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At-home recovery following hospitalization for bronchiolitis
James M Robbins1, Uma R Kotagal, Narendra M Kini
1Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA. robbinsjamesm@uams.edu
Insights
Many infants struggle with feeding and sleeping after bronchiolitis hospitalization. Delayed infant recovery impacts parental work and satisfaction with hospital care.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Bronchiolitis is a common respiratory infection in infants.
- Hospitalization for bronchiolitis can lead to prolonged recovery periods.
- The impact of infant recovery on family dynamics is not well understood.
Purpose of the Study:
- To characterize infant recovery at home after bronchiolitis hospitalization.
- To assess the impact of recovery on families.
- To examine the link between delayed recovery and parental satisfaction with hospital care.
Main Methods:
- A cohort of 486 infants under 1 year hospitalized for bronchiolitis was studied.
- Parents were interviewed 1-2 weeks post-discharge via telephone.
- Interviews assessed functional recovery, symptoms, family disruption, and satisfaction.
Main Results:
- Two-thirds of infants had routine difficulties (feeding, sleeping) on discharge day.
- Lingering symptoms like cough (56%) and wheezing (27%) were common.
- Delayed recovery correlated with parental work loss, increased daycare absence, and lower satisfaction.
Conclusions:
- A significant proportion of infants experience protracted recovery post-bronchiolitis hospitalization.
- Delayed infant recovery negatively affects parental work and hospital care perceptions.
- Anticipatory guidance can help families prepare for extended recovery and improve satisfaction.
Objectives:
To characterize the at-home recovery of infants after hospitalization for bronchiolitis, the impact of recovery from this illness on the family, and the association between delayed infant recovery and parental satisfaction with hospital care.
Methods:
Otherwise healthy infants less than 1 year of age admitted to 6 children's hospitals were eligible. Telephone interviews with 486 parents (85% of sampled), 1-2 weeks following discharge, addressed functional recovery, lingering symptoms, family disruption, returns to the emergency department, and parental recall of satisfaction with care.
Results:
Two thirds of infants experienced difficulties with normal routines (feeding, sleeping, contentedness, liveliness) on the day of discharge. By 5 days at home, 22% continued to experience disruption in sleeping, and 16% in feeding routines. Coughing (56%) and wheezing (27%) were common 4 to 6 days after discharge. Parents who reported longer delays in return to normal family routines took additional time off work, kept their infants out of day care twice as many days, and were more likely to take their infants to the doctor or hospital for repeat medical care. Parents from families slower to return to a normal routine recalled the hospital stay less favorably.
Conclusions:
A small but important proportion of infants have a protracted recovery period following hospitalization for bronchiolitis. Delayed recovery is associated with parental work time loss and less favorable parental impressions of care in the hospital. Anticipatory guidance about home recovery could allow parents to plan for extended home care and improve satisfaction with hospital care.
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