Financial Burden, Depression and Coping Strategies among Parents of Children Admitted to Paediatric Intensive Care Unit (PICU)

Introduction: In India, direct out of pocket expenditure on healthcare is about 70%. Taking care of an ill child is one of the most emotionally draining and difficult tasks a parent can face. Pursuing social support, positive reappraisals are most used strategies by parents to cope. There are few studies catering to these aspects among parents whose child is admitted in PICU in Indian population. Aim: The study aimed to assess financial burden and depression amongst parents of a child admitted in PICU and their variance with social support and household coping strategies. Materials and Methods: A cross-sectional survey was conducted on parents of 150 parents of patients admitted to PICU at rural tertiary care teaching hospital. Patient Health Questionnaire (PHQ-9) was used to measure depression. Sociodemographic and clinical profile, financial burden and social support were measured using semi-structured questionnaires. Descriptive statistics were used to depict the sociodemographic and clinical profile of the study population and Analysis of Variance (ANOVA) was used to assess associations. Results: Mean age of the fathers was 31.22 years (range 23-50) and of mothers was 30.39 years (range 22-42). Mean family income was 6186.3 rupees per month and median was 5000 rupees. Only 6% families had below poverty line status and majority (96.7%) had no health insurance. Median (IQR) duration of PICU stay was four days (IQR: 2, 6) and of hospital stay was six days (IQR: 3.75, 10). The median (IQR) medical and nonmedical cost in INR incurred were 20,000 (IQR: 13725, 50375), 1,200 (IQR: 600, 2525) respectively. Borrowing money from friends/relatives (58%) was most frequently used household coping strategy. Using PHQ-9, 11(7.5%) parents screened positive for mild depression. Conclusion: Unplanned admission, lack of insurance cover and significant direct medical cost as inferred from the high income to cost ratio, indirect cost incurred by staying away from work push parents into financial and psychological distress.