Impact of critical risk factors on PTSD symptoms & salivary cortisol in PICU hospitalized children - A pilot study

2.50
Hdl Handle:
http://hdl.handle.net/10755/157073
Category:
Abstract
Type:
Presentation
Title:
Impact of critical risk factors on PTSD symptoms & salivary cortisol in PICU hospitalized children - A pilot study
Author(s):
Board, Rhonda
Author Details:
Rhonda Board, Northeastern University, Boston, MA, USA, email: r.board@neu.edu
Abstract:
PURPOSE: The aim of this pilot study was to examine the contribution of five known, critically important risk factors on the psychological and neuroendocrine status of children admitted to a pediatric intensive care unit (PICU) and to explore the feasibility of testing the hypotheses in a full-scale study. BACKGROUND: Research strongly supports that serious sequelae may occur in children following unusually stressful events such as violence or disaster. Researchers have examined post-traumatic stress disorder (PTSD) in children with physical disease and children undergoing medical treatments and found the variables most predictive of stress symptoms in children include parent distress, child acute distress, and degree of exposure to traumatic experiences. There are no studies of PICU hospitalization as a primary traumatic experience for children yet stress response can significantly influence children's development and cause considerable damage to their psychological, biological and social health. METHODS: A prospective, correlational design was used to yield baseline hospitalization data, parental data, and child data and two weeks and three-month follow-up outcomes data. Families of eight PICU hospitalized children aged 7-12 years were recruited from two large academic medical centers. Five risk factors measured were parental stress, parental anxiety, child anxiety, severity of child illness and invasive procedures of child. Outcomes variables were child PTSD symptom severity and salivary cortisol levels. Descriptive statistics, repeated-measures analysis of variance methods, and case study were used to analyze the data. RESULTS: Parental stress was low during hospitalization but all were anxious during and after discharge. Mothers' state anxiety significantly increased over time from baseline to two weeks (p = .009) and baseline to three months (p = .0244). Child post-traumatic stress symptoms decreased from baseline to two weeks (p = .0841) and then continued to decrease at the three month time period (p = .0596). Most children with average or high anxiety had varying degrees of PTSD symptomatology while children with low anxiety had doubtful or mild PTSD symptoms. As the severity of PTSD symptoms increased over time, the level of salivary cortisol decreased for times two and three (p=.090; p=.076; respectively). CONCLUSIONS: Predicted trends in data were found. All variables warrant further investigation using similar methodology in a full-scale study with an emphasis on recruiting the most seriously ill children. A thorough understanding of the PICU experience on all members of a family can facilitate appropriate screening of problems and timely support in order to improve quality of care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImpact of critical risk factors on PTSD symptoms & salivary cortisol in PICU hospitalized children - A pilot studyen_GB
dc.contributor.authorBoard, Rhondaen_GB
dc.author.detailsRhonda Board, Northeastern University, Boston, MA, USA, email: r.board@neu.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157073-
dc.description.abstractPURPOSE: The aim of this pilot study was to examine the contribution of five known, critically important risk factors on the psychological and neuroendocrine status of children admitted to a pediatric intensive care unit (PICU) and to explore the feasibility of testing the hypotheses in a full-scale study. BACKGROUND: Research strongly supports that serious sequelae may occur in children following unusually stressful events such as violence or disaster. Researchers have examined post-traumatic stress disorder (PTSD) in children with physical disease and children undergoing medical treatments and found the variables most predictive of stress symptoms in children include parent distress, child acute distress, and degree of exposure to traumatic experiences. There are no studies of PICU hospitalization as a primary traumatic experience for children yet stress response can significantly influence children's development and cause considerable damage to their psychological, biological and social health. METHODS: A prospective, correlational design was used to yield baseline hospitalization data, parental data, and child data and two weeks and three-month follow-up outcomes data. Families of eight PICU hospitalized children aged 7-12 years were recruited from two large academic medical centers. Five risk factors measured were parental stress, parental anxiety, child anxiety, severity of child illness and invasive procedures of child. Outcomes variables were child PTSD symptom severity and salivary cortisol levels. Descriptive statistics, repeated-measures analysis of variance methods, and case study were used to analyze the data. RESULTS: Parental stress was low during hospitalization but all were anxious during and after discharge. Mothers' state anxiety significantly increased over time from baseline to two weeks (p = .009) and baseline to three months (p = .0244). Child post-traumatic stress symptoms decreased from baseline to two weeks (p = .0841) and then continued to decrease at the three month time period (p = .0596). Most children with average or high anxiety had varying degrees of PTSD symptomatology while children with low anxiety had doubtful or mild PTSD symptoms. As the severity of PTSD symptoms increased over time, the level of salivary cortisol decreased for times two and three (p=.090; p=.076; respectively). CONCLUSIONS: Predicted trends in data were found. All variables warrant further investigation using similar methodology in a full-scale study with an emphasis on recruiting the most seriously ill children. A thorough understanding of the PICU experience on all members of a family can facilitate appropriate screening of problems and timely support in order to improve quality of care.en_GB
dc.date.available2011-10-26T19:23:49Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:23:49Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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