Posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment compared to children who survived a major fire disaster

<p>Abstract</p> <p>Background</p> <p>The goals were to determine the presence of posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands.</p> <p>Methods</p> <p>Children completed the Dutch Children's Responses to Trauma Inventory at three and nine months after discharge from the paediatric intensive care unit (PICU). Comparison data were available from 355 children survivors who completed the same questionnaire 10 months after a major fire disaster.</p> <p>Results</p> <p>Thirty-six children aged eight to 17 years completed questionnaires at three month follow-up, nine month follow-up, or both. More than one third (34.5%) of the children had subclinical PTSD, while 13.8% were likely to meet criteria for PTSD. Maternal PTSD was the strongest predictor for child PTSD. There were no significant differences in (subclinical) PTSD symptoms either over time or compared to symptoms of survivors from the fire disaster.</p> <p>Conclusion</p> <p>This study shows that a considerable number of children have persistent PTSD after PICU treatment. Prevention of PTSD is important to minimize the profound adverse effects that PTSD can have on children's well-being and future development.</p

A systematic review of interactive multimedia interventions to promote children's communication with health professionals: implications for communicating with overweight children

Background: Interactive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes. Methods: An extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11 years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods. Results: A total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children’s health- related self-efficacy, which could make them more able partners in face-to-face communications with health professionals. Conclusions: The findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research in this field is needed. Particular attention should be given to designing appropriate MIs that are clinically relevant

Parents' experiences of their child being admitted to a paediatric intensive care unit : a qualitative study–like being in another world

Background: There is very little research on the parent's experiences of having a child admitted to a paediatric intensive care unit. Identifying and describing ‘such experiences’ could facilitate better parental support from the paediatric intensive care team and help the parents manage a stressful situation. Aims: This study aimed to describe parents' experiences of having their child admitted to a paediatric intensive care unit. Methods: Interviews were conducted with 12 parents whose children had been admitted to a paediatric intensive care unit. A qualitative design was used, and the interviews were analysed based on content analysis. Result: The analysis revealed two categories: ‘being involved’ and ‘being informed’ with seven subcategories: ‘caring for the parents’, ‘security and trust’, ‘altering the parental role’, ‘stress and fear’, ‘the importance of knowing’, ‘interaction in the care process’ and ‘being prepared’. An overarching theme emerged: the experience was ‘like being in another world’. The study concludes that a child's admission to a paediatric intensive care unit is a stressful situation, and for the parents to be able to handle the anxiety and stress, they need to be informed of and involved in their child's care. Conclusions: The parents' experience when their child is admitted to a paediatric intensive care unit is fraught with a range of emotion and fear. There are indications that things such as good information, involvement and a positive experience of the transfer to the paediatric ward reduce the stress and anxiety associated with paediatric intensive care admission. The result of this study could be used as a basis for a post-paediatric intensive care follow-up service for the children and their families