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PICU Early Mobilization and Impact on Parent Stress

Blair R L Colwell1, Erin Olufs2, Katharine Zuckerman3

  • 1Division of Pediatric Critical Care, Department of Pediatrics, University of California, Davis, Sacramento, California brcolwell@ucdavis.edu.

Hospital Pediatrics
|March 28, 2019
PubMed

Insights

Parental stress during pediatric intensive care unit (PICU) mobilization therapy is linked to child and therapy factors. Addressing these stressors can improve mobilization therapy implementation for critically ill children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Patient and Family Experience
  • Healthcare Quality Improvement

Background:

  • Early mobilization in the pediatric intensive care unit (PICU) can improve outcomes for critically ill children.
  • Parental refusal of mobilization therapies is a significant barrier to its implementation.
  • Understanding parental stress related to mobilization is crucial for optimizing care.

Purpose of the Study:

  • To evaluate the level and factors associated with parental stress during mobilization therapy in the PICU.
  • To identify specific stressors and positive aspects of mobilization therapy from the parents' perspective.

Main Methods:

  • A cross-sectional survey was conducted with 120 parents/legal guardians of children admitted to a tertiary-care PICU.
  • Parental stress levels were measured and correlated with parent and child characteristics, as well as mobilization therapy details.
  • Exclusion criteria included imminent child death, suspected abuse/neglect, or mobilization contraindications.

Main Results:

  • Parental stress during mobilization therapy was significantly correlated with overall PICU-related stress.
  • Increased mobilization stress was associated with higher parental education, lower child functional status, more strenuous activities, and therapy provided by non-nursing staff.
  • Key parental stressors included medical equipment, concerns about child pain/fragility, and perceived dyspnea.

Conclusions:

  • Parental stress during mobilization is multifactorial, influenced by child, parent, and therapy-related elements.
  • Identifying both stressful and positive aspects of mobilization allows for targeted interventions.
  • Addressing parental stress can enhance the successful implementation of mobilization therapies in the PICU.
Abstract

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