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Pediatric Critical Care-Associated Parental Traumatic Stress: Beyond the First Year

Mekela Whyte-Nesfield1, Daniel Kaplan2, Peter S Eldridge3

  • 1Department of Pediatrics, Division of Pediatric Critical Care, Children's National Hospital, Washington, DC.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|January 20, 2023
PubMed

Insights

Parental posttraumatic stress disorder (PTSD) affects nearly 15% of parents after pediatric intensive care unit (PICU) admission, persisting long-term. Identifying risk factors like acute stress disorder is crucial for targeted interventions.

Area of Science:

  • Pediatric Critical Care Medicine
  • Psychotraumatology
  • Parental Mental Health

Background:

  • Pediatric intensive care unit (PICU) admission is a significant stressor for parents.
  • Parental mental health outcomes, particularly posttraumatic stress disorder (PTSD), following PICU discharge require further investigation.

Purpose of the Study:

  • To conduct a longitudinal analysis of parental traumatic stress up to 30 months after PICU discharge.
  • To identify risk factors associated with the development and persistence of parental PTSD.

Main Methods:

  • Prospective observational cohort study involving parents of children admitted to tertiary care PICUs.
  • Utilized the PTSD Symptom Scale Interview for DSM-5 to assess PTSD symptoms at 3-9 and 18-30 months post-discharge.
  • Employed multivariable analysis to identify predictors of parental PTSD.

Main Results:

  • At 3-9 months, 14.8% of parents met PTSD criteria. Risk factors included acute stress disorder (ASD), child's severe neurological status, concerns about permanent injury, and increased knowledge of illness.
  • At 18-30 months, 12.5% of parents met PTSD criteria. Risk factors included ASD, family history of ICU admission, and concerns about child's mortality.
  • Parents with PTSD at 18-30 months were more likely to report decreased household income.

Conclusions:

  • Parental PTSD is a significant, persistent morbidity following PICU admission for a subset of parents.
  • Identifiable risk factors, such as ASD and family history of ICU admission, can inform targeted interventions.
  • Longitudinal assessment is vital for understanding the trajectory and impact of parental PTSD after PICU discharge.
Abstract

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