Experiencing the pediatric intensive care unit: perspective from parents of children with severe antecedent disabilities.
OBJECTIVE
To describe the experience of pediatric intensive care hospitalization from the perspective of a parents of children with severe, antecedent disability.


METHODS
Qualitative analysis of data obtained through semistructured interviews.


METHODS
Pediatric intensive care unit (PICU) in a children's hospital.


METHODS
Parents of eight children admitted to the PICU with severe antecedent disabilities.


METHODS
None.


RESULTS
Data were collected between May and July 2006. Parents were interviewed during, or just after, PICU admission until data saturation was achieved. Seven major themes emerged from analysis: 1) know my child's baseline; 2) integrate and bridge multiple services; 3) disconnect between role of parent at home versus parent in the PICU; 4) a PICU admission does not equate with respite; 5) high stakes learning environment; 6) heterogeneity within group; and 7) lack of fit within the acute care model. The need for stellar communication and mutuality within the parent-professional relationship were common conceptual threads through all interviews.


CONCLUSIONS
Children with severe antecedent disabilities and their parents are inextricably linked with critical care services. Study results provide data that can be used to help clinicians better understand the perspectives of these parents and also help guide interventions to improve care and support. Although communication is essential, the structure and processes of critical care including rounding format, continuity in management, and mutual participation models should be tested and tailored to better meet parental needs and expectations.
Graham
Robert J
RJ
Department of Anesthesiology, Perioperative and Pain Medicine, Division of Critical Care, Children's Hospital Boston, Boston, MA, USA. Robert.Graham@childrens.harvard.edu
Pemstein
Dvora M
DM
Curley
Martha A Q
MA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities; D019988:Children with Disabilities; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D012720:Severity of Illness Index; D055815:Young Adult