The OCTO-Plus Intervention to Support Families of Chronically Critically Ill Children in Paediatric Critical Care: A...

Families of chronically critically ill (CCI) children admitted to paediatric critical care (PCC) experience significant and long-lasting psychological distress. Structured family-centred care consultations, using a family system approach, have shown promise in mitigating these effects. Though most studies in PCC are single-component or lack methodological rigour. There is a need for complex, multi-component interventions that address the evolving needs of families in PCC.

To assess the feasibility of a co-developed complex multi-component family-centred intervention to support families of CCI children on the PCC ward before effectiveness testing in a future clinical trial.

This single-centre pilot feasibility study used a descriptive observational design guided by Bowen's feasibility framework. The intervention consisted of structured family consultations delivered by trained healthcare professionals, supported by interprofessional handovers. Quantitative data were collected at multiple time points using validated instruments to assess feasibility and limited efficacy outcomes.

Of 802 patients screened, 55 were eligible and 19 families enrolled (34.5%) representing 19 children and 27 parents. All allocated parents completed the intervention. Parents reported clinically meaningful reductions in acute stress, anxiety and depression from admission to follow-up. Family functioning improved across most domains, and no parent met the threshold for PTSD at follow-up. Satisfaction scores remained high throughout.

This study demonstrates the clinical feasibility of a multi-component family-centred intervention for parents of children hospitalised in paediatric critical care. Findings suggest a protective effect on parental mental health and improved family functioning, supporting progression to a full-scale effectiveness trial.

The OCTO-Plus intervention offers a structured, family-centred approach to support parents of CCI children in PCC. Its integration into clinical practice may enhance emotional regulation, communication and resilience, ultimately improving long-term outcomes for families.