Post-traumatic reactions in parents following admission of their child to the Intensive Care Unit

Systematic literature review: Purpose: To identify the demographic, clinical, and psychological factors associated with post-traumatic growth (PTG) in parents following their child's admission to the intensive care unit (ICU). Methods: Papers were identified following a search of electronic databases. Studies were included if they involved a sample of parents whose children were previously admitted to ICU and reported correlational data. Twelve studies were eligible for inclusion. Results: Factors associated with PTG were identified. Mothers (p ≤0.05), and parents of older children (p ≤ 0.01), experienced greater PTG. Parents who perceived their child’s illness as more severe had greater PTG (p ≤0.05). Strong associations were uncovered between PTG and posttraumatic-stress, psychological-wellbeing, and coping. Conclusions: PTG is commonly experienced by this population. Psychological factors are more commonly associated with PTG in comparison to demographic and clinical factors, suggesting that parents’ subjective ICU experience may be greater associated with PTG than the objective reality. Large scale research project: Objective: To investigate the acceptability and feasibility of a brief intervention including Tetris gameplay to prevent intrusive trauma memories in parents whose child has been admitted to the Paediatric Intensive Care Unit (PICU). Method: Nineteen parents, recruited from a regional children’s hospital, were randomly assigned to an intervention group (n = 11) or a control group receiving treatment as usual (n = 8). Parents were eligible to participate if their child was approaching discharge (< 24hrs), or recently discharged (< 24hrs), from PICU. Participants completed assessments of post-traumatic stress, anxiety and depression symptoms at baseline, one-week, and one-month follow-up. Additionally, participants recorded the number of intrusive memories experienced in the first week post-intervention in a daily diary. Semi-structured interviews were conducted with parents in the intervention group to assess acceptability. Results: Findings demonstrate that the intervention is both feasible to deliver in a PICU setting and acceptable to parents. Participant opt-in rate was 76%. Completion rate for the diary measure was 91% for the intervention group(n = 10) and 100% for the control group (n = 8). Attrition rates for the whole sample were 5% at one-week follow-up and 21% at one-month follow-up. Conclusions: The present study demonstrates the feasibility and acceptability of a brief intervention seeking to prevent intrusive trauma memories in parents of children admitted to PICU. It is recommended that a proof-of-concept randomised control trial of this intervention be carried out with parents whose child was admitted to PICU to assess effectiveness in this population.