Daughtrey Hannah, Slain Katherine N, Derrington Sabrina, Evans Idris V R, Goodman Denise M, Christie LeeAnn M, Li Simon, Lin John C, Long Debbie A, Madden Maureen A, VandenBranden Sara, Smith McKenna, Pinto Neethi P, Maddux Aline B, Fink Ericka L, Watson R Scott, Dervan Leslie A
8404Children's National Hospital Heart Institute, Division of Pediatric Cardiology, Children's National Hospital, Washington, DC, USA.
Division of Pediatric Critical Care Medicine, Department of Pediatrics, 159284Case Western Reserve University School of Medicine & UH Rainbow Babies & Children's Hospital, Cleveland, OH, USA.
J Intensive Care Med. 2023 Jan;38(1):32-41. doi: 10.1177/08850666221102815. Epub 2022 May 22.
Social health is an important component of recovery following critical illness as modeled in the pediatric Post-Intensive Care Syndrome framework. We conducted a scoping review of studies measuring social outcomes (measurable components of social health) following pediatric critical illness and propose a conceptual framework of the social outcomes measured in these studies.
PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Registry.
We identified studies evaluating social outcomes in pediatric intensive care unit (PICU) survivors or their families from 1970-2017 as part of a broader scoping review of outcomes after pediatric critical illness.
We identified articles by dual review and dual-extracted study characteristics, instruments, and instrument validation and administration information. For instruments used in studies evaluating a social outcome, we collected instrument content and described it using qualitative methods adapted to a scoping review.
Of 407 articles identified in the scoping review, 223 (55%) evaluated a social outcome. The majority were conducted in North America and the United Kingdom, with wide variation in methodology and population. Among these studies, 38 unique instruments were used to evaluate a social outcome. Specific social outcomes measured included individual (independence, attachment, empathy, social behaviors, social cognition, and social interest), environmental (community perceptions and environment), and network (activities and relationships) characteristics, together with school and family outcomes. While many instruments assessed more than one social outcome, no instrument evaluated all areas of social outcome.
The full range of social outcomes reported following pediatric critical illness were not captured by any single instrument. The lack of a comprehensive instrument focused on social outcomes may contribute to under-appreciation of the importance of social outcomes and their under-representation in PICU outcomes research. A more comprehensive evaluation of social outcomes will improve understanding of overall recovery following pediatric critical illness.
在儿科重症监护后综合征框架中，社会健康是危重症康复的重要组成部分。我们对测量儿科危重症后社会结局（社会健康的可测量组成部分）的研究进行了范围综述，并提出了这些研究中所测量社会结局的概念框架。
PubMed、EMBASE、PsycINFO、CINAHL和Cochrane注册库。
我们确定了1970年至2017年评估儿科重症监护病房（PICU）幸存者或其家庭社会结局的研究，作为儿科危重症后结局更广泛范围综述的一部分。
我们通过双人评审和双人提取研究特征、工具以及工具验证和管理信息来确定文章。对于评估社会结局的研究中使用的工具，我们收集了工具内容，并使用适用于范围综述的定性方法进行描述。
在范围综述中确定的407篇文章中，223篇（55%）评估了社会结局。大多数研究在北美和英国进行，方法和人群差异很大。在这些研究中，38种独特的工具用于评估社会结局。所测量的具体社会结局包括个体（独立性、依恋、同理心、社会行为、社会认知和社会兴趣）、环境（社区认知和环境）和网络（活动和关系）特征，以及学校和家庭结局。虽然许多工具评估了不止一个社会结局，但没有一个工具评估了社会结局的所有领域。
没有任何单一工具能够涵盖儿科危重症后报告的所有社会结局。缺乏专注于社会结局的综合工具可能导致对社会结局重要性的认识不足，以及它们在PICU结局研究中的代表性不足。对社会结局进行更全面的评估将有助于更好地理解儿科危重症后的整体康复情况。
