Peer-reviewed article

Parental psychological involvement and health-related quality of life in hospitalized children: Evidence from a family-centered care study.

Alfiyanti D, Setyawati D, Setyaningtyas RJ · 9 Sept 2026

Abstract

Aim This study examined the association between multidimensional parental participation in hospital care and health-related quality of life (HRQoL) among hospitalized children within a Family-Centered Care framework. Methods This cross-sectional study included 100 mother-child dyads recruited consecutively from a private referral hospital in Indonesia. Parental participation and children's HRQoL were assessed using validated, culturally adapted questionnaires. Descriptive statistics, Spearman's rank correlations, nonparametric tests, and hierarchical multiple linear regression were used. Results Psychological care (95%) and safety care (75%) were predominantly rated as high, whereas physical care was most often moderate (58%). Most children (96%) had moderate HRQoL. Total parental participation correlated positively with HRQoL (r = 0.462, p < .001), with psychological care showing the strongest bivariate association (r = 0.517, 95% CI [0.357, 0.648], p < .001). After adjustment for demographic and clinical variables, adding the three participation domains increased explained variance by 2.2% (ΔR2 = 0.022; p = .536); none remained independently associated with HRQoL. Conclusion Psychological parental involvement showed the strongest bivariate association with children's HRQoL, although parental participation did not independently explain HRQoL after adjustment. Practice implications Pediatric nurses could facilitate family-centered emotional support and tailor physical-care participation to parental readiness, safety, and clinical appropriateness. Longitudinal and interventional studies are needed to clarify these relationships. Key practice points Parental participation, particularly psychological involvement, is vital for improving the health-related quality of life of hospitalized children. Emotional support, reassurance, and parent-child interaction help reduce stress and support psychosocial adaptation. Pediatric nurses should promote parental engagement through family-centered interventions, clear communication, and supportive care. Children with prolonged or repeated hospitalizations may need extra psychosocial support to maintain their well-being. Strengthening hospital policies that encourage meaningful parental involvement can improve pediatric nursing care and enhance children's hospitalization experiences.