| ObjectiveThis study is intended to the state of illness uncertainty among parents of children who have experienced operation of congenital hydronephrosis,to understand the influence of sense of parenting competence on their sense of illness uncertainty,to explore the chain mediating effect of family function and fatigue on the association between parenting competence and illness uncertainty,so as to provide an evidence basisand practical guidance for clinical interventions for caregivers in this group.MethodsCross-sectional study design played an important role in this study.During the period from March 2018 to March 2021,they were 352 parents of children with congenital hydronephrosis who were hospitalized in two third-class first-class hospitals in Jinan were taken as the survey objects by convenient sampling method.Measurement tools include general demographic data questionnaire,parents’perception uncertainty in illness scale,PPUS),Family Function Rating Scale-General Functioning Sub-scale of McMaster Family Assessment Device（GF-FAD）,Fatigue Scale-14,FS-14),Chinese version of the Parenting Sense of Competence Scale（C-PSOC）.EpiData 3.0 software was used to establish the database,and SPSS 25.0 was used to conduct descriptive analysis,T-test,one-way ANOVA,Pearson correlation analysis and multiple linear regression analysis.AMOS 24.0 is used in modeling,and nonparametric percentile Bootstrap method is used in estimating and correcting 95%confidence interval of deviation.Results1.In this study,a total of 374 respondents were asked to fill out questionnaires,of which 22 questionnaires failed to meet the requirements,and the effective rate was 94.1%.2.The mean score of disease uncertainty in all respondents was（79.70±9.42）,which was at an intermediate level.The major participants were mothers,accounting for 77.6%;most of the children were aged from 29 to 40,accounting for 66.2%;the majority of occupations were farmers,accounting for 35.2%;most of them had junior high school education,accounting for 33.8%;most of them lived in rural areas,accounting for 45.2%;most of them had an income of 3,000-5,000 yuan,accounting for 36.1%.The results of one-way ANOVA showed that the differences in the total scores of parents’ uncertainty about illness were statistically significant in six baseline characteristics:parents of children,parents’ age,occupation,education level,place of residence,and monthly family income.The disease uncertainty score of mothers was much higher than that of fathers（t=-4.918,P<0.001）.The younger the parentswere,the higher the uncertainty score was（F=3.126,P=0.045）.In terms of occupation,full-time caregivers had the highest parental disease uncertainty score（F=4.225,P=0.002）.The score of disease uncertainty of parents with junior middle school education and below was higher than that of parents with other education level（F=6.621,P<0.001）.Parents of children living in rural areas had higher disease uncertainty scores than those living in cities and counties（F=3.445,P=0.033）.Parents with per capita monthly family income less than 3000 yuan had the highest score of disease uncertainty（F=13.608,P<0.001）.3.Pearson correlation analysis shows that parents’ uncertainty of illness is positively correlated with family function（r=0.305）and fatigue（r=0.331）（p<0.001）,and negatively correlated with parenting competence（r=-r=-0.273,P<0.001）.4.From the statistical point of view,the most valuable factor in one-way ANOVA were included in the multivariate analysis,and the results showed that parents’ age,residence,family monthly income,parenting competence,family function and fatigue were the main influencing factors of parents’ uncertainty of disease.5.AMOS 24.0 was used to establish a structural equation model forparenting competence,family function,fatigue and disease uncertainty of the research object.The fitting index of model M1 was shown as follows:X2=42.762,df=16,X2/df=2.673,fit index（GFI）=0.970,normalized fit index（NFI）=0.922,showings that the fitting of model M1 was ideal.6.Based on the output results,path 1:parenting competence→family function→parental illness uncertainty;path 2:parenting competence→fatigue→parental illness uncertainty;and path 3:parenting competence→family function→fatigue→parental illness uncertainty are 17.8%,18.6%,and 5.1%,respectively,indicating that the chain mediating effect accounted for 41.5%of the total effect.Conclusion1.Parents of children with congenital hydronephrosis have a moderate level of current disease uncertainty.Among them,younger parents,less educated parents,parents living in rural areas,and parents with low monthly family income deserve more attention from clinical caregivers.2.Significant correlation exists objectively between them parental competence and their uncertainty about the disease,and higher levels of parental competence were effective in alleviating their uncertainty about the disease.3.Parenting sense of competency can also affect their sense of disease uncertainty indirectly.Family function and fatigue levels of parents of children with congenital hydronephrosis not only showed a simple mediating effect between their parenting competence and disease uncertainty,but also chain mediating effect between this association. |
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