Child and family reactions during and after pediatric ICU hospitalization: A pilot study

Objective: To describe child behaviors and level of family functioning after discharge from the pediatric ICU (PICU) and to begin to explore the relationship of family reactions and the child's severity of illness to child and family outcomes after discharge. Design: Exploratory, repeated measures: Time 1 (T1) at 24 hours after admission; Time 2 (T2) at 2 to 4 weeks after hospital discharge. Subjects: Nine mothers and fathers of children who were 5 years of age or younger, hospitalized in a PICU for at least 1 day, expected to survive. Main study measures: Parental Concern Scale and Parental Stressor Scale: PICU at T1; Posthospitalization Behavior Questionnaire at T2; Feetham Family Functioning Survey and FACES III, at both T1 and T2; and Pediatric Risk of Mortality to measure illness severity. Results: Mothers' cohesion scores decreased significantly from T1 to T2. Scores from the Pediatric Risk of Mortality were not related to family measures. Mothers' family cohesion and satisfaction with family after discharge were negatively related to time the child was intubated. Few family measures were related to the Parental Concern Scale and Parental Stressor Scale: PICU subscales. Conclusions: PICU admission of a child is a stressful event for parents, independent of the child's illness severity. Mothers' perceptions of family may be negatively affected.