Meeting Psychosocial and Developmental Needs of Children during Prolonged Intensive Care Unit Hospitalization

Abstract

In order to optimize psychosocial and cognitive development and family function of chronically ill patients who are acutely stable in a pediatric intensive care unit, the philosophy of care was changed. Psychosocial development was enhanced by practices that develop trust in caregivers, including change in visiting policies and consistency in caregivers. Cognitive development was enhanced by increasing interaction with the environment outside of the Pediatric Intensive Care Unit bed. Family function was maintained by communication and family participation.

Mechanical Ventilation Beyond the Intensive Care Unit

“…173 For discharge to this type of care, clinical stability generally means no major diagnostic considerations or changes in therapeutic interventions requiring ICU resources within 1 week, but patients with greater or less stability may be cared for, depending on the individual unit capabilities. For some children, prolonged but not indefinite need for mechanically assisted ventilation can be anticipated.…”

“…173 Outcomes of mechanical ventilation in a home setting in in fants and children have been examined in several studies, I3S,J36.146,J52. However, one researcher has described a program in which an ICU adopted policies that eased restrictions on the activities of ventilatorassisted children and thus both created a more normalized environment and served as a first step toward permitting care of ventilator-assisted children outside the ICU.…”

Home Care for Children with Chronic Respiratory Failure

“…46,47 Furthermore, it is difficult to meet psychosocial and developmental needs of these children in the hospital. 48 However, home care of ventilator-assisted children is also associated with major alterations in family life style. These affect all family members and interfere not only with day-to-day activities, but also with major factors, such as parents' careers.…”