ABSTRACT 75

Abstract

Background and aims: There is a high risk of psychological sequelae for parents after a child’s admission to PICU. Colville et al. (2010) found that a one-off PICU follow-up clinic significantly reduced intrusive psychological symptoms for a sub-group of parents particularly distressed during admission. Aims: Consistent with guidelines on post-traumatic stress disorder (PTSD) (NICE, 2005) this study aimed to assess whether screening parents of children discharged from PICU for psychological vulnerability could enable beneficial targeting of a subsequent follow-up clinic. Methods: If either parent was deemed to be at high risk of PTSD at PICU discharge on the Post-traumatic Adjustment Screen (PAS) (O’Donnell et al. 2008), the family was randomised to the intervention (clinic) or control condition. The follow-up clinic, staffed by a Clinical Psychologist, an Intensivist and a PICU nurse, was arranged 2 months after discharge. At 7 months post discharge, all parents were asked to complete The Impact of Event Scale-Revised (PTSD measure) and the Hospital Anxiety & Depression Scale. Ethical approval was obtained for the study and written informed consent was provided by participants. Results: Of the 209 parents recruited to the study, 75(36%) were identified as at risk of PTSD. At follow up there were no significant differences in PTSD or anxiety symptoms but parents who were offered the clinic had significantly lower depression scores than controls (median scores 3 vs 6, p=0.029). Conclusions: Screening parents for psychological vulnerability may enable more efficient targeting of limited resources. Future studies could also consider more flexible follow-up, such as telephone support.