Parent-child interaction is related to emotional and behavioral problems in pediatric intestinal failure

Objectives: Parent-child interaction in pediatric intestinal failure (IF) and in parenteral nutrition (PN) graduates can be disturbed due to parental responsibilities related to the condition, and could affect the child's emotional and behavioral functioning (EBF). The aim was to assess parent-child interaction, to examine associations with clinical features, and to relate parent-child interaction to EBF. Methods: A cross-sectional study of IF patients and PN graduates aged 1.5−18 years and one primary caregiver was performed in two Dutch multidisciplinary pediatric IF teams. Parent-child interaction was observed using the Emotional Availability Scales (EAS), reported with the Parent Child Interaction Questionnaire (PACHIQ) and compared to normvalues when available. Associations between parent-child interaction and clinical factors and EBF were examined. EBF was assessed using the Child Behavior Checklist. All measures are validated. Results: A total of 41 parent-child dyads were included, 17 (41.4%) received PN at time of assessment and median age was 8.9 [interquartile range 5.8−11.9] years. No significant differences in parent-reported interaction compared to normative values or between PN-receiving and weaned children were found. Exploratory multivariable regression indicated that only the child's female sex was significantly positively related to parent-child interaction. Parent-child interaction was negatively related to EBF for nonhostility, conflict resolution, and acceptance. Conclusion: Our findings suggest that (self-reported) parent-child interaction in IF patients and PN graduates is not significantly different as compared to healthy peers, and unrelated to clinical characteristics. However, aspects of parent-child interaction were correlated to EBF, potentially being a target for prevention or intervention in children with diminished EBF.