Post-intensive care syndrome in pediatrics—enhancing understanding through a novel bioecological theory of human development lens

Abstract

BackgroundThe post-intensive care syndrome in pediatrics (PICS-p) framework offers a new understanding of the long-term impact of critical illness on child’s and family’s health. However, a comprehensive theoretical guide to investigate potential factors influencing these outcomes and recoveries is needed.ObjectiveThe aim of the study is to conceptualize post-intensive care outcomes in children and their families after PICU discharge in the context of the child’s surrounding environment and systems.MethodWe used Theory Adaptation, a shift in the use and perspective of the Bioecological Theory of Human Development (BTHD), and Theory Synthesis, the integration of BTHD and the PICS-p, to provide a novel PICSS-PF perspective for understanding PICS-p within the broader context of the child and family. This integration helps to see higher-order perspectives to link post-PICU outcomes and child development within the context of child’s surroundings.ResultsWhile PICS-p is a model for understanding and studying post-PICU outcomes and recovery in four domains of physical, cognitive, emotional, and social health, the BTHD offers a new lens for a holistic view of the contextual systems and factors affecting the outcomes and recovery. The BTHD contextual systems include intrapersonal (demographics, clinical), interpersonal (adjacent people’s characteristics and interactions), institutional (family situations, PICU environment), community, social resources, and networks.ConclusionsKnowing the complex nature of post-PICU outcomes in children and their families, the PICSS-PF helps in the better understanding of the complex interplay of factors that contribute to PICS in children and their families, leading to the development of more effective interventions to address this condition.