Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;20(4):e208-e215.
doi: 10.1097/PCC.0000000000001894.

The Effects of Family Functioning on the Development of Posttraumatic Stress in Children and Their Parents Following Admission to the PICU

Lara P Nelson  1   2   3 , Sage E Lachman  3 , Sara W Li  4 , Jeffrey I Gold  1   2   3   5
Affiliations

The Effects of Family Functioning on the Development of Posttraumatic Stress in Children and Their Parents Following Admission to the PICU

Lara P Nelson et al. Pediatr Crit Care Med. 2019 Apr.

Abstract

Objectives: To report the rate of acute stress and posttraumatic stress among children and parents following PICU admission and the relation between family function and posttraumatic stress.

Design: Prospective, longitudinal, multi-informant observational study. Pediatric patients (n = 69) and parents were recruited in the ICU. They completed measures evaluating acute stress and posttraumatic stress during their hospitalization and at 3-month follow-up. Parents completed measures of family functioning during the hospitalization. Pearson correlations and multiple regression models were used to examine the relations between family functioning and acute stress and posttraumatic stress.

Setting: An academic, urban, pediatric hospital in California.

Patients: Children, 8-17 years old, admitted to the PICU for greater than 24 hours and their English- or Spanish-speaking parents.

Interventions: None.

Measurements and main results: All children endorsed acute stress during their PICU admission, with 51% meeting criteria for acute stress disorder. At 3-month follow-up, 53% of the children continued to endorse posttraumatic stress with 13% meeting criteria for posttraumatic stress disorder. Among parents, 78% endorsed acute stress during admission with 30% meeting criteria for acute stress disorder, and at follow-up, 35% endorsed posttraumatic stress with 10% meeting criteria for posttraumatic stress disorder. In multiple linear regression modeling, child acute stress significantly predicted child posttraumatic stress (β = 0.36; p < 0.01). In the parent model, parent acute stress (β = 0.29; p < 0.01) and parent education (β = 0.59; p < 0.00) positively predicted parent's posttraumatic stress. Family function was not a predictor of either's posttraumatic stress.

Conclusions: Both children and parents have alarmingly high rates of acute stress and posttraumatic stress following the child's PICU admission. Although family function did not emerge as a predictor in this study, further understanding of the influence of the family and the interplay between child and parent posttraumatic stress is needed to improve our understanding of the model of development of posttraumatic stress in this population to inform the intervention strategies.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Consort Diagram
See this image and copyright information in PMC

Comment in

References

    1. Randolph AG, Gonzales CA, Cortellini L, et al.: Growth of pediatric intensive care units in the United States from 1995 to 2001. J Pediatr 2004; 144:792–798 - PubMed
    1. Nelson LP, Gold JI: Posttraumatic stress disorder in children and their parents following admission to the pediatric intensive care unit: a review. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc 2012; 13:338–347 - PubMed
    1. Center for Pediatric Traumatic Stress: Medical Events and Traumatic Stress in Children and Families [Internet]. Natl Child Trauma Stress Netw 2011; [cited 2018 Apr 6] Available from: https://www.nctsn.org/resources/medical-events-and-traumatic-stress-chil...
    1. Rees G, Gledhill J, Garralda ME, et al.: Psychiatric outcome following paediatric intensive care unit (PICU) admission: a cohort study. Intensive Care Med 2004; 30:1607–1614 - PubMed
    1. Shears D, Nadel S, Gledhill J, et al.: Short-term psychiatric adjustment of children and their parents following meningococcal disease. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc 2005; 6:39–43 - PubMed

Publication types