The impact of parental psychological distress on child behavior issues in hospitalized children

Submitted: 10 February 2023
Accepted: 21 May 2023
Published: 12 June 2023
Abstract Views: 749
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  • Ayu Widya Lestari Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia; Department of Nursing, Universitas Indonesia Hospital, Depok, Indonesia.
  • Chia-Kuei Lee Department of Nursing, Medical College, National Cheng Kung University, Tainan, Taiwan.
  • Happy Hayati Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.

Child hospitalization has a negative impact on both children and parents’ psychological well-being. Although prior studies in the general context demonstrated a favorable link between parental psychological distress and child behavior problems, research in the hospital situation was restricted. The purpose of this study was to see if parental psychological distress has an effect on child behavior problems in hospitalized children in Indonesia. This cross-sectional study included 156 parents who were recruited from four pediatric wards using a convenience sampling method between August 17 and December 25, 2020. The Hospital Anxiety and Depression Scale and the Child Behavior Checklist 1.5-5 and 6-18 were utilized. Parental anxiety was found to be a significant predictor of increased total behavior issue, internalizing behavior, externalizing behavior, anxious/ depressed, somatic complaints, and violent conduct in hospitalized children. Parental depression, on the other hand, was not related with any of the child behavior issue syndrome measures. The findings imply that identifying and treating parent anxiety early on is critical for preventing or reducing child behavior problems during hospitalization.

Hostert PCCP, Motta AB, Enumo SRF. Coping with hospitalization in children with cancer: the importance of the hospital school. Estud Psicol 2015;32:627-39. DOI:

Kennedy C, Kools S, Kong SKF, et al. Behavioral, emotional and family functioning of hospitalized children in China and Hong Kong. Int Nurs Rev 2004;51:34-6. DOI:

Levy MC, Kronenberger WG, Carter BD. Brief report: illness factors and child behavior before and during pediatric hospitalization. J Pediatr Psychol 2008;33:905-9. DOI:

Doupnik SK. Mental health conditions and symptoms in pediatric hospitalizations: a single-center point prevalence study. Acad Pediatr 2017;17:184-90. DOI:

Markovic, Jasminka, Romic T. Mental health problems and speech development in toddlers with physical illnesses. Med Pregl 2015;68:5-6. DOI:

Rukabyarwema JP, McCall N, Ngambe T, et al. Behavior problems in physically ill children in Rwanda. J Dev Behav Pediatr 2019;40:642-50. DOI:

Yeh CH, Wang YF. Competence of and emotional/behavioral problems in pediatric oncology patients in Taiwan. Cancer Nurs 2004;27:413–22. DOI:

Othman A, Mohamad N, Hussin ZA, Blunden S. Psychological distress and associated factors in parents of children with cancer. Int J Soc Sci Humanit 2011;1:37-42. DOI:

Jee R, Shepherd J, Boyles C, et al. Evaluation and comparison of parental needs, stressors, and coping strategies in a pediatric intensive care unit. Pediatr Crit Care Med 2012;13:166–75. DOI:

Stremler R, Haddad S, Pullenayegum E, Parshuram C. Psychological outcomes in parents of critically ill hospitalized children. J Pediatr Nurs 2017;34:36-43. DOI:

Verkleij M, Van de Griendt E-J, Colland V, et al. Parenting stress related to behavioural problems and disease severity in children with problematic severe asthma. J Clin Psychol 2015;22:179-93. DOI:

Achenbach TM, Rescorla LA. Manual for the ASEBA preschool forms & profiles. Burlington, VT: University of Vermont; 2000

Achenbach TM, Rescorla LA Manual for the ASEBA preschool forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families; 2001

Hartini S, Sunartini, Herini ES, et al. Effectiveness of CBCL 1.5-5 for detection of emotional and behavioral problem in autistic spectrum disorder children. Indian J Public Health Res Dev 2019;10:1981-6. DOI:

Hartini S, Hapsara S, Herini SE, Takada S. Verifying the Indonesiaan version of the child behavior checklist. Pediatr Int 2015;57:936-41. DOI:

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70. DOI:

Rudi M, Widyadharma IPE, Adnyana IMO. Reliability Indonesian Version of The Hospital Anxiety and Depression Scale (HADS) of Stroke Patient In Sanglah General Hospital Denpasar. Research Gate; 2012. DOI:10.13140/RG.2.1.3604.5928

Irwanto, Kahfi M, Febriyana N, Hartini S, Takada S. Emotional and behavioral problems of pre-school children with autistic spectrum disorder assessed by the child behavior checklist 1.5-5. Kobe J Med Sci 2018;64:E170-3.

Jones R, White P, Armstrong D, et al. London: The King's Fund; 2010. Managing acute illness. An inquiry into the quality of general practice in England.

Lestari, A. W., Lee, C.-K., & Hayati, H. (2023). The impact of parental psychological distress on child behavior issues in hospitalized children. La Pediatria Medica E Chirurgica, 45(1).


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