One not only has to look at childhood chronic conditions in terms of the perspectives of children, but also of their parents. The children have disorders that produce pain and discomfort, but parents have stress and worry about their children’s condition. Salisbury and coworkers pointed out that spinal fusion surgery for scoliosis during adolescence is a tremendous stressor for parents. They examined parents' pre- and postoperative stressors and how they coped with them. Ninety-two parents identified their predominant stressor and completed a coping questionnaire during their adolescent's preoperative clinic visit and 77 completed this procedure 4 days postoperatively. Results showed that primary stressors were parental role loss (28.26%), possibility of poor surgical outcomes (28.26%), and uncertainty about successful recovery (27.17%) before the operation, and concerns about pain (32.47%) and parental role loss (32.47%) after the operation. The greatest increase between the two periods centered on concerns about pain. Parents used both emotion-focused and problem-focused coping strategies with significant increases post operatively in coping, problem solving, and positive reappraisal. They also showed significant decreases in self-control and seeking social support.

VALUE OF STUDY TO READER: In working with childhood surgical patients, the authors conclude that providers should target interventions to alleviate stress and bolster coping skills for parents. This is a reasonable conclusion. However, teaching self-management skills to patients and their parents before surgery could not only alleviate unnecessary worry, but provide skills that could be used on a systematic basis to help patients cope better and recover faster from their back surgery. This outcome should wipe away the stress experienced by their parents.

M.H. Salisbury et al. Parents' self-identified stressors and coping strategies during adolescents' spinal surgery experiences. Clinical Nursing Research, 2007;16:212-230.