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Child and family reactions during and after pediatric ICU hospitalization: a pilot study
1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106-4904.
Insights
Pediatric intensive care unit (PICU) admission is stressful for parents, regardless of illness severity. Mothers
Area of Science:
- Pediatric critical care medicine
- Family psychology
- Child health outcomes
Background:
- Pediatric intensive care unit (PICU) admission presents significant challenges for families.
- Understanding post-discharge outcomes is crucial for supporting children and their families.
Purpose of the Study:
- To describe child behaviors and family functioning post-PICU discharge.
- To explore the relationship between parental reactions, illness severity, and child/family outcomes.
Main Methods:
- Exploratory, repeated measures design with 9 parents of young children hospitalized in the PICU.
- Utilized validated scales for parental concern, stress, family functioning, and illness severity (Pediatric Risk of Mortality).
- Data collected at 24 hours post-admission and 2-4 weeks post-discharge.
Main Results:
- Mothers' family cohesion scores significantly decreased from initial assessment to post-discharge.
- Illness severity scores did not correlate with family measures.
- Increased intubation time was linked to lower maternal family cohesion and satisfaction post-discharge.
Conclusions:
- PICU admission is a stressful event for parents, irrespective of the child's illness severity.
- Maternal perceptions of family cohesion and satisfaction may be negatively impacted by PICU admission.
Objective:
To describe child behaviors and level of family functioning after discharge from the pediatric ICU (PICU) and to begin to explore the relationship of family reactions and the child's severity of illness to child and family outcomes after discharge.
Design:
Exploratory, repeated measures: Time 1 (T1) at 24 hours after admission; Time 2 (T2) at 2 to 4 weeks after hospital discharge.
Subjects:
Nine mothers and fathers of children who were 5 years of age or younger, hospitalized in a PICU for at least 1 day, expected to survive.
Main Study Measures:
Parental Concern Scale and Parental Stressor Scale: PICU at T1; Posthospitalization Behavior Questionnaire at T2; Feetham Family Functioning Survey and FACES III, at both T1 and T2; and Pediatric Risk of Mortality to measure illness severity.
Results:
Mothers' cohesion scores decreased significantly from T1 to T2. Scores from the Pediatric Risk of Mortality were not related to family measures. Mothers' family cohesion and satisfaction with family after discharge were negatively related to time the child was intubated. Few family measures were related to the Parental Concern Scale and Parental Stressor Scale: PICU subscales.
Conclusions:
PICU admission of a child is a stressful event for parents, independent of the child's illness severity. Mothers' perceptions of family may be negatively affected.