Predictors of long term post-traumatic stress in mothers and fathers after a child s admission to PICU
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1 Prictors of log tr post-trutic strss i othrs fthrs ftr chil s issio to PICU Colvill G, Boyls C, Gry S, Ross O, Mht R PICU, Southpto Grl Hospitl
2 Rlvt Litrtur
3 Post Trutic Strss Disorr DSM IV critri Trutic vt ivolvig thrt to lif or itgrity of slf or lov o Avoic (voiig rirs) Itrusios (ightrs, thoughts) Hyprrousl (slp probls, irritbility)
4 PTSD i PICU Prts % ths Bluffi t l (2004) 21% Rs t l (2002) 27% 8 33 Colvill t l (2006) 18% 8 34
5 PTSD: Prictors Grlly (Ozr t l, 2003) Fl gr Lowr IQ Prvious Mtl Hlth probls Prvious Tru Aftr PICU fr of th; cut strss urig issio; rgcy issio; subsqut tru (Blluffi t l, 2004 ) strss urig issio; ot tlkig (Colvill & Grcy, 2006) prciv llss svrity; LOS; fr of th; chil strss (Rs t l, 2002)
6 PTSD: Gr Diffrcs Grlly Wo >M Aftr PICU othrs > fthrs strss urig issio, =510 chilr (Ril t l, 1989) othrs > 8 oths, =17 coupls (Colvill t l, 2003)
7 Fthrs xprics? Pitric Litrtur: Dt fro fthrs usully bst If prst, rrly lys sprtly fro othrs t PICU: (Phrs t l 2005) Mor istrss rport urig issio by 15 PICU fthrs th 10 G Wr fthrs (Bor, 2004)
8 First COMPASS Stuy
9 Copss qustioir Copig (24 its) Ns (15 its) Strsss (19 its) Ross t l, Southpto PICU
10 =87 othr-fthr Mothrs highr strss rlt to sprtio fro chil chil s pprc Strikigly siilr pttrs of rspos fro othrs fthrs (Boyls t l, WCPCC 2007, Gv)
11 tr t t c h g s x p tio s p rtic ip tio tr s f r q u ip t l v h o s p p l c p rs s r s t t l p h o b th ro o fi c lo c l u it s u rs u rs b s i o th r p r ts t lk o c to r ily u rs b s t c r k i o k h o p w h t w ro g o u tc o h o s t s w rs % C I % C I COMPASS Copig subscl
12 Follow up COMPASS Stuy
13 COMPASS Follow up Stuy Follow up ( ths) Ipct of Evts Scl (PTSD) Ns t (pt fro origil scl)
14 Rsrch Qustios Do prticulr strsss or copig strtgis urig issio, prict log tr psychologicl strss? Dos th filur to t crti s giv ris to grtr istrss i th log ru? Ar thr systtic iffrcs btw othrs fthrs t follow up?
15 Rcruitt 87 origil coupls 8 chilr i 8 utrcbl 1 GP rfusl 70 coupls 46/70 t lst o prt rpli (67%) 34 fthrs; 38 othrs; 26 coupls
16 Spl Chrctristics Chil g 0-14y (i 5 ths) Chil sx 63% l LOS 1-34 ys (i 3 ys) 59% rgcy 41% cric 24% rspirtory 69% prts g 31-40y
17 Dscriptiv Dt
18 Viws o how wll s wr t ot t t ll copltly t 0% 100% 21/24 s t rt ovr 85% Botto 3 wr tlkig to othr prts; hvig s urs; hlp with ficil cocrs
19 Ns t : iffrcs btw othrs fthrs ot t t ll hlp with ficil cocrs 52% 80% copltly t 0% p=0.016* 100% i fthr scor i othr scor
20 Ns t : iffrcs btw othrs fthrs ot t t ll 0% tlk to othr prts 70% p=0.026* 86% copltly t 100% i fthr scor i othr scor
21 Proportio ovr PTSD cut off (25/26 coupls) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% othrs fthrs
22 Coupls PTSD scors othr fthr
23 Associtios with PTSD
24 Associtios with PTSD Ergcy issio? NS LOS? NS Ti sic ischrg? NS Ag of chil? NS
25 Associtios btw Strss t issio PTSD sttus Mothrs: Tlkig with octors (p=0.002**) Fthrs: Lck of urstig (p=0.038*) Distc fro ho (p=0.045*)
26 Associtios btw Copig t issio PTSD sttus NS
27 Associtios btw Ns t PTSD sttus Mothrs: NS Fthrs: N for support with ficil ttrs (p=0.02*)
28 Coclusios
29 1) Do prticulr strsss or copig strtgis urig issio prict log tr psychologicl strss? No ssocitio with prfrr copig strtgis t 48 hours So strsss ssocit with PTSD sttus t follow up
30 2) Dos th filur to t crti s giv ris to grtr istrss i th log ru? I th i, s ovrwhligly t For so fthrs lck of hlp with fics ssocit with poorr outco
31 3) Ar thr systtic iffrcs btw othrs fthrs t follow up? So iffrcs i sll ubr of strsss prcptios r s t No iffrcs i PTSD rts 1 i 5 prts rport prsistt syptos
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