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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e3181a706c9
Clinical Investigations

Parental anxiety and medical comprehension within 24 hrs of a child's admission to the pediatric intensive care unit*

Needle, Jennifer S. MD, MPH; O’Riordan, MaryAnn MS; Smith, Paul G. DO

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Abstract

Objective: Admission of a child to the pediatric intensive care unit (PICU) can create high-parental anxiety. The authors examined the factors that contribute to parental anxiety and the effect of parental anxiety on comprehension of medical information within 24 hrs of a child's admission to the PICU. The physician's recognition of parental anxiety related to their child's hospitalization was also evaluated.

Design: Prospective cohort study with a convenience sample of primary caregivers of critically ill children.

Setting: Twenty-bed PICU at an urban tertiary children's hospital.

Subjects: The primary caregivers of 35 children with Pediatric Risk of Mortality III scores ≥7 admitted to the PICU as well as PICU fellows.

Interventions: Parental anxiety was assessed with the State-Trait Anxiety Inventory, a validated tool used to measure both the temporary (State) and long-standing (Trait) anxiety in adults. Comprehension of medical information was assessed by an open-ended questionnaire. Physician assessment of parental anxiety was measured by multiple-choice questionnaire.

Measurements and Main Results: Of the 34 parents completing the State-Trait Anxiety Inventory, 21 (62%) had State Anxiety that was significantly higher than a validated sample of patients with generalized anxiety disorder. The child's need for mechanical ventilation was the only significant predictor of high-parental State Anxiety (p = .03). Among the 28 parents completing the questionnaire of comprehension of medical information, 26 (93%) demonstrated excellent or fair comprehension. Physicians had generally low recognition of parental anxiety but were significantly more likely to rate a parent's anxiety as high if the child was on mechanical ventilation.

Conclusion: Parental anxiety is high following a child's admission to the PICU. Physicians failed to recognize high-parental anxiety in nearly one third of the parents. Despite the high anxiety associated with a child's admission to the PICU, parents seem to understand their children's medical issues within the first 24 hrs.

©2009The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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