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Mental and physical well-being following admission to pediatric intensive care
Lorraine C Als1, Maria D Picouto, Sau-Ming Hau
11Centre for Mental Health, Department of Medicine, Imperial College London, London, United Kingdom. 2Department of Child and Adolescent Psychiatry and Psychology, Sant Joan de Déu Hospital, Universitat de Barcelona, Barcelona, Spain. 3Department of Paediatric Intensive Care, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 4Department of Paediatric Intensive Care, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
Insights
Children admitted to the pediatric intensive care unit (PICU) experience significant short-term mental and physical well-being issues. Septic illness and longer PICU stays predict worse outcomes, highlighting the need for targeted support.
Area of Science:
- Pediatric Intensive Care
- Child Psychology
- Critical Care Medicine
Background:
- Admission to a pediatric intensive care unit (PICU) can impact a child's long-term health.
- Understanding the mental and physical well-being of these children post-discharge is crucial.
Purpose of the Study:
- To assess mental and physical well-being in school-aged children after PICU admission.
- To identify risk factors associated with poorer outcomes in this population.
Main Methods:
- A prospective cohort study was conducted in two PICUs.
- 88 children (5-16 years) admitted for critical illnesses were assessed 5 months post-discharge.
- Outcomes were compared to 100 healthy controls using validated questionnaires.
Main Results:
- PICU patients showed worse mental and physical well-being compared to controls.
- Significant percentages were at risk for psychiatric disorders (20%), PTSD (34%), fatigue (38%), and sleep disturbance (80%).
- Septic illness predicted PTSD; family status, prior health, and PICU length of stay predicted general mental well-being.
Conclusions:
- A significant minority of school-aged children face reduced mental and physical well-being post-PICU.
- Both patient vulnerability factors and critical illness characteristics contribute to adverse mental health outcomes.
Objective:
To assess mental and physical well-being in school-aged children following admission to pediatric intensive care and to examine risk factors for worse outcome.
Design:
A prospective cohort study.
Setting:
Two PICUs.
Subjects:
A consecutive sample of 88 patients 5-16 years old (median age, 10.00 yr; interquartile range, 6.00-13.00 yr) admitted to PICU from 2007 to 2010 with septic illness, meningoencephalitis, or other critical illnesses were assessed a median of 5 months following discharge and outcomes compared with 100 healthy controls.
Interventions:
None.
Measurements And Main Results:
Parents completed questionnaires documenting child mental and physical well-being, including the Strengths and Difficulties Questionnaires, Chalder Fatigue Scale, and Child Sleep Habits Questionnaire. Children over 8 years completed the Impact of Event Scale -8. The children admitted to PICU scored worse on all measures in comparison with the healthy controls, with 20% scoring at risk for psychiatric disorder, 34% with high levels of post-traumatic stress symptoms, 38% at risk for fatigue disorder, and 80% scoring at risk for sleep disturbance. In the PICU group, multivariable regression analyses identified septic illness as an independent predictor of post-traumatic stress symptoms and family status, past child health problems, and PICU length of stay as predictors of reduced general mental well-being.
Conclusions:
Our findings indicate that a significant minority of school-aged children admitted to PICU are at risk for reduced mental and physical well-being in the short term. Symptoms of poor mental well-being were linked to both vulnerability factors and critical illness factors.
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