School of Social Work, University of Washington, Seattle, WA.
Department of Medicine, University of Washington, Seattle, WA.
Pediatr Crit Care Med. 2022 Apr 1;23(4):306-314. doi: 10.1097/PCC.0000000000002913. Epub 2022 Feb 22.
To identify the prevalence of screening criteria for acute and posttraumatic stress disorders (PTSDs) and stress symptoms among family members of children in the PICU for more than 8 days and examine risk factors for stress symptoms.
Secondary analysis of data from a randomized trial of a palliative care intervention conducted between 2010 and 2014.
An urban pediatric hospital in Seattle, WA.
The sample included 377 family members of 220 children.
Family Communication Study.
Outcomes were symptom scores and diagnostic screening criteria for acute stress disorder (ASD) and PTSD. Predictors included demographic- and admission-related characteristics and hypothesized risk factors for developing stress-related mental health disorders. The mean score for acute stress symptoms during the ICU stay was 40.3 (sd = 13.8) and 59 family members in total met diagnostic screening criteria for ASD during hospitalization (15.6%). At 3-month follow-up, the mean score for posttraumatic stress symptoms was 30.8 (sd = 12.9) and 52 family members met diagnostic criteria for PTSD (13.8%). Factors associated with meeting ASD screening criteria were unplanned admission and poorer family relationships. Factors associated with PTSD symptoms and diagnosis were longer length of stay, meeting ASD criteria during admission, child's death, and less perceived social support.
Meeting screening criteria for PTSD was associated with demographic, length of stay, and family relationships among family members of seriously ill children. PTSD outcomes were higher among family members whose child died. This study helps identify risk factors that can be used to target needed psychosocial screening, monitoring and support during and following a prolonged PICU admission, as well as family-centered interventions and supportive bereavement intervention for the family members of a deceased child.
确定重症监护病房（PICU）中儿童住院时间超过 8 天的家属出现急性和创伤后应激障碍（PTSD）及应激症状的筛查标准的流行情况，并探讨应激症状的危险因素。
对 2010 年至 2014 年期间进行的姑息治疗干预随机试验的数据进行二次分析。
华盛顿州西雅图市的一家城市儿科医院。
样本包括 220 名儿童的 377 名家属。
家庭沟通研究。
结局指标为症状评分和急性应激障碍（ASD）和 PTSD 的诊断筛查标准。预测因素包括人口统计学和入院相关特征以及应激相关心理健康障碍发生的假设危险因素。ICU 住院期间急性应激症状的平均得分为 40.3（标准差=13.8），共有 59 名家属在住院期间符合 ASD 诊断筛查标准（15.6%）。在 3 个月的随访中，创伤后应激症状的平均得分为 30.8（标准差=12.9），有 52 名家属符合 PTSD 诊断标准（13.8%）。符合 ASD 筛查标准的因素包括计划外入院和较差的家庭关系。与 PTSD 症状和诊断相关的因素包括住院时间延长、入院期间符合 ASD 标准、患儿死亡以及感知到的社会支持较少。
在患有重病的儿童的家属中，符合 PTSD 筛查标准与人口统计学、住院时间和家庭关系有关。在患儿死亡的家属中，PTSD 结局更高。这项研究有助于确定可用于在长时间 PICU 住院期间和之后进行有针对性的心理社会筛查、监测和支持的危险因素，以及针对死亡患儿家属的以家庭为中心的干预和支持性丧亲干预。
