الفهرس 
Pediatric Intensive Care UnitOnly 14 pages are availabe for public view
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Abstract
Many studies have shown the negative psychological impact on children hospitalized in the pediatric intensive care unit for a long time after discharge.
The current study assessed the psychological sequelae among children admitted to the PICU in Egyptian settings and identified the factors and variables associated with these psychological outcomes.
This prospective cohort study was conducted at the Hospital of Pediatrics; Ain Shams University included 100 children admitted to the PICU and ward.
A face-to-face interview was conducted by the researcher to gather socio-demographic data, take history, and conduct a clinical examination to assess eligibility, inclusion, and exclusion criteria within 48 hours of admission, and then follow-up by telephone interviews at 6 weeks and 6 months after discharge.
The demographic characteristics of the two groups (ward and ICU) with respect to age, gender, residency, parental age, and social class, were insignificant, which suggests that both groups are relatively similar in terms of demographics, which can be helpful when interpreting other findings from this study.
Four questionnaires (SDQ, BASC, PSI, HAD) were used to assess the psychological impact of PICU admission on children and their parents.
Concerning SDQ, there was a statistically significant increase in the PICU group compared to the ward group regarding the SDQ total difficulties scores with a percentage of (12% and 8%) among the ICU group at the high and very high-risk ranges, respectively, and also a higher percentage at 6 months at the very high-risk range (8%) among the ICU group, months, with emotional subscale was the most affected at high risk and very high range of 24% and 16% at 6 weeks and 6 months respectively, compared to 6% and 2% in the ward group.
Regarding BASC-3 score, children admitted to the PICU had worse scores for externalizing problems, internalizing problems, and behavioral symptoms at 6 weeks and 6 months, while the internalizing problems composite was the most affected.
According to the HAD score, Parents of the PICU group showed significant Depression in the PICU group compared to the ward group, with a percentage of 12% and 8% in the PICU group at 6 weeks and 6 months, respectively. Regarding anxiety in the HAD score it showed a significant increase in the PICU group compared with the ward group, with the highest percentage of abnormality in the PICU group was at 6 weeks after discharge with a percentage of 14%.
According to the Parenting Stress Index short form (PSI-short form) score, we found that a significant percentage of parents felt that their children had difficulties with self-regulatory process (physical or temperamental problems) and that they had a hard time managing their child’s cooperation and/or behavior. The most affected domain in PSI was a PSI-total score of 3o% at 6 months after discharge.
Additionally, the present study showed a significant negative correlation between age & anxiety T-score at 6 weeks and 6 months. On the other hand, there was no significant correlation between age and other variables.
In the current study, regression analysis of data revealed that there was a statistically significant association between externalizing problems, internalizing problems, behavioral symptoms index, and PSI total stress score at 6 weeks and 6 months after discharge from the PICU, with predictors of these problems shown to be the number of previous hospital admission, the severity of the disease and the number of invasive procedures, length of stay in PICU, while there was a significant association between adaptive skills composite and the number of previous hospital admission (negative association) and age of the child (positive association) at 6 months after discharge from PICU.