Screening for Factors Influencing Parental Psychological Vulnerability During a Child's PICU Admission.
Journal
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
ISSN: 1529-7535
Titre abrégé: Pediatr Crit Care Med
Pays: United States
ID NLM: 100954653
Informations de publication
Date de publication:
01 04 2022
01 04 2022
Historique:
pubmed:
27
1
2022
medline:
3
5
2022
entrez:
26
1
2022
Statut:
ppublish
Résumé
To identify the risks of developing post-traumatic stress disorder (PTSD) and/or depression in parents following their child's PICU admission using a brief screening instrument and to examine the associations with these risks. A cross-sectional parental survey. A general 13-bed PICU at a large teaching hospital. One hundred and seven parents of 75 children admitted to the PICU. None. All parents completed the 10-item Posttraumatic Adjustment Screen (PAS) before discharge. The PAS assesses risk factors known to be associated with poorer psychological outcome, including psychosocial variables pretrauma and peritrauma, and acute stress. Parents' scores on the PAS indicated that 64 (60%) were at risk of developing PTSD and 80 (75%) were at risk of developing depression following their child's admission. Univariate analyses suggested that psychosocial variables, such as preexisting stressors and a history of previous mental health problems, were more strongly associated with PAS risk scores for PTSD and depression than medical or sociodemographic factors. In logistic regression analyses, a history of previous mental health problems was significantly associated with risk of developing PTSD and depression (p < 0.001) explaining 28% and 43% of the variance in these outcomes. This study suggests that a significant number of parents on PICU are potentially at risk of developing PTSD and/or depression postdischarge and that psychosocial factors, pretrauma and peritrauma, are stronger determinants of this risk, and of acute distress, than other variables. Identification of vulnerable parents during admission, using a measure such as the PAS, could facilitate the targeting of support and monitoring, acutely and postdischarge, at those who might be most likely to benefit.
Identifiants
pubmed: 35081084
doi: 10.1097/PCC.0000000000002905
pii: 00130478-202204000-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
286-295Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Déclaration de conflit d'intérêts
Dr. Pathan’s institution received funding from a research grant from Addenbrooke’s Charitable Trust. The remaining authors have disclosed that they do not have any potential conflicts of interest.
Références
Needham DM, Davidson J, Cohen H, et al.: Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders’ conference. Crit Care Med. 2012; 40:502–509
Davidson JE, Jones C, Bienvenu OJ: Family response to critical illness: Postintensive care syndrome-family. Crit Care Med. 2012; 40:618–624
Rees G, Gledhill J, Garralda ME, et al.: Psychiatric outcome following paediatric intensive care unit (PICU) admission: A cohort study. Intensive Care Med. 2004; 30:1607–1614
Nelson LP, Gold JI: Posttraumatic stress disorder in children and their parents following admission to the pediatric intensive care unit: A review. Pediatr Crit Care Med. 2012; 13:338–347
Board R, Ryan-Wenger N: Long-term effects of pediatric intensive care unit hospitalization on families with young children. Heart Lung. 2002; 31:53–66
Bronner MB, Kayser AM, Knoester H, et al.: A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child’s unexpected admission to a pediatric intensive care unit. Child Adolesc Psychiatry Ment Health. 2009; 3:33
Colville G, Pierce C: Patterns of post-traumatic stress symptoms in families after paediatric intensive care. Intensive Care Med. 2012; 38:1523–1531
Le Brocque RM, Hendrikz J, Kenardy JA: The course of posttraumatic stress in children: Examination of recovery trajectories following traumatic injury. J Pediatr Psychol. 2010; 35:637–645
Yagiela LM, Carlton EF, Meert KL, et al.: Parent medical traumatic stress and associated family outcomes after pediatric critical illness: A systematic review. Pediatr Crit Care Med. 2019; 20:759–768
Balluffi A, Kassam-Adams N, Kazak A, et al.: Traumatic stress in parents of children admitted to the pediatric intensive care unit. Pediatr Crit Care Med. 2004; 5:547–553
O’Donnell ML, Creamer MC, Parslow R, et al.: A predictive screening index for posttraumatic stress disorder and depression following traumatic injury. J Consult Clin Psychol. 2008; 76:923–932
Samuel VM, Colville GA, Goodwin S, et al.: The value of screening parents for their risk of developing psychological symptoms after PICU: A feasibility study evaluating a pediatric intensive care follow-up clinic. Pediatr Crit Care Med. 2015; 16:808–813
Slater A, Shann F, Pearson G; Paediatric Index of Mortality (PIM) Study Group: PIM2: A revised version of the Paediatric Index of Mortality. Intensive Care Med. 2003; 29:278–285
Jaramillo S, Suffoletto B, Callaway C, et al.: Early screening for posttraumatic stress disorder and depression among injured emergency department patients: A feasibility study. Acad Emerg Med. 2019; 26:1232–1244
Blanchard EB, Hickling EJ, Mitnick N, et al.: The impact of severity of physical injury and perception of life threat in the development of post-traumatic stress disorder in motor vehicle accident victims. Behav Res Ther. 1995; 33:529–534
Ehlers A, Mayou RA, Bryant B: Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. J Abnorm Psychol. 1998; 107:508–519
Pynoos RS, Frederick C, Nader K, et al.: Life threat and posttraumatic stress in school-age children. Arch Gen Psychiatry. 1987; 44:1057–1063
March JS: What constitutes a stressor? The “Criterion A” issue. In : Posttraumatic Stress Disorder: DSM-IV and Beyond. Washington, DC, American Psychiatric Press, 1993, pp 37–54
Alzawad Z, Marcus Lewis F, Ngo L, et al.: Exploratory model of parental stress during children’s hospitalisation in a paediatric intensive care unit. Intensive Crit Care Nurs. 2021; 67:103109
Carter MC, Miles MS: The parental stressor scale: Pediatric intensive care unit. Matern Child Nurs J. 1989; 18:187–198
Nelson LP, Lachman SE, Goodman K, et al.: Admission psychosocial characteristics of critically ill children and acute stress. Pediatr Crit Care Med. 2021; 22:194–203
Stuber ML, Kazak AE, Meeske K, et al.: Predictors of posttraumatic stress symptoms in childhood cancer survivors. Pediatrics. 1997; 100:958–964
Ehlers A, Clark DM: A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000; 38:319–345
Kazak AE, Kassam-Adams N, Schneider S, et al.: An integrative model of pediatric medical traumatic stress. J Pediatr Psychol. 2006; 31:343–355
Brewin CR: Systematic review of screening instruments for adults at risk of PTSD. J Trauma Stress. 2005; 18:53–62
Franck LS, Wray J, Gay C, et al.: Predictors of parent post-traumatic stress symptoms after child hospitalization on general pediatric wards: A prospective cohort study. Int J Nurs Stud. 2015; 52:10–21
Muscara F, McCarthy MC, Thompson EJ, et al.: Psychosocial, demographic, and illness-related factors associated with acute traumatic stress responses in parents of children with a serious illness or injury. J Trauma Stress. 2017; 30:237–244
National Institute for Health and Care Excellence: Post-Traumatic Stress Disorder: National Guideline No 116. London, United Kingdom, National Institute for Health and Care Excellence, 2018
Colville GA: Narrative exposure therapy with parents who have been traumatized in pediatric settings: A case series. Clin Pract Pediatr Psychol. 2017; 5:161–169
Colville GA, Cream PR, Kerry SM: Do parents benefit from the offer of a follow-up appointment after their child’s admission to intensive care?: An exploratory randomised controlled trial. Intensive Crit Care Nurs. 2010; 26:146–153
Rodríguez-Rey R, Alonso-Tapia J: Development of a screening measure of stress for parents of children hospitalised in a paediatric intensive care unit. Aust Crit Care. 2016; 29:151–157
Bryant RA, Moulds ML, Guthrie RM: Acute stress disorder scale: A self-report measure of acute stress disorder. Psychol Assess. 2000; 12:61–68
Liaw KR, Cho J, Devins L, et al.: Co-designed PICU family stress screening and response system to improve experience, quality, and safety. Pediatr Qual Saf. 2019; 4:e145
Kazak AE, Hwang WT, Chen FF, et al.: Screening for family psychosocial risk in pediatric cancer: Validation of the psychosocial assessment tool (PAT) version 3. J Pediatr Psychol. 2018; 43:737–748
Rothschild CB, Rychlik KL, Goodman DM, et al.; Navigate Study Investigators: Association between resilience and psychological morbidity in parents of critically ill children. Pediatr Crit Care Med. 2020; 21:e177–e185
Baker SC, Gledhill JA: Systematic review of interventions to reduce psychiatric morbidity in parents and children after PICU admissions. Pediatr Crit Care Med. 2017; 18:343–348
National Institute for Health and Care Excellence: Rehabilitation After Critical Illness for Adults: Clinical Guideline No 83. London, United Kingdom, National Institute for Health and Care Excellence, 2009
Manning JC, Pinto NP, Rennick JE, et al.: Conceptualizing post intensive care syndrome in children-the PICS-p framework. Pediatr Crit Care Med. 2018; 19:298–300
Morris A, Gabert-Quillen C, Delahanty D: The association between parent PTSD/depression symptoms and child PTSD symptoms: A meta-analysis. J Pediatr Psychol. 2012; 37:1076–1088
Abela KM, Wardell D, Rozmus C, et al.: Impact of pediatric critical illness and injury on families: An updated systematic review. J Pediatr Nurs. 2020; 51:21–31