Associations of Participation-Focused Strategies and Rehabilitation Service Use With Caregiver Stress After Pediatric Critical Illness
Jessica M Jarvis, Karen Choong, Mary A Khetani, Jessica M Jarvis, Karen Choong, Mary A Khetani
Abstract
Objective(s): Determine the associations between having participation-focused strategies and receiving rehabilitation services in the pediatric intensive care unit (PICU) with caregiver stress over 6 months post-PICU discharge.
Design: Substudy of a data from Wee-Cover, a prospective cohort study.
Setting: Two PICU sites.
Participants: Caregivers (N=168) of children 1-17 years old admitted into a PICU for ≥48 hours.
Main outcome measures: Data were collected from caregivers at enrollment and 3 and 6 months post-PICU discharge. Caregiver stress was assessed using the Pediatric Inventory for Parents. Having strategies to support their child's participation in home-based activities was assessed using the Participation and Environment Measure (PEM). In PEM, caregivers report on strategies used to support their child's participation in home-based activities. Data were dichotomized (yes, no) to denote having participation-focused strategies and if their child received PICU rehabilitation services. Additional covariates were history of a preexisting condition, child age, length of PICU stay, and change in functional capacities at PICU discharge.
Results: History of a preexisting condition, time, and change in functional capacities significantly predicted caregiver stress frequency and difficulty. The interaction of having strategies-by-rehabilitation-by-time significantly predicted caregiver stress frequency and difficulty.
Conclusion(s): Results highlight the role of early rehabilitation and the importance of working with caregivers to develop participation-focused strategies to support their child's functioning post-PICU. Families of children with a preexisting condition or those who experience a decrease in function during a PICU stay are susceptible to higher levels of stress and may be a priority population to target for rehabilitation services.
Trial registration: ClinicalTrials.gov NCT02148081.
Keywords: Critical care; Pediatrics; Rehabilitation.
Copyright © 2018 American Congress of Rehabilitation Medicine. All rights reserved.
Source: PubMed