Parental resilience and child quality of life following paediatric hospitalisation: a prospective cohort study.

Objective: To investigate how parental resilience affects children's health-related quality of life (QoL) following hospital discharge, comparing outcomes between paediatric intensive care and general ward admissions.

Design: Prospective cohort study with 2-month follow-up.

Setting: Tertiary care hospital in Thailand (February 2021-August 2022).

Participants: 100 parent-child dyads (58 paediatric intensive care unit (PICU), 42 general ward) with children aged 4-16 years; 95% completed both assessments.

Main outcome measures: Parental resilience assessed using the Resilience Quotient questionnaire and children's QoL measured using the Paediatric QoL Inventory 4.0.

Results: Cross-lagged analysis revealed that baseline parental resilience significantly predicted child QoL at follow-up (β=0.426, p=0.038), but baseline child QoL did not significantly predict changes in parental resilience. Hierarchical regression identified changes in parental resilience (β=1.090, p<0.01) and baseline child QoL (β=0.524, p<0.01) as key predictors of later QoL. Parents of general ward patients showed greater improvements in resilience and their children demonstrated significant improvements in social functioning (21.67 vs 8.58 points, p=0.005) and total QoL scores (12.06 vs 4.13 points, p=0.038) compared with the PICU group.

Conclusions: Parental resilience is a significant predictor of children's QoL following hospital discharge, with a unidirectional relationship where parental resilience influences subsequent child outcomes. This association persisted after controlling for demographic and clinical factors, suggesting the potential importance of psychological support for parents during their child's hospitalisation regardless of care setting. Longitudinal studies with longer follow-up periods are needed to validate these findings and assess their clinical significance.