Poh Pei-Fen, Lee Jan Hau, Sultana Rehena, Manning Joseph C, Carey Matthew C, Latour Jos M
School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK.
Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore 229899, Singapore.
Children (Basel). 2024 Aug 6;11(8):948. doi: 10.3390/children11080948.
Childhood critical illness can have long-term effects on families, but the extent and trajectory of recovery for parents are unknown. Using prospective longitudinal design, we describe the health outcomes of parents and their trajectory six months after paediatric intensive care unit (PICU) discharge. Parents reported health outcomes at PICU discharge (baseline), and 1-, 3-, and 6-months post-discharge. We used the Pediatric Quality-of-Life Family Impact Module, Patient Health Questionnaire-4, and post-traumatic stress disorder (PTSD) Checklist for DSM-5. The group-based trajectory model was used to identify recovery patterns. We included 128 parents of children aged 1 month to 18 years, admitted to the PICU for ≥48 h. Three post-discharge composite health trajectory groups were classified: 54 mild (42%), 68 moderate (53%), and 6 severe (4%). Parents in the mild and moderate groups returned to baseline health within the first 3 months, but those in the severe group exhibited worse outcomes at 6-months. The mean (SD) PICU stay durations for mild, moderate, and severe groups were 9 (16), 7 (10), and 38 (61) days; days of mechanical ventilation were 4 (5), 4 (7), and 18 (25) days; and readmission rates were 12 (22%), 23 (34%), and 4 (66%), respectively. Identifying these trajectories enables novel, targeted interventions for at-risk parents, underscoring the significance of integrated PICU follow-up care.
儿童危重病会对家庭产生长期影响,但父母恢复的程度和轨迹尚不清楚。我们采用前瞻性纵向设计,描述了儿科重症监护病房(PICU)出院后六个月父母的健康状况及其轨迹。父母在PICU出院时(基线)以及出院后1个月、3个月和6个月报告了健康状况。我们使用了儿童生活质量家庭影响模块、患者健康问卷-4以及DSM-5创伤后应激障碍(PTSD)检查表。基于组的轨迹模型用于识别恢复模式。我们纳入了128名1个月至18岁儿童的父母,这些儿童在PICU住院≥48小时。出院后将复合健康轨迹分为三组:54例轻度(42%)、68例中度(53%)和6例重度(4%)。轻度和中度组的父母在头3个月内恢复到基线健康水平,但重度组的父母在6个月时健康状况较差。轻度、中度和重度组的PICU平均住院天数分别为9(16)天、7(10)天和38(61)天;机械通气天数分别为4(5)天、4(7)天和18(25)天;再入院率分别为12例(22%)、23例(34%)和4例(66%)。识别这些轨迹能够为有风险的父母提供新颖、有针对性的干预措施,突出了PICU综合随访护理的重要性。