Pediatr Crit Care Me
-
Pediatr Crit Care Me · Nov 2015
Randomized Controlled TrialThe Value of Screening Parents for Their Risk of Developing Psychological Symptoms After PICU: A Feasibility Study Evaluating a Pediatric Intensive Care Follow-Up Clinic.
This study aimed to assess whether prospectively screening parents for psychological vulnerability would enable beneficial targeting of a subsequent follow-up clinic. ⋯ All parents completed Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale at 6 months. Of the 209 parents of 145 children recruited to the study, 78 (37%) were identified, on the basis of their Posttraumatic Adjustment Scale score at baseline, as being at risk of developing posttraumatic stress disorder, and randomized to the control or intervention condition. Follow-up data were provided by 157 of 209 parents (75%). Logistic regression analyses controlling for parent gender and child length of stay showed that high-risk control parents (n = 32) were significantly more likely to score above the clinical cutoff for all three psychological outcomes than parents deemed low risk at baseline (n = 89) (posttraumatic stress: odds ratio = 3.39; 95% CI, 1.28-8.92; p = 0.014; anxiety: odds ratio = 6.34; 95% CI, 2.55-15.76; p < 0.001; depression: odds ratio = 4.13; 95% CI, 1.47-11.61; p = 0.007). Only 14 of 38 (37%) high-risk intervention parents attended the follow-up clinic appointment they were offered. At follow-up, there were no statistically significant differences between the intervention and control groups, but there were small effect sizes in favor of the intervention for anxiety scores (Cohen d = 0.209) and depression scores (Cohen d = 0.254) CONCLUSIONS:: Screening parents for psychological vulnerability using measures such as the Posttraumatic Adjustment Scale may enable more efficient targeting of support. However, further research is needed on how best to provide effective follow-up intervention for families.
-
Pediatr Crit Care Me · Nov 2015
Randomized Controlled Trial Multicenter StudyTargeting Glycemic Control After Pediatric Cardiac Surgery: The Influence of Age on Insulin Requirement.
Factors influencing the development of hyperglycemia and pattern of insulin requirement in children undergoing cardiac surgery are poorly understood. This study investigated the impact of age on the pattern of hyperglycemia and insulin requirement in children after cardiac surgery. ⋯ When tight glycemic control is targeted in children who have undergone cardiac surgery, children in the older child age group (5-16 yr) require insulin at significantly higher doses. Further study is needed to understand the mechanisms involved.