Improving Family Outcomes with a Communication Intervention in the Pediatric ICU

描述（由申请人提供）：在儿科ICU中通过沟通干预改善家庭结局。 本计画将评估整合标准化跨学科沟通介入于儿科重症监护室（PICU）的效果。拟议的干预措施旨在支持家庭，当他们的孩子在PICU 7天或更长时间，并减少与经验相关的压力。干预组家庭将从入住PICU的第7天开始接受最多3次每周护理会议，由跨学科儿科姑息治疗团队的成员提供协助，每周至少3次由同一名主持人进行随访，以使家庭了解孩子的健康状况，并提供情感支持和信息资源。对照组家庭将在PICU接受常规护理。将在PICU出院时和研究入组后90天评估结局。本项目将采用整群随机对照试验设计，采用定量和定性的方法，评价（1）沟通干预对减少研究入组后3个月创伤后应激障碍的家庭症状和儿童从PICU出院时急性应激障碍的疗效;（2）干预对提高家属对医生沟通的满意度和减少家属对冲突的看法的影响;（3）干预措施在减少PICU住院时间和资源利用而不影响死亡率方面的有效性;（4）干预组和对照组家庭和临床医生的ICU经验，以及实施干预措施的障碍和促进因素。

DESCRIPTION (provided by applicant): Improving family outcomes with a communication intervention in the pediatric ICU. This project will evaluate the effects of integrating a standardized interdisciplinary communication intervention into the pediatric intensive care unit (PICU). The proposed intervention is designed to support families when their child is in the PICU for 7 days or more and to reduce the stress associated with the experience. Intervention group families will receive up to 3 weekly care conferences beginning on day 7 of the PICU stay that will be facilitated by members of the interdisciplinary pediatric palliative care team and at least 3 follow-up visits per week by the same facilitator to keep families informed about their child's health status and offer emotional support and informational resources. Control group families will receive usual care in the PICU. Outcomes will be assessed at discharge from the PICU and 90 days after study enrollment. The project will use a cluster-randomized control trial design and quantitative and qualitative methods to evaluate (1) the efficacy of the communication intervention on reducing family symptoms of post-traumatic stress disorder 3 months after study enrollment and acute stress disorder at the time the child is discharged from the PICU; (2) the effect of the intervention on increasing family satisfaction with clinician communication and reducing family perceptions of conflict; (3) the efficacy of the intervention on reducing PICU length of stay and resource utilization without affecting mortality rates; and (4) the ICU experience for families in the intervention and control groups and clinicians, and barriers and facilitators to implementing the intervention.