Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*

Manning, Joseph C; Pinto, Neethi; Rennick, Janet E.; Colville, Gillian; Curley, Martha A. Q.

doi:10.1097/pcc.0000000000001476

Cited by 305 publications

(335 citation statements)

References 14 publications

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“…In 2018, the framework of pediatric PICS (PICS‐p) was conceptualized (Fig. ) . The fundamental framework was similar to that of adult PICS, with several unique features.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, a variety of recovery trajectories of surviving children and their families are indicated in the PICS‐p framework, including improvement, deterioration, vacillation, or plateau over days or decades. Available evidence, although still limited, suggests that their outcomes are more heterogeneous than those for adult ICU survivors and their spouses …”

Section: Introductionmentioning

confidence: 99%

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Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Inoue

Hatakeyama

Kondo

et al. 2019

Acute Medicine & Surgery

379

365

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Expanding elderly populations are a major social challenge in advanced countries worldwide and have led to a rapid increase in the number of elderly patients in intensive care units (ICUs). Innovative advances in medical technology have enabled lifesaving of patients in ICUs, but there remain various problems to improve their long‐term prognoses. Post‐intensive care syndrome (PICS) refers to physical, cognition, and mental impairments that occur during ICU stay, after ICU discharge or hospital discharge, as well as the long‐term prognosis of ICU patients. Its concept also applies to pediatric patients (PICS‐p) and the mental status of their family (PICS‐F). Intensive care unit‐acquired weakness, a syndrome characterized by acute symmetrical limb muscle weakness after ICU admission, belongs to physical impairments in three domains of PICS. Prevention of PICS requires performance of the ABCDEFGH bundle, which incorporates the prevention of delirium, early rehabilitation, family intervention, and follow‐up from the time of ICU admission to the time of discharge. Diary, nutrition, nursing care, and environmental management for healing are also important in the prevention of PICS. This review outlines the pathophysiology, prevention, and future directions of PICS.

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“…In 2018, the framework of pediatric PICS (PICS‐p) was conceptualized (Fig. ) . The fundamental framework was similar to that of adult PICS, with several unique features.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Inoue

Hatakeyama

Kondo

et al. 2019

Acute Medicine & Surgery

379

365

View full text Add to dashboard Cite

show abstract

“…4 In addition to morbidity in children after admission to the PICU, parents and families are faced with substantial stress when their children are admitted to the PICU 1 and are at risk for developing postintensive care syndrome in pediatrics (PICS-p), which is a recently described framework to understand surviving childhood critical illness with a focus on the interdependence of children and their families. 3,5,6 Parents identify stress surrounding a change in their children' s appearance and behavior and especially due to an alteration in their parental role when their children have been admitted to the PICU. 1,7 Parent stress continues after discharge from the hospital 7 and can include psychiatric disorders.…”

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confidence: 99%

PICU Early Mobilization and Impact on Parent Stress

Colwell

Olufs

Zuckerman

et al. 2019

Hospital Pediatrics

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A B S T R A C TBACKGROUND AND OBJECTIVES: Early mobilization of critically ill children may improve outcomes, but parent refusal of mobilization therapies is an identified barrier. We aimed to evaluate parent stress related to mobilization therapy in the PICU. METHODS:We conducted a cross-sectional survey to measure parent stress and a retrospective chart review of child characteristics. Parents or legal guardians of children admitted for $1 night to an academic, tertiary-care PICU who were proficient in English or Spanish were surveyed. Parents were excluded if their child's death was imminent, child abuse or neglect was suspected, or there was a contraindication to child mobilization. RESULTS:We studied 120 parent-child dyads. Parent mobilization stress was correlated with parent PICU-related stress (r s [119] 5 0.489; P # .001) and overall parent stress (r s [110] 5 0.272; P 5 .004). Increased parent mobilization stress was associated with higher levels of parent education, a lower baseline child functional status, more strenuous mobilization activities, and mobilization therapies being conducted by individuals other than the children's nurses (all P , .05). Parents reported mobilization stress from medical equipment (79%), subjective pain and fragility concerns (75%), and perceived dyspnea (24%). Parent-reported positive aspects of mobilization were clinical improvement of the child (70%), parent participation in care (46%), and increased alertness (38%).CONCLUSIONS: Parent mobilization stress was correlated with other measures of parent stress and was associated with child-, parent-, and therapy-related factors. Parents identified positive and stressful aspects of mobilization therapy that can guide clinical care and educational interventions aimed at reducing parent stress and improving the implementation of mobilization therapies.

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“…Parents carry much of the burden of care and worry associated with caring for these children. Studies of experiences of parents of children with respiratory distress who require bronchoscopy are rare, even though studies of children with respiratory distress or critical illness admitted to a paediatric intensive care unit have demonstrated that parents experience stress and anxiety in response to multiple stressors arising from the child's illness trajectory (Foster et al ., ; Terp and Sjöström‐Strand, ) and post‐traumatic stress disorder or symptoms resulting from being aware of or witnessing the intrusive treatment given to the child (Nelson and Gold, ; Manning et al ., ). They may report feelings of alienation and uncertainty in relation to use of hospital systems and care (Caicedo, ; Simeone et al ., ), and a recent survey reported that the stress levels of primary caregivers with oxygen‐dependent children is high.…”

Section: Introductionmentioning

confidence: 97%

Stress and uncertainty in parents of children with tracheobronchial malacia and stenosis

Soong

Wang

2019

Nursing in Critical Care

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Background: An increasing number of children are undergoing flexible bronchoscopy because of tracheobronchial malacia and stenosis, but there is little research related to their parents' stress and uncertainty. Aim: To explore and identify risk factors associated with stress and uncertainty among Taiwanese parents of children with tracheobronchial malacia and tracheabronchostenosis in a paediatric intensive care unit. Methods: A cross-sectional study design was implemented using two psychometric scales: Parenting Stress Index and Parents' Perception of Uncertainty Scale. Parents of Taiwanese children (0-18 years/o) with a diagnosis of tracheobronchial malacia or/and tracheabronchostenosis who underwent bronchoscopy in a paediatric intensive care unit were recruited. The analysis used descriptive statistics and multivariable linear regression. Results: Ninety parents who were caring for a total of 51 children were recruited. Stress and uncertainty both scored high and were positively correlated with each other. Four risk factors arising from parental stress were unemployment, parental uncertainty, the child's tracheobronchial malacia and tracheabronchostenosis and use of oxygen. Conclusions: Identifying likely causes of stress and uncertainty is essential for this parental group, particularly for parents facing unemployment, feelings of uncertainty and caring for children with both tracheobronchial malacia and tracheabronchostenosis and requiring oxygen. Relevance to clinical practice: Nursing practice can focus on better parental support for those parents who are unemployed, show feeling of uncertainty and care for children with combined tracheobronchial malacia and tracheabronchostenosis and other medical care, such as breathing symptom management, nasogastric feeding and oxygen therapy.

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Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*

Cited by 305 publications

References 14 publications

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

PICU Early Mobilization and Impact on Parent Stress

Stress and uncertainty in parents of children with tracheobronchial malacia and stenosis

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