The association of severe pain experienced in the <scp>pediatric intensive care unit</scp> and <scp>postdischarge health‐related</scp> quality of life: A retrospective cohort study

Smith, Mallory B; Killien, Elizabeth Y; Dervan, Leslie A.; Rivara, Frederick P.; Weiss, Noel S.; Watson, R. Scott

doi:10.1111/pan.14460

Cited by 7 publications

(2 citation statements)

References 25 publications

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“…[1][2][3] The goal of pain management in PICU settings is to improve patient comfort and reduce associated physiological stress responses while managing risks such as respiratory depression, addiction, haemodynamic instability, delirium, and end organ injury. 2,4,5 Children admitted to PICUs experience on average >10 painful and/or distressing procedures per day. 1,[6][7][8] This number significantly increases for children who are mechanically ventilated.…”

Section: Introductionmentioning

confidence: 99%

Extended Reality Use in Paediatric Intensive Care: A Scoping Review

Goldsworthy

Chawla

Baumann

et al. 2023

J Intensive Care Med

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Background: Extended reality (XR) technology such as virtual and augmented reality is increasingly being utilised in paediatric medicine due to its role in medical education and reported positive impacts on outcomes including pain, anxiety, and sleep. To the author’s knowledge, no previous reviews investigating the use of XR in paediatric intensive care have been undertaken. Objectives: To scope the use of XR in paediatric intensive care, and assess its barriers to adoption, including safety considerations, cleaning and infection control. Eligibility criteria: All articles of any methodological design discussing the use of XR within paediatric intensive and critical care were included. Sources of evidence: Four databases (EMBASE, CINAHL, PsychInfo, PubMed) and Google Scholar were searched without any limitations on publication year. Charting methods: Data was extracted into Microsoft Excel by two authors independently (AG & SF) and cross-checked for completeness. Results: One hundred and eighty-eight articles were originally identified. Following the application of eligibility criteria 16 articles utilising XR in clinical interventions (n = 7) and medical education (n = 9) were included. Articles utilised VR and AR for highly variable purposes within both medical education (eg disaster preparedness, intubation) and clinical interventions (eg decrease pain, nausea, anxiety and improve Glasgow Coma Scale). Conclusions: While research into the use of XR in paediatric intensive care is still in its infancy it has increased dramatically over the past 5 years within two key areas. Firstly, in healthcare education, to assist in the acquisition of PICU-specific knowledge and practice of skills such as intubation of difficult airways. Secondly, studies have evaluated and demonstrated that with appropriate use, VR appears to be a safe and feasible intervention to decrease pain and anxiety in PICU patients.

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Section: Introductionmentioning

confidence: 99%

Extended Reality Use in Paediatric Intensive Care: A Scoping Review

Goldsworthy

Chawla

Baumann

et al. 2023

J Intensive Care Med

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“…P ediatric critical illness is associated with pain, anxiety, and delirium that may contribute to lower health-related quality of life (HRQL) and poor mental health outcomes after discharge (1)(2)(3). However, family presence during pediatric hospitalization may mitigate some of these adverse effects.…”

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confidence: 99%

Family Presence at the PICU Bedside: A Single-Center Retrospective Cohort Study*

Smith

Dervan

Watson

et al. 2023

Pediatric Critical Care Medicine

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Objectives: To determine factors associated with bedside family presence in the PICU and to understand how individual factors interact as barriers to family presence. Design: Mixed methods study. Setting: Tertiary children’s hospital PICU. Subjects: Five hundred twenty-three children of less than 18 years enrolled in the Seattle Children’s Hospital Outcomes Assessment Program from 2011 to 2017. Interventions: None. Measurements and Main Results: Quantitative: Family was documented every 2 hours. Exposures included patient and illness characteristics and family demographic and socioeconomic characteristics. We used multivariable logistic regression to identify factors associated with presence of less than 80% and stratified results by self-reported race. Longer PICU length of stay (LOS), public insurance, and complex chronic conditions (C-CD) were associated with family presence of less than 80%. Self-reported race modified these associations; no factors were associated with lower bedside presence for White families, in contrast with multiple associations for non-White families including public insurance, C-CD, and longer LOS. Qualitative: Thematic analysis of social work notes for the 48 patients with family presence of less than 80% matched on age, LOS, and diagnosis to 48 patients with greater than or equal to 95% family presence. Three themes emerged: the primary caregiver’s prior experiences with the hospital, relationships outside of the hospital, and additional stressors during the hospitalization affected bedside presence. Conclusions: We identified sociodemographic and illness factors associated with family bedside presence in the PICU. Self-reported race modified these associations, representing racism within healthcare. Family presence at the bedside may help identify families facing greater disparities in healthcare access.

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