Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies | 2019
Parent Medical Traumatic Stress and Associated Family Outcomes After Pediatric Critical Illness: A Systematic Review.
Abstract
OBJECTIVES\nTo critically review, analyze, and synthesize the literature on parent medical traumatic stress from a child s critical illness requiring PICU admission and its association with outcomes of parent mental and physical health, and family functioning.\n\n\nDATA SOURCES\nSystematic literature search of Pubmed, Embase, CINAHL, and PsychInfo.\n\n\nSTUDY SELECTION\nTwo reviewers identified peer-reviewed published articles with the following criteria: 1) published between January 1, 1980, and August 1, 2018; 2) published in English; 3) study population of parents of children with a PICU admission; and 4) quantitative studies examining factors associated with outcomes of parent mental health, parent physical health, or family functioning.\n\n\nDATA EXTRACTION\nLiterature search yielded 2,476 articles, of which 23 studies met inclusion criteria. Study data extracted included study characteristics, descriptive statistics of parent outcomes after critical illness, and variables associated with parent and family outcomes.\n\n\nDATA SYNTHESIS\nStudies examined numerous variables associated with parent and family outcomes and used multiple survey measures. These variables were categorized according to their phase in the Integrative Trajectory Model of Pediatric Medical Traumatic Stress, which included peri-trauma, acute medical care, and ongoing care or discharge from care. The majority of objective elements of a child s illness, such as severity of illness and length of hospitalization, did not have a clear relationship with parent and family outcomes. However, familial preexisting factors, a parent s subjective experience in the PICU, and family life stressors after discharge were often associated with parent and family outcomes.\n\n\nCONCLUSIONS\nThis systematic literature review suggests that parent and family outcomes after pediatric critical illness are impacted by familial preexisting factors, a parent s subjective experience in the PICU, and family life stressors after discharge. Developing parent interventions focused on modifying the parent s subjective experience in the PICU could be an effective approach to improve parent outcomes.