Improving family outcomes with a communication intervention in the pediatric ICU. This project will evaluate the effects of integrating a standardized interdisciplinary communication intervention into the pediatric intensive care unit (PICU). The proposed intervention is designed to support families when their child is in the PICU for 7 days or more and to reduce the stress associated with the experience. Intervention group families will receive up to 3 weekly care conferences beginning on day 7 of the PICU stay that will be facilitated by members of the interdisciplinary pediatric palliative care team and at least 3 follow-up visits per week by the same facilitator to keep families informed about their child's health status and offer emotional support and informational resources. Control group families will receive usual care in the PICU. Outcomes will be assessed at discharge from the PICU and 90 days after study enrollment. The project will use a cluster-randomized control trial design and quantitative and qualitative methods to evaluate (1) the efficacy of the communication intervention on reducing family symptoms of post-traumatic stress disorder 3 months after study enrollment and acute stress disorder at the time the child is discharged from the PICU;(2) the effect of the intervention on increasing family satisfaction with clinician communication and reducing family perceptions of conflict;(3) the efficacy of the intervention on reducing PICU length of stay and resource utilization without affecting mortality rates;and (4) the ICU experience for families in the intervention and control groups and clinicians, and barriers and facilitators to implementing the intervention.
The pediatric intensive care unit (PICU) is an emotionally-charged atmosphere that places significant demands on patients and families and can induce symptoms of acute stress and post-traumatic stress disorder amongst parents. Reducing stress in families of critically ill children is very important as they must maintain a reserve of resources to manage whatever demands will follow after their child transitions to home or dies in the hospital. The study intervention is designed to provide families with additional psychosocial resources (i.e., open communication with the clinical team, and instrumental and emotional support) to reduce the stress of the PICU and extends successful research done in adult ICUs to pediatric settings.
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