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Background <p>Children with medical complexity not only have physical but also psychological symptoms. The pattern of their health service use based on symptom burden and how symptom burden affects the parental self-efficacy in symptom management is not well identified. It is crucial to understand the relationships among them for developing effective strategies in enhancing parental knowledge and skills in responding to symptom management for children with complex health conditions.</p> Methods <p>This study conducted a secondary analysis of data from a randomised controlled trial. Convenience sampling was adopted to recruit 102 parents of children from four special schools and three non-government organisations in Hong Kong between March 2023 and May 2024. Regression bootstrapping methods were used to analyse the mediating effects of parental self-efficacy between parent-reported children’s symptom burden and their health service use.</p> Results <p>The mediation analysis showed that parent-reported symptom burden had a significant relationship with health service use (B = 2.30, <i>p</i> = 0.0003; 95% Confidence interval [CI]: 1.1, 3.5) and parental self-efficacy (B = − 14.7, <i>p</i> = 0.0025; 95% CI: −24.7, -5.3). However, the mediating role of parental self-efficacy between the parent-reported symptom burden and health service use was not statistically significant (B = 0.17; 95% CI: −0.18, 0.62). Moreover, the parent-reported children’s symptom burden had a significant correlation with the type of CMC (<i>r</i> = 0.36, <i>p</i> &lt; 0.001) and the education level (<i>r</i> = 0.22, <i>p</i> = 0.025). Additionally, parental self-efficacy was found to be positively correlated with their financial status (<i>r</i> = 0.21, <i>p</i> = 0.03).</p> Conclusion <p>The severity of child symptom burden was found to have a significant direct effect on parental self-efficacy and child health service utilisation, thereby contributing valuable insights to the existing literature in this field. Understanding how these factors interact can provide valuable insights to improve the supporting system and intervention development for these parents.</p>

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Associations among parental self-efficacy, symptom burden in children with medical complexity, and their use of health services

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Winsome Lam,
  • Vivian F. W. Ngai,
  • Raymond C. K. Chung,
  • Cathrine Fowler,
  • Reta Tsegaye Gayesa

摘要

Background

Children with medical complexity not only have physical but also psychological symptoms. The pattern of their health service use based on symptom burden and how symptom burden affects the parental self-efficacy in symptom management is not well identified. It is crucial to understand the relationships among them for developing effective strategies in enhancing parental knowledge and skills in responding to symptom management for children with complex health conditions.

Methods

This study conducted a secondary analysis of data from a randomised controlled trial. Convenience sampling was adopted to recruit 102 parents of children from four special schools and three non-government organisations in Hong Kong between March 2023 and May 2024. Regression bootstrapping methods were used to analyse the mediating effects of parental self-efficacy between parent-reported children’s symptom burden and their health service use.

Results

The mediation analysis showed that parent-reported symptom burden had a significant relationship with health service use (B = 2.30, p = 0.0003; 95% Confidence interval [CI]: 1.1, 3.5) and parental self-efficacy (B = − 14.7, p = 0.0025; 95% CI: −24.7, -5.3). However, the mediating role of parental self-efficacy between the parent-reported symptom burden and health service use was not statistically significant (B = 0.17; 95% CI: −0.18, 0.62). Moreover, the parent-reported children’s symptom burden had a significant correlation with the type of CMC (r = 0.36, p < 0.001) and the education level (r = 0.22, p = 0.025). Additionally, parental self-efficacy was found to be positively correlated with their financial status (r = 0.21, p = 0.03).

Conclusion

The severity of child symptom burden was found to have a significant direct effect on parental self-efficacy and child health service utilisation, thereby contributing valuable insights to the existing literature in this field. Understanding how these factors interact can provide valuable insights to improve the supporting system and intervention development for these parents.