Measuring Social Health Following Pediatric Critical Illness: A Scoping Review and Conceptual Framework

Area of Science:

• Pediatric critical care medicine
• Social health research
• Outcomes assessment

Background:

• Social health is crucial for recovery after critical illness, as recognized by the pediatric Post-Intensive Care Syndrome framework.
• Measuring social outcomes in pediatric critical illness survivors is essential for a holistic understanding of recovery.

Purpose of the Study:

• To conduct a scoping review of studies measuring social outcomes in pediatric critical illness survivors.
• To propose a conceptual framework for social outcomes identified in the literature.
• To identify existing instruments used to measure social outcomes in this population.

Main Methods:

• Searched major databases (PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Registry) for relevant studies.
• Included studies evaluating social outcomes in pediatric intensive care unit survivors or their families from 1970-2017.
• Employed dual review and dual data extraction, with qualitative methods to describe instrument content.

Main Results:

• 55% of reviewed articles (223/407) evaluated a social outcome.
• Studies were predominantly from North America and the UK, with diverse methodologies and populations.
• 38 unique instruments were used, measuring individual, environmental, and network social outcomes, alongside school and family factors. No single instrument covered all areas.

Conclusions:

• No single instrument comprehensively assesses the full spectrum of social outcomes post-pediatric critical illness.
• The absence of a comprehensive social outcomes instrument may lead to under-appreciation and under-representation in research.
• Developing a more complete evaluation of social outcomes is vital for understanding overall recovery in pediatric critical illness.