Family Presence at the PICU Bedside: A Single-Center Retrospective Cohort Study.
Pediatr Crit Care Med
; 24(12): 1053-1062, 2023 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-38055001
ABSTRACT
OBJECTIVES:
To determine factors associated with bedside family presence in the PICU and to understand how individual factors interact as barriers to family presence.DESIGN:
Mixed methods study.SETTING:
Tertiary children's hospital PICU.SUBJECTS:
Five hundred twenty-three children of less than 18 years enrolled in the Seattle Children's Hospital Outcomes Assessment Program from 2011 to 2017.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Quantitative Family was documented every 2 hours. Exposures included patient and illness characteristics and family demographic and socioeconomic characteristics. We used multivariable logistic regression to identify factors associated with presence of less than 80% and stratified results by self-reported race. Longer PICU length of stay (LOS), public insurance, and complex chronic conditions (C-CD) were associated with family presence of less than 80%. Self-reported race modified these associations; no factors were associated with lower bedside presence for White families, in contrast with multiple associations for non-White families including public insurance, C-CD, and longer LOS. Qualitative Thematic analysis of social work notes for the 48 patients with family presence of less than 80% matched on age, LOS, and diagnosis to 48 patients with greater than or equal to 95% family presence. Three themes emerged the primary caregiver's prior experiences with the hospital, relationships outside of the hospital, and additional stressors during the hospitalization affected bedside presence.CONCLUSIONS:
We identified sociodemographic and illness factors associated with family bedside presence in the PICU. Self-reported race modified these associations, representing racism within healthcare. Family presence at the bedside may help identify families facing greater disparities in healthcare access.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Acessibilidade aos Serviços de Saúde
/
Hospitalização
Limite:
Child
/
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article