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The Effects of Expectation Setting and Bundle Consent on Acute Caregiver Stress in the PICU: A Randomized Controlled

Gregory Goldstein1, Oliver Karam2, Nikki Miller Ferguson3

  • 1Pediatric Critical Care Medicine, Golisano Children's Hospital, SUNY Upstate Medical University, Syracuse, NY.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|May 1, 2023
PubMed

Insights

Bundled consent for pediatric intensive care unit (PICU) procedures did not reduce parental acute stress. However, this approach lowered parents' perception of their child's illness severity.

Area of Science:

  • Pediatric Intensive Care
  • Parental Mental Health
  • Informed Consent

Background:

  • Parental admission of a child to the Pediatric Intensive Care Unit (PICU) is highly stressful.
  • This stress can lead to long-term negative mental health outcomes for parents.

Purpose of the Study:

  • To investigate if formalized expectation setting and bundled consent for invasive procedures impact parental acute stress.
  • To assess the effect of bundled consent on parental perception of illness severity.

Main Methods:

  • A prospective cluster randomized controlled trial was conducted.
  • Parents completed the Stress Overload Scale-Short (SOS-S) and a threat-to-life perception survey.
  • The study compared bundled consent with separate consent procedures over 73 weeks.

Main Results:

  • No significant difference in Personal Vulnerability (PV) or Event Load (EL) scores between bundled and separate consent groups.
  • Bundled consent was associated with a significantly lower percentage of parents rating their child's illness as extremely life-threatening (17% vs. 26%).

Conclusions:

  • Bundled consent did not decrease parental acute stress in the PICU setting.
  • The intervention did, however, reduce parents' perceived severity of their child's illness.
  • Further multicenter studies are recommended to validate these findings.
Abstract

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