Uncertainty Scale (PPUS) and a self-designed general information questionnaire. Questionnaires were administered 48-72 h after mechanical ventilation initiation, with independent completion by parents or researcher assistance for those with reading difficulties. Statistical analyses included Pearson/Spearman correlation and multivariate linear regression.

Clinical trial number: not applicable.

Results: A total of 208 parents were included in the final analysis. The total score of parental illness uncertainty was (122.41 ± 18.06). Parental illness uncertainty scores were significantly correlated with parental age, place of residence, educational level, marital status, per capita monthly household income, and number of children (all p < 0.05). Multivariate linear regression analysis identified these six variables as independent influencing factors, collectively explaining 59.2% of the variance in illness uncertainty (R²=0.592, F = 24.688, p < 0.001).

Conclusions: Parents of children with pneumonia undergoing mechanical ventilation exhibit a high level of illness uncertainty, with unpredictability and ambiguity as the primary contributing dimensions. Clinical nursing interventions should target these high-risk groups, implementing individualized strategies such as simplified health education (for low-education parents), one-on-one emotional counseling (for single-child and divorced parents), and social resource linkage (for rural and low-income families) to reduce illness uncertainty and enhance family coping capacities.

Keywords: Care; Children; Clinical; Nursing; Parents; Perception; Uncertainty.