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Early predictors of post-hospital adjustment problems in critically ill young children

Leigh Small1, Bernadette Mazurek Melnyk

  • 1Arizona State University College of Nursing, Tempe, AZ, USA.

Research in Nursing & Health
|November 30, 2006
PubMed

Insights

Children hospitalized unexpectedly in the intensive care unit (ICU) may experience behavioral issues. Maternal anxiety and child

Area of Science:

  • Pediatric Psychology
  • Child Psychiatry
  • Critical Care Medicine

Background:

  • Children, particularly toddlers and preschoolers, are vulnerable to behavioral problems after unexpected intensive care unit (ICU) hospitalizations.
  • These post-hospitalization behavioral sequelae can manifest as internalizing or externalizing behaviors and negative behavioral changes.

Purpose of the Study:

  • To identify early demographic and clinical predictors of behavioral outcomes in young children (2-7 years) following unplanned ICU admissions.
  • To analyze factors that predict internalizing behaviors, externalizing behaviors, and behavioral changes at 3 and 6 months post-hospitalization.

Main Methods:

  • Secondary analysis of data from 163 mother-child dyads.
  • Utilized pre-hospitalization behavioral data, child's sex, maternal state anxiety, marital status, and maternal emotional caregiving levels as predictor variables.

Main Results:

  • Pre-hospitalization behavioral tendencies (internalizing/externalizing), child's sex, elevated maternal state anxiety, marital status, and maternal emotional caregiving significantly predicted child behavior.
  • These factors were associated with internalizing behaviors, externalizing behaviors, and behavioral changes observed post-hospitalization.

Conclusions:

  • Several risk factors can be identified early during hospitalization to predict adverse behavioral outcomes in children after critical care.
  • Targeting identified risk factors, such as maternal anxiety and pre-existing child behaviors, may improve emotional and behavioral health post-hospitalization.

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