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Determinants of change in home participation among critically ill children
Author(s) -
Khetani Mary A,
Albrecht Erin C,
Jarvis Jessica M,
Pogorzelski David,
Cheng Emmy,
Choong Karen
Publication year - 2018
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13731
Subject(s) - psychological intervention , medicine , pediatric intensive care unit , paediatric intensive care unit , critically ill , rehabilitation , prospective cohort study , pediatrics , gerontology , intensive care medicine , nursing , physical therapy , surgery
Aim To estimate changes in home participation among critically ill children in the first 6 months after discharge from a pediatric intensive care unit ( PICU ), and to explore the effect of child, service, and environmental factors on change in home participation. Method This was a prospective bi‐center, longitudinal cohort study. Caregivers of 180 children, aged 1 to 17 years, who were admitted into the PICU for at least 48 hours were included. Patient‐reported outcomes were used to capture caregivers’ perspectives of their child's participation and environmental supports for participation in home activities. Data were collected at enrollment, and 3 and 6 months after discharge. Results There were no significant changes in home participation frequency or involvement, but involvement rates across time were moderated by functional status. Age significantly predicted participation frequency. Pre‐ PICU functional status and capabilities were significant predictors of participation frequency and involvement, and home environmental support significantly predicted home involvement. Interpretation Results suggest relatively stable participation trajectories in the 6 months after PICU admission. Children with abnormal baseline function experienced a greater increase in home involvement after PICU . Rehabilitation interventions targeting functional capabilities and home environment may be viable approaches during the early phase of recovery. Environmental interventions may be more time‐efficient after PICU stay and merit further study. What this paper adds Children's pre‐pediatric intensive care unit (PICU) functional status and capabilities impact their participation after critical illness. Children's trajectories of home involvement may differ over time based on their pre‐PICU functional status. Caregiver perceptions of environmental support impact a child's home involvement after discharge from a PICU.