The impact of the PICU diary on post-intensive care syndrome in children and their parents: A pilot randomized controlled trial

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing Pub Date : 2025-08-13 DOI:10.1016/j.iccn.2025.104190

Catia Genna , Kiara Ros Thekkan , Federica Cancani , Matteo Di Nardo , Angela Rossi , Marina Franci , Tiziana Satta , Fabrizio Chiusolo , Cristiana De Ranieri , Simone Piga , Emanuela Tiozzo , Immacolata Dall’Oglio , Corrado Cecchetti , Orsola Gawronski , for the PICU Diaries Study Group

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引用次数: 0

Abstract

Objectives

1) to evaluate the feasibility of a pilot trial on the effectiveness of a pediatric intensive care unit (PICU) diary intervention; 2) to explore group differences in parent’s and child’s psychological outcomes and children’s behaviors after discharge from PICU.

Methods

A non-blinded, single-centered, pilot randomized controlled trial (RCT) was performed in two PICUs at a tertiary care children’s hospital in Italy. Children admitted to the PICU, <18 years old, sedated and intubated for ≥ 48 h were eligible. The exclusion criteria included severe disability (Pediatric Overall Performance Category > 3), low Italian communication proficiency, and no life expectancy. The intervention was the PICU narrative diary.

Results

A total of 119 patients were prospectively enrolled from June 2021 to June 2024, of which 60 received a PICU diary, and 59 did not. The composite feasibility outcomes, including eligibility, recruitment, retention, attrition, and protocol adherence met 6 of the 8 criteria. At 1 and 3 months after PICU discharge Post Traumatic Stress Disease (PTSD), anxiety, depression in parents and children, and children’s behaviors were measured with validated scales. At the one-month follow-up, parents in the control group had a higher PTSD (21 % vs 11 % p = 0.1) and depression (28 % vs 25 % p = 0.7) and lower anxiety (54 % vs 60 % p = 0.5) compared to the intervention group. At 3 months, lower levels were observed across all outcomes. Parent satisfaction with the intervention was high. The small sample size and lack of blinding were the main study limitations.

Conclusions

The trial was feasible and acceptable. No significant differences in parents’ and children’ psychological outcomes were found among the study groups.

Implications for Clinical Practice

PICU diaries could be a valuable support tool for parents and children admitted to PICU. Further evidence through larger RCTs is needed to understand the effect of post-PICU discharge psychological outcomes on children and their parents.

查看原文本刊更多论文

PICU日记对儿童及其父母重症监护后综合征的影响：一项随机对照试验

目的：1)评价儿科重症监护病房（PICU）日记干预的可行性；2)探讨PICU出院后父母与儿童心理结局及儿童行为的组间差异。方法采用非盲法、单中心、随机对照试验（RCT）对意大利某三级儿童医院的2个picu患儿进行研究。入PICU的儿童，18岁，镇静和插管≥48小时。排除标准包括严重残疾(儿科综合表现类别>；3)，意大利语沟通能力低，没有预期寿命。干预是PICU记事日记。结果从2021年6月至2024年6月，共纳入119例患者，其中60例接受PICU日记，59例未接受PICU日记。综合可行性结果，包括资格、招募、保留、减员和方案依从性满足8项标准中的6项。在PICU出院后1个月和3个月，采用经验证的量表测量创伤后应激障碍（PTSD）患儿家长和儿童的焦虑、抑郁及行为。在一个月的随访中，与干预组相比，对照组的父母有更高的创伤后应激障碍（21%对11% p = 0.1）和抑郁（28%对25% p = 0.7），更低的焦虑（54%对60% p = 0.5）。在3个月时，所有结果均出现较低水平。家长对干预的满意度较高。小样本量和缺乏盲法是研究的主要局限性。结论本试验可行，可接受。在研究小组中，父母和孩子的心理结果没有显著差异。对临床实践的启示PICU日记可能是一个有价值的支持工具，父母和儿童入住PICU。需要通过更大的随机对照试验进一步的证据来了解picu出院后心理结果对儿童及其父母的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.