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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Interventions to Reduce Psychologic Morbidity After PICU Discharge: Challenges to Establishing Efficacy
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Interventions to Reduce Psychologic Morbidity After PICU Discharge: Challenges to Establishing Efficacy

机译：干预措施减少PICU院外心理发病率：建立疗效的挑战

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摘要

Although mortality from critical illness during childhood is low, survivors of critical illness are at risk for adverse psychologic and behavioral outcomes. For example, posttraumatic stress disorder (PTSD) has been estimated to occur in 5-28% of children following a PICU admission, and posttraumatic stress symptoms (PTSS) occur in 35-62%. Among parents of PICU patients, PTSD has been reported in 10-21% and PTSS in as many as 84%. Psychologic morbidity following a PICU admission can lead to serious disturbances in child and family functioning; these disturbances, in turn, can have a major impact on child health. In this issue of Pediatric Critical Care Medicine, Baker and Gledhill report the results of a systematic review of interventions to reduce psychologic morbidity in parents and children after discharge from the PICU. Only six studies were identified that could be included in the review; three of these were reported as full randomized controlled trials (RCT) and three as feasibility studies. Two of the feasibility studies also had RCT designs, and one was an intervention without a control arm. Participants included parents and children. In some studies, all families discharged from the PICU were eligible; in others, only families at high risk for psychologic morbidity were included. The interventions evaluated primarily included psychoeducation and parental support in written and verbal formats (in-person or telephone) delivered during the hospital stay or at a follow-up clinic visit.
机译：虽然儿童期间危重疾病的死亡率低，但危重疾病的幸存者面临不利心理和行为结果的风险。例如，估计PICU入院后5-28％的儿童发生后的暴力应激障碍（PTSD），并且出现了患者的后压力症状（PTS）以35-62％发生。在PICU患者的父母中，PTSD已在10-21％和PTS中报告，多达84％。 PICU入学后的心理发病率可能导致儿童和家庭功能的严重骚乱;又可以对儿童健康产生重大影响。在这个问题的儿科关键护理医学中，贝克和GLEDHILL报告了对干预措施进行系统审查的结果，以减少父母和儿童从PICU排放后的心理发病。只确定了六项研究，可以包含在审查中;其中三项被报告为完全随机对照试验（RCT）和三种作为可行性研究。其中两个可行性研究也具有RCT设计，并且一个是没有控制臂的干预。参与者包括父母和孩子。在一些研究中，所有来自PICU的家庭都有资格;在其他人中，只包括心理发病率高风险的家庭。评估的干预措施主要包括在住院期间或随访的诊所访问期间提供的书面和口头格式（个人或电话）的心理教育和父母支持。

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