Rennick Janet E, Dougherty Geoffrey, Dryden-Palmer Karen, Campbell-Yeo Marsha, Knox Alyssa M, Chambers Christine T, Stack Dale M, Treherne Stephanie, Stremler Robyn
Department of Nursing and Division of Critical Care, Montreal Children's Hospital, McGill University Health Centre and Ingram School of Nursing and Department of Pediatrics, McGill University, Montreal, QC, Canada.
Division of General Pediatrics, Montreal Children's Hospital, McGill University Health Centre and Department of Pediatrics, McGill University, Montreal, QC, Canada.
Pediatr Crit Care Med. 2025 Apr 1;26(4):e516-e530. doi: 10.1097/PCC.0000000000003701. Epub 2025 Feb 14.
To report the 3-year follow-up results of the "Caring Intensively" study, which examined children's psychological and behavioral responses after PICU hospitalization.
Prospective mixed methods, concurrent triangulation design. In the quantitative arm, study group (SG) and comparison group (CG) children and their parents were administered a battery of measures assessing psychological and behavioral outcomes, and telephone survey data were collected 6 weeks, 6 months, 1, 2, and 3 years post-discharge. In the qualitative arm, SG interviews were conducted 1 and 3 years post-discharge. Recruitment 2014-2018, with follow-up completed 2021.
SG recruited from PICUs of three Canadian quaternary care pediatric hospitals; CG from two hospitals' ear, nose, and throat (ENT) day surgery units.
Age (3-12 yr) and gender-matched PICU children (SG, 158) or day surgery ENT children (CG, 169) and their parents were recruited; 62% of families completed the study (SG, 97; CG, 106). Selected SG families were interviewed at year 1 (17 families, 30 participants) and year 3 (14 families, 27 participants).
None.
No group differences on primary or secondary outcomes. Both groups reported emotional and behavioral changes in children via telephone survey; however, group findings diverged on their nature and attribution. SG parents attributed changes primarily to PICU hospitalization; CG parents attributed changes to other life events. At year 3, 40.3% of SG parents still reported negative emotional and behavioral changes in children suggesting a chronic trajectory of recovery. Qualitative interview findings converged with SG survey responses, reflecting the adaptive and relational challenges confronting children and families.
This study highlights children's emotional and behavioral responses over the 3 years post-PICU and the need to study child recovery within the family. These findings contribute to our understanding of the nature and duration of trajectories of recovery and emphasize the importance of providing clinical follow-up and prioritizing family-identified outcomes in future research.
报告“深度关怀”研究的3年随访结果，该研究考察了儿童重症监护病房（PICU）住院后儿童的心理和行为反应。
前瞻性混合方法、并行三角测量设计。在定量研究部分，研究组（SG）和对照组（CG）的儿童及其父母接受了一系列评估心理和行为结果的测量，并在出院后6周、6个月、1年、2年和3年收集电话调查数据。在定性研究部分，在出院后1年和3年对研究组进行访谈。招募时间为2014 - 2018年，随访于2021年完成。
研究组从加拿大三家四级护理儿科医院的PICU招募；对照组从两家医院的耳鼻喉（ENT）日间手术科室招募。
招募年龄（3 - 12岁）和性别匹配的PICU儿童（研究组，158名）或日间手术耳鼻喉科儿童（对照组，169名）及其父母；62%的家庭完成了研究（研究组，97个；对照组，106个）。选定的研究组家庭在第1年（17个家庭，30名参与者）和第3年（14个家庭，27名参与者）接受访谈。
无。
在主要或次要结果上无组间差异。两组均通过电话调查报告了儿童的情绪和行为变化；然而，两组在变化的性质和归因上存在分歧。研究组父母将变化主要归因于PICU住院；对照组父母将变化归因于其他生活事件。在第3年，40.3%的研究组父母仍报告儿童有负面情绪和行为变化，表明恢复过程呈慢性轨迹。定性访谈结果与研究组的调查反应一致，反映了儿童和家庭面临的适应性和关系性挑战。
本研究突出了PICU后3年儿童的情绪和行为反应，以及在家庭环境中研究儿童恢复情况的必要性。这些发现有助于我们理解恢复轨迹的性质和持续时间，并强调在未来研究中提供临床随访以及优先考虑家庭确定的结果的重要性。
