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Post-Intensive Care Syndrome in Children: A Concept Analysis
Maoting Tang1, Min Xu1, Shaoyu Su1
1Department of PICU Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Insights
Post-intensive care syndrome in paediatrics (PICS-p) affects children
Area of Science:
- Pediatric critical care medicine
- Child health outcomes
- Syndrome conceptualization
Background:
- Post-intensive care syndrome in paediatrics (PICS-p) describes impairments after pediatric intensive care unit (PICU) discharge.
- Lack of consensus and assessment guidance for PICS-p hinders understanding and management.
- This study addresses the need for a clear conceptual definition of PICS-p.
Purpose of the Study:
- To define the concept of PICS-p using the Walker and Avant concept analysis approach.
- To provide a detailed understanding of PICS-p for practitioners and researchers.
- To establish a theoretical basis for PICS-p diagnosis and treatment.
Main Methods:
- Systematic literature review across multiple databases (PubMed, Google Scholar, Web of Science, etc.).
- Keywords included 'post-intensive care syndrome', 'PICU', 'children', and 'PICS-p'.
- Included both quantitative and qualitative studies published up to November 21, 2020; 24 publications met criteria from 762 initial articles.
Main Results:
- PICS-p is characterized by four core aspects: physical dysfunction, cognitive dysfunction, psychological dysfunction, and social dysfunction.
- These dysfunctions represent newly acquired or worsened impairments in children post-PICU.
- The analysis provides a structured definition based on these identified domains.
Conclusions:
- Reduced case fatality is not the sole measure of pediatric critical care success; long-term outcomes are increasingly important.
- A clear definition of PICS-p is crucial for medical staff to understand and manage the syndrome effectively.
- This conceptualization offers a foundation for improved diagnosis, treatment, and support for children affected by PICS-p.
Problem:
Post-intensive care syndrome in paediatrics (PICS-p) is a term used to describe newly acquired or worsened impairment in one or more aspects of a child's physical, psychological, cognitive, and social functioning after discharge from the paediatric intensive care unit (PICU). However, consensus, conceptual insights, and assessment guidance are lacking for this syndrome. Therefore, this analysis aimed to define the concept of PICS-p to help practitioners and researchers understand the syndrome in detail using the Walker and Avant approach.
Eligibility Criteria:
We reviewed studies retrieved from several databases, namely PubMed, Google Scholar, Web of Science, Ovid, ScienceDirect, and the Springer database, using the following keywords: 'post-intensive care syndrome', 'PICU', 'children', 'PICS-p', and 'concept analysis'. Both quantitative and qualitative studies on PICS-p were included in the search. The articles were limited to those published up to November 21, 2020.
Sample:
Of the 762 publications selected, 24 publications met the inclusion criteria.
Results:
PICS-p is defined on the basis of the following aspects: (1) Physical dysfunction; (2) Cognitive dysfunction; (3) Psychological dysfunction; and (4) Social dysfunction.
Conclusion:
With the increasing success rate of PICU treatment, reduced case fatality is no longer the only outcome of critical illness in children. The long-term outcomes in children discharged from hospitals have attracted attention from families, hospitals, and communities.
Implications:
A clear definition of PICS-p will help medical staff understand PICS-p in detail and provide a theoretical basis for the diagnosis and treatment of this syndrome.
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