Acute Stress in Parents of Patients Admitted to the Pediatric Intensive Care Unit: A Two-Center Cross-Sectional Observational Study.

Autor:	Kaplan D; Department of Pediatrics, Division of Pediatric Critical Care, 554322Northwell Health Cohen Children's Medical Center, New Hyde Park, NY, USA., Nesfield MW; Department of Pediatrics, Division of Pediatric Critical Care, Children's National Hospital, Washington, DC, USA., Eldridge PS; Department of Pediatrics, Division of Pediatric Critical Care, 583289Maria Fareri Children's Hospital, Valhalla, NY, USA., Cuddy W; Department of Pediatrics, Division of Pediatric Critical Care, 583289Maria Fareri Children's Hospital, Valhalla, NY, USA., Ansari N; Department of Pediatrics and Child Health, 66705The Aga Khan University, Karachi, Pakistan., Siller P; Interborough Developmental and Consultation Center, Brooklyn, NY, USA., Li S; Department of Pediatrics, Division of Pediatric Critical Care, 25044Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Jazyk:	angličtina
Zdroj:	Journal of intensive care medicine [J Intensive Care Med] 2023 Jan; Vol. 38 (1), pp. 11-20. Date of Electronic Publication: 2022 May 20.
DOI:	10.1177/08850666221100482
Abstrakt:	Objective: To examine medical and psychosocial risk factors associated with the development of acute stress in parents of patients unexpectedly admitted to the PICU. Design: Cross-sectional observational study. Setting: Two tertiary care children's hospitals with mixed medical/surgical/cardiac PICU. Patients: Parents of patients unexpectedly admitted to the PICU. Intervention: None. Measurements and Main Results: 265 parents of 188 children were enrolled of whom 49 parents (18%) met ASD qualification and 108 (41%) parents developed ASD symptoms as determined by the ASDS-5 scale. Risk factors making parents likely to meet ASD qualification include parents from area served by Penn State (p < 0.001), prior psychiatric illness (p < 0.01), and female gender (p < 0.05), while graduating college was protective (p < 0.05). In the multivariate analysis, parents from area served by Penn State (OR 3.00 (1.49-6.05) p < 0.01) and parents with prior psychiatric illness (OR 2.16 (1.03-4.52) p < 0.05) were associated with ASD qualification. Parents who graduated college or had prior medical problems were not significant.Risk factors making parents more likely to develop ASD symptoms (significant symptoms that do not meet ASD qualification) include patients with higher PRISM-III scores (p < 0.01), patients receiving cardiovascular support (p < 0.05), parents with a history of prior physical/sexual abuse (p < 0.01), parental involvement in the past with a major disaster/accident (p < 0.01), a family member admitted to an ICU in the past (p < 0.05) and preexisting parental psychiatric/medical disorders (p < 0.001). In a multivariate analysis, prior parental psychiatric disorder (OR 4.11 (1.80-6.42) p < 0.001), history of parental abuse (OR 3.11 (1.14-5.08) p < 0.05), and parental prior medical problem (OR 2.03 (1.01-3.05) p < 0.05) were associated with the development of ASD symptoms. However, PRISM-III score and prior involvement in major disaster were not significant. Conclusions: A combination of psychosocial parental risk factors and patient factors were associated with acute stress in parents. Further studies evaluating targeted hospital interventions towards parents most at-risk are needed.
Databáze:	MEDLINE
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