Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors

Debelić, Ivana; Mikolčić, Anamaria; Tihomirović, Jovana; Barić, Iva; Lendić, Đurđica; Nikšić, Željka; Šencaj, Barbara; Lovrić, Robert

doi:10.3390/ijerph191811450

Cited by 11 publications

(6 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The themes home life, financial, external, work, and self-care align with previous literature suggesting that managing family needs is a primary stressor among parents of critically ill children (29,30). Furthermore, the themes diagnosis distress and uncertainty reflect previous findings that uncertainty about their child's health outcome and not knowing how to best help their child are prevalent sources of parental distress in the PICU (29)(30)(31)(32). Suggestions for improvement involved addressing challenges both internal and external to the hospital environment.…”

Section: At the Bedsidesupporting

confidence: 77%

Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset*

Tager,

Hinojosa,

LiaBraaten

et al. 2023

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

Objectives: To describe challenges experienced by parents of children hospitalized in the PICU during PICU admission as reported by family navigators. Design: A preplanned secondary analysis of open-response data coded via inductive qualitative approach from the Navigate randomized controlled trial (RCT) dataset (ID NCT02333396). Setting: Two university-affiliated PICUs in the Midwestern United States as part of an RCT. Patients: Two hundred twenty-four parents of 190 PICU patients. Interventions: In 2015–2017, trained family navigators assessed and addressed parent needs, offered weekly family meetings, and provided post-PICU discharge parent check-ins as part of a study investigating the effectiveness of a communication support intervention (“PICU Supports”). Measurements and Main Results: We analyzed qualitative data recorded by family navigators weekly across 338 encounters. Navigators described families’ “biggest challenge,” “communication challenges,” and ways the team could better support the family. We used an inductive qualitative coding approach and a modified member-checking exercise. The most common difficulties included home life, hospitalization, and diagnosis distress (45.2%, 29.0%, and 17.2% of families, respectively). Navigators often identified that parents had co-occurring challenges. Communication was identified as a “biggest challenge” for 8% of families. Communication challenges included lack of information, team communication, and communication quality (7.0%, 4.8%, and 4.8% of families, respectively). Suggestions for improving care included better medical communication, listening, rapport, and resources. Conclusions: This study describes families’ experiences and challenges assessed throughout the PICU stay. Family navigators reported families frequently experience stressors both internal and external to the hospital environment, and communication challenges between families and providers may be additional sources of distress. Further research should develop and assess interventions aimed at improving provider-family communication and reducing stressors outside the hospitalization itself, such as home life difficulties.

show abstract

Section: At the Bedsidesupporting

confidence: 77%

Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset*

Tager,

Hinojosa,

LiaBraaten

et al. 2023

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…Thus, when chronic/complex patients are eliminated, there is no effect of dynamic resilience, and these previously healthy children are at increased risk of MH sequelae after hospitalization. Children with ICU admission during hospitalization experience parental separation, disturbed sleep, disordered day-night cycles, constant noises, repetitive painful procedures, stranger anxiety, intrusive physical handling, loss of privacy to genital areas, wakefulness under muscle relaxants, or other types of stressful experiences ( 30 , 31 ). The cumulative trauma and stress resulting from these experiences is extremely likely to affect their social-emotional processing of ICU experiences.…”

Section: Discussionmentioning

confidence: 99%

Incidence of mental health conditions following pediatric hospital admissions: analysis of a national database

Daughtrey,

Ruiz,

Felix

et al. 2024

Front. Pediatr.

View full text Add to dashboard Cite

IntroductionDespite increasing survival of children following hospitalization, hospitalization may increase iatrogenic risk for mental health (MH) disorders, including acute stress, post-traumatic stress, anxiety, or depression. Using a population-based retrospective cohort study, we assessed the rates of new MH diagnoses during the 12 months after hospitalization, including the moderating effects of ICU exposure.Study design/methodsThis was a retrospective case control study using the Truven Health Analytics insurance database. Inclusion criteria included children aged 3–21 years, insurance enrollment for >12 months before and after hospital admission. We excluded children with hospitalization 2 years prior to index hospitalization and those with prior MH diagnoses. We extracted admission type, ICD-10 codes, demographic, clinical, and service coordination variables from the database. We established age- and sex-matched cohorts of non-hospitalized children. The primary outcome was a new MH diagnosis. Multivariable regression methods examined the risk of incident MH disorder(s) between hospitalized and non-hospitalized children. Among hospitalized children, we further assessed effect modification from ICU (vs. non-ICU) stay, admission year, length of stay, medical complexity, and geographic region.ResultsNew MH diagnoses occurred among 19,418 (7%) hospitalized children, 3,336 (8%) ICU-hospitalized children and 28,209 (5%) matched healthy controls. The most common MH diagnoses were anxiety (2.5%), depression (1.9%), and stress/trauma (2.2%) disorders. Hospitalization increased the odds of new MH diagnoses by 12.3% (OR: 1.123, 95% CI: 1.079–1.17) and ICU-hospitalization increased these odds by 63% (OR: 1.63, 95% CI: 1.483–1.79) as compared to matched, non-hospitalized children. Children with non-complex chronic diseases (OR: 2.91, 95% CI: 2.84–2.977) and complex chronic diseases (OR: 5.16, 95% CI: 5.032–5.289) had a substantially higher risk for new MH diagnoses after hospitalization compared to patients with acute illnesses.ConclusionPediatric hospitalization is associated with higher, long-term risk of new mental health diagnoses, and ICU hospitalization further increases that risk within 12 months of the acute episode. Acute care hospitalization confers iatrogenic risks that warrant long-term mental and behavioral health follow-up.

show abstract

“…The stay in the pediatric intensive care unit (PICU) can be an emotional and stressful experience for both children and parents [ 53 ]. In a pilot study with 32 critically ill children, Badke et al investigated the feasibility and satisfaction of virtual reality in the PICU.…”

Section: Part 1: Vrmentioning

confidence: 99%

Virtual and augmented reality in intensive care medicine: a systematic review

Kanschik,

Bruno,

Wolff

et al. 2023

Ann. Intensive Care

View full text Add to dashboard Cite

Background Virtual reality (VR) and augmented reality (AR) are rapidly developing technologies that offer a wide range of applications and enable users to experience digitally rendered content in both physical and virtual space. Although the number of studies about the different use of VR and AR increases year by year, a systematic overview of the applications of these innovative technologies in intensive care medicine is lacking. The aim of this systematic review was to provide a detailed summary of how VR and AR are currently being used in various areas of intensive care medicine. Methods We systematically searched PubMed until 1st March 2023 to identify the currently existing evidence for different applications of VR and AR for both health care providers in the intensive care unit and children or adults, who were in an intensive care unit because of a critical illness. Results After screening the literature, a total of 59 studies were included. Of note, a substantial number of publications consists of case reports, study plans or are lacking a control group. Furthermore, study designs are seldom comparable. However, there have been a variety of use cases for VR and AR that researchers have explored. They can help intensive care unit (ICU) personnel train, plan, and perform difficult procedures such as cardiopulmonary resuscitation, vascular punctures, endotracheal intubation or percutaneous dilatational tracheostomy. Patients might benefit from VR during invasive interventions and ICU stay by alleviating stress or pain. Furthermore, it enables contact with relatives and can also assist patients in their rehabilitation programs. Conclusion Both, VR and AR, offer multiple possibilities to improve current care, both from the perspective of the healthcare professional and the patient. It can be assumed that VR and AR will develop further and their application in health care will increase. Graphic Abstract

show abstract

Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors

Cited by 11 publications

References 46 publications

Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset*

Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset*

Incidence of mental health conditions following pediatric hospital admissions: analysis of a national database

Virtual and augmented reality in intensive care medicine: a systematic review

Contact Info

Product

Resources

About