Mary A Khetani1, Erin C Albrecht2, Jessica M Jarvis1, David Pogorzelski3, Emmy Cheng3, Karen Choong3. 1. Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA. 2. Invest in Kids, Denver, CO, USA. 3. Department of Pediatrics, Critical Care, Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Abstract
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.
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.
Authors: Jessica M Jarvis; Vera C Kaelin; Dana Anaby; Rachel Teplicky; Mary A Khetani Journal: Dev Med Child Neurol Date: 2020-04-07 Impact factor: 5.449
Authors: Vera C Kaelin; Erin R Wallace; Martha M Werler; Brent R Collett; Mary A Khetani Journal: Disabil Rehabil Date: 2020-06-01 Impact factor: 3.033
Authors: Joseph C Manning; Jos M Latour; Martha A Q Curley; Elizabeth S Draper; Tahseen Jilani; Philip R Quinlan; R Scott Watson; Janet E Rennick; Gillian Colville; Neethi Pinto; Asam Latif; Emma Popejoy; Jane Coad Journal: BMJ Open Date: 2020-05-17 Impact factor: 2.692
Authors: E C Albrecht; V C Kaelin; B L Rigau; J K Dooling-Litfin; E A Scully; N J Murphy; B M McManus; M A Khetani Journal: BMC Med Inform Decis Mak Date: 2020-08-24 Impact factor: 2.796