Acute and Posttraumatic Stress in Family Members of Children With a Prolonged Stay in a PICU: Secondary Analysis of a Randomized Trial.
Acute and Posttraumatic Stress in Family Members of Children With a Prolonged Stay in a PICU: Secondary Analysis of a Randomized Trial.
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DOI：
10.1097/pcc.0000000000002913
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发表时间：
2022-04-01
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确定急性和创伤后应激障碍筛查标准的患病率，以及在儿科重症监护室（PICU）超过8天的儿童家庭成员中的应激症状，并检查应激症状的危险因素。对家庭沟通研究数据的二次分析，这是一项2010年至2014年进行的姑息治疗干预随机试验。样本包括220名儿童的377名家庭成员。结果是急性应激障碍（ASD）和创伤后应激障碍（PTSD）的症状评分和诊断筛选标准。预测因素包括人口统计学和入院相关特征，以及发展压力相关心理健康障碍的假设风险因素。华盛顿州西雅图的一家城市儿科医院。ICU住院期间急性应激症状的平均评分为40.3（标准差= 13.8），共有59名家庭成员在住院期间符合ASD的诊断筛选标准（15.6%）。在3个月的随访中，创伤后应激症状的平均评分为30.8（标准差= 12.9），52名家庭成员符合创伤后应激障碍的诊断标准（13.8%）。符合ASD筛查标准的相关因素是计划外入院和较差的家庭关系。与创伤后应激障碍症状和诊断相关的因素是住院时间较长，入院时符合ASD标准，儿童死亡和较少的社会支持。符合PTSD筛查标准与重病儿童家庭成员的人口统计学、住院时间和家庭关系有关。PTSD的结果在孩子死亡的家庭成员中更高。这项研究有助于确定风险因素，可用于在长期PICU入院期间和之后针对所需的心理社会筛查，监测和支持，以及以家庭为中心的干预措施和对已故儿童家庭成员的支持性丧亲干预。
To identify the prevalence of screening criteria for acute and post-traumatic stress disorders, and stress symptoms among family members of children in the pediatric intensive care unit (PICU) for more than 8 days and examine risk factors for stress symptoms. Secondary analysis of data from the Family Communication Study, a randomized trial of a palliative care intervention conducted between 2010 and 2014. The sample included 377 family members of 220 children. Outcomes were symptom scores and diagnostic screening criteria for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD). Predictors included demographic and admission related characteristics, and hypothesized risk factors for developing stress-related mental health disorders. An urban pediatric hospital in Seattle, WA. 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.