Department of Pediatrics, Royal Hospital, Muscat, Oman.
Department of Paediatrics, Western University, London, ON, Canada.
Pediatr Crit Care Med. 2018 Aug;19(8):e387-e393. doi: 10.1097/PCC.0000000000001597.
To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside.
Prospective cohort study.
PICU in a single tertiary care children's hospital.
Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015.
None.
A total of 111 observations of 108 unique PICU admissions and families were performed. Children had at least one parent present a mean of 58.2% (SD, 34.6%) of the time. Mothers spent more time at the bedside (56.3% [SD, 31.0%]) than fathers (37.3% [SD, 29.5%]) (p = 0.0001). Percent of time with parental presence at the bedside was positively correlated with age (rs = 0.23; p = 0.02) and negatively associated with Pediatric Risk of Mortality III score (rs = -0.26; p = 0.01). Percent of time with parental presence at the bedside was lower for children who were mechanically ventilated (42.8% [SD, 35.5%]) than not (64.5% [SD, 32.2%]) (p = 0.01) and whose parent(s) were single (45.5% [SD, 27.5%]) or cohabitating/common-law (35.7% [SD, 26.4%]) compared with parents who were married (64.2% [SD, 34.2%]) or separated/divorced (68.3% [SD, 28.8%]) (p = 0.02). Percent of time with parental presence at the bedside was higher for children with chronic illnesses (63.4% [SD, 32.9%] vs 50.1% [SD, 35.8%] without; p = 0.04), when there was a bed in the patient room (61.4% [SD, 34.0%] vs 32.5% [SD, 28.3%] without; p = 0.01), and when parents slept in the patient room (90.3% [SD, 11.2%]) compared with their own home (37.6% [SD, 34.4%]) (p < 0.0001). Percent of time with parental presence at the bedside was not correlated with day of PICU stay, number of siblings, previous PICU admission, isolation status, or nursing ratio.
Children had a parent present at the bedside approximately 60% of the time. The parents of younger, sicker children may benefit from supportive interventions during PICU admission. Further research is needed to examine both extrinsic and intrinsic factors affecting parental presence at the bedside.
确定危重症患儿有家长陪伴的时间比例，并确定与父母在床边陪伴时间百分比相关的外在因素。
前瞻性队列研究。
2014 年至 2015 年期间，一家三级儿童专科医院的 PICU 中 12 天内选定的 12 名患儿的 2 名主要父母。
无。
共对 108 名 PICU 入院和家庭进行了 111 次观察。儿童至少有一位家长陪伴，平均时间为 58.2%（SD，34.6%）。母亲在床边的时间（56.3%[SD，31.0%]）多于父亲（37.3%[SD，29.5%]）（p = 0.0001）。父母在床边的陪伴时间百分比与年龄呈正相关（rs = 0.23；p = 0.02），与儿科死亡率风险 III 评分呈负相关（rs = -0.26；p = 0.01）。与未机械通气的患儿（64.5%[SD，32.2%]）相比，机械通气的患儿（42.8%[SD，35.5%]）父母在床边的陪伴时间百分比更低（p = 0.01），与单身（45.5%[SD，27.5%]）或同居/事实婚姻（35.7%[SD，26.4%]）的父母相比，已婚（64.2%[SD，34.2%]）或离异/分居（68.3%[SD，28.8%]）的父母（p = 0.02）。与没有慢性疾病的患儿（50.1%[SD，35.8%]）相比，患有慢性疾病的患儿（63.4%[SD，32.9%]）父母在床边的陪伴时间百分比更高（p = 0.04），当患儿病房有床位时（61.4%[SD，34.0%]）与没有床位时（32.5%[SD，28.3%]）相比（p = 0.01），当父母睡在患儿病房时（90.3%[SD，11.2%]）与睡在自己家时（37.6%[SD，34.4%]）相比（p < 0.0001）。父母在床边的陪伴时间百分比与 PICU 住院天数、兄弟姐妹数量、以前的 PICU 入院、隔离状态或护理比例无关。
患儿有家长陪伴的时间约为 60%。年龄较小、病情较重的患儿的父母在 PICU 入院期间可能需要支持性干预。需要进一步研究以检查影响父母在床边陪伴时间的外在和内在因素。
