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
Rlvt Litrtur
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)
PTSD i PICU Prts % ths Bluffi t l (2004) 21% 4 161 Rs t l (2002) 27% 8 33 Colvill t l (2006) 18% 8 34
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)
PTSD: Gr Diffrcs Grlly Wo >M Aftr PICU othrs > fthrs strss urig issio, =510 chilr (Ril t l, 1989) othrs > fthrs @ 8 oths, =17 coupls (Colvill t l, 2003)
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)
First COMPASS Stuy
Copss qustioir Copig (24 its) Ns (15 its) Strsss (19 its) Ross t l, Southpto PICU
=87 othr-fthr pirs @48hrs 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)
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 0 10 20 30 40 50 60 70 80 90 100 110 120 130 9 5 % C I 1 2 3 4 5 6 7 8 9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 2 0 2 1 2 2 2 3 2 4 0 10 20 30 40 50 60 70 80 90 100 110 120 130 9 5 % C I COMPASS Copig subscl
Follow up COMPASS Stuy
COMPASS Follow up Stuy Follow up ( 11-29 ths) Ipct of Evts Scl (PTSD) Ns t (pt fro origil scl)
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?
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
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
Dscriptiv Dt
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
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
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
Proportio ovr PTSD cut off (25/26 coupls) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% othrs fthrs
Coupls PTSD scors 70 60 50 40 30 20 10 0 othr fthr
Associtios with PTSD
Associtios with PTSD Ergcy issio? NS LOS? NS Ti sic ischrg? NS Ag of chil? NS
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*)
Associtios btw Copig t issio PTSD sttus NS
Associtios btw Ns t PTSD sttus Mothrs: NS Fthrs: N for support with ficil ttrs (p=0.02*)
Coclusios
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
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
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