Abdelmageed Reham I, Youssef Azza M, Magdy Sondos M, Nasr Ahmed N, Abdelaziz Asmaa W
Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
BMC Pediatr. 2025 Sep 18;25(1):682. doi: 10.1186/s12887-025-06156-9.
With increasing survival rates following pediatric intensive care unit (PICU) hospitalization, assessing functional outcomes is imperative. We compared children's psychosocial and adaptive functioning six weeks and six months after discharge from the PICU with children hospitalized in a general ward.
This prospective observational cohort study followed 100 children aged 2 to 11 years after PICU and ward discharge (control group) for six months. The two groups were compared for psychosocial and adaptive functioning using the Behavioral Assessment System for Children, Third Edition (BASC-3) parent report scale. Parents also completed the Parenting Stress Index-Short Form scale to assess parenting stress. Multivariate regression analysis adjusted for demographics, PICU-related factors, and parental stress was used to investigate the potential variables associated with children's psychosocial and adaptive functioning six weeks and six months after PICU discharge.
Our findings indicated that children experienced greater psychosocial problems and worse adaptive functioning up to six months after PICU discharge than children after ward discharge, P < 0.05. The number of intervention procedures and parental stress were common factors associated with impaired psychosocial and adaptive functioning post-PICU discharge. Six months after PICU discharge, younger age and length of stay were associated with psychosocial problems, while internalizing and externalizing problems were associated with poorer adaptive functioning, P < 0.05.
Given the impact of PICU experience on children's psychosocial and adaptive outcomes, it is crucial to implement psychological assessments with a follow-up plan extended longitudinally after PICU discharge. This study underscores the need to integrate adaptive behavior assessment in children's psychological evaluation to identify significant deficits, develop relevant behavioral management plans, and monitor their progress.
随着儿科重症监护病房（PICU）住院后存活率的提高，评估功能结局势在必行。我们将PICU出院后六周和六个月的儿童的心理社会和适应性功能与普通病房住院的儿童进行了比较。
这项前瞻性观察性队列研究对100名2至11岁的儿童在PICU和病房出院后（对照组）进行了为期六个月的随访。使用儿童行为评估系统第三版（BASC-3）家长报告量表对两组儿童的心理社会和适应性功能进行比较。家长们还完成了育儿压力指数简表来评估育儿压力。采用多变量回归分析，对人口统计学、PICU相关因素和父母压力进行调整，以调查与PICU出院后六周和六个月儿童心理社会和适应性功能相关的潜在变量。
我们的研究结果表明，与病房出院后的儿童相比，PICU出院后的儿童在长达六个月的时间里经历了更多的心理社会问题，适应性功能更差，P < 0.05。干预程序的数量和父母压力是与PICU出院后心理社会和适应性功能受损相关的常见因素。PICU出院六个月后，年龄较小和住院时间较长与心理社会问题相关，而内化和外化问题与较差的适应性功能相关，P < 0.05。
鉴于PICU经历对儿童心理社会和适应性结局的影响，在PICU出院后实施纵向延长随访计划的心理评估至关重要。本研究强调了在儿童心理评估中纳入适应性行为评估的必要性，以识别显著缺陷、制定相关行为管理计划并监测其进展。
