Visiting a loved one in the ICU with the aid of dedicated booklets is associated with reduced separation anxiety in children and adolescents.

Abstract

Background: Opening visits in Intensive Care Units (ICU) to children and adolescents encounters fears and resistance. The aim of this study was to evaluate the impact on children's psychological well-being of a prepared visit to family members hospitalized in the ICU.

Methods: A quasi-experimental, pre-post-intervention design was implemented in 3 ICUs where children were allowed to visit. Children (7-17 years) with a close family member (parent, sister/brother, grandparent) hospitalized in ICU on mechanical ventilation for ≥ 48 h were eligible to participate. Within three days of the family member's admission, children completed online pre-questionnaires to assess separation anxiety, Post Traumatic Stress Disorder (PTSD) symptoms and positive and negative affects. After completion of pre-questionnaires, if parents and children expressed the desire to visit, an age-appropriate educational booklet, which was purposefully developed, was offered and the visit was planned and prepared by ICU staff. After the visit, children completed the same questionnaires. Children who did not visit completed the same questionnaires a week after having completed the pre-questionnaires.

Results: 25 children (8 boys; mean age = 11.3; SD = 2.4) completed pre and post-questionnaires. Children who visited (n = 17) were older than children who did not visit (U = 109.000; p = 0.016), presented higher separation anxiety (U = 102.500; p = 0.043) and lower positive affects (U = 30.000; p =0.027) at pre-questionnaires. Children who visited reported a decrease in separation anxiety (Median-pre = 8; Median-post = 5; p = 0.004), PTSD symptoms (Median-pre = 25; Median-post = 18; p = 0.008) and an increase in positive affect (Median-pre = 33; Median-post = 34; p = 0.004) at post-questionnaires. Children who did not visit reported a decrease in PTSD symptoms (Median-pre = 13; Median-post = 10; p =.018) at post-questionnaires. Compared to children who did not visit, children who visited reported a decrease in separation anxiety (U = 22.500; p =.006) at post questionnaires. All children who visited (100%) were satisfied and 94% perceived the educational booklets as useful.

Conclusion: Findings suggest that a prepared visit to family members in ICU may decrease children's separation anxiety, without evident harm.