PSYCHOLOGICAL CONSEQUENCES IN PEDIATRIC INTENSIVE CARE SURVIVORS: THE UNSUSPECTED IMPACT
S Birajdar*, MN Muranjan**, H Shah***, P Sundaram****, MS Tullu*****
Dept. of Pediatrics and Psychiatry, KEM Hospital, Parel, Mumbai *, Dept. of Pediatrics and Psychiatry, KEM Hospital, Parel, Mumbai **, Dept. of Pediatrics and Psychiatry, KEM Hospital, Parel, Mumbai ***, Dept. of Pediatrics and Psychiatry, KEM Hospital, Parel, Mumbai ****, Dept. of Pediatrics and Psychiatry, KEM Hospital, Parel, Mumbai *****
Stress in a PICU could originate from the disease itself or from pain, disruptions of the child's routine or the ICU ambience and can be experienced at a physical, emotional or social level. There is insufficient data on the psychological well-being of children admitted to a PICU. Such information is vital to impart holistic care in PICU. This study was conceptualized to overcome this lacuna in knowledge.
Objectives
To determine whether hospitalization in a PICU results in adverse psychological effects on a sick child and to identify factors contributing to the psychological stress.
Type of study
Prospective cohort study
Setting
Level III PICU of a Tertiary care hospital in Mumbai, India
Patients & Methods
Consecutive patients admitted to PICU over 8 months and fulfilling inclusion criteria (age = 5 years, absence of neurological abnormalities precluding an interview, during of stay in PICU of at least 48 hours of conscious period) were enrolled. Age and sex matched controls were selected from the general pediatric wards. PRISM scores and level of therapeutic intervention (TISS 76 score) were assessed. Tools for psychological assessment were Temperament Measurement Schedule, Impact of Event Scale, Depression scale and the Self Esteem Scale. Statistical analysis was performed using SPSS version 11.5 for Windows.
Results
Thirty patients (M:F ratio 1:2) and an equal number of age and sex matched controls were enrolled. Significantly higher proportion of patients in PICU had intrusive thoughts (43%) as compared to controls from the ward (6.7%) (p = 0.001). Development of intrusive thoughts correlated significantly with TISS score. Age, socioeconomic status, educational status, nature of the underlying disease, duration of the hospitalization and severity of disease as measured by PRISM score did not significantly correlate with the psychological outcome.
Conclusions
Children in a PICU are at risk to develop psychological impairment manifest as experiencing intrusive thoughts related to the degree and type of therapeutic intervention.
Clinical Implications
Impact of PICU hospitalization can be neutralized by measures such as pre-procedure counseling, analgesia and sedation for invasive procedures, recreational facilities and service of a psychologist.
How to Cite URL :
Birajdar S, Muranjan M, Shah H, Sundaram P, Tullu M.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=308
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.