Post-Traumatic Stress Disorder (PTSD) develops after exposure to an extremely traumatic event such as death, injury, or physical threat to self, family member, or other significant person.
Admission to a paediatric intensive care unit (PICU) with acute disease carries a high level of stress for families, as the disease is of sudden onset and is life-threatening. The incidence of PTSD (21%) was significant among parents well after their child was discharged from the PICU.
Symptoms of PTSD include
reexperiencing the traumatic event through recurrent, intrusive recollections, repetitive play, or distressing dreams;
avoidance of associations with the event through restricted affect and feelings of detachment; and
hyperarousal symptoms such as sleep difficulties, poor concentration, irritability, aggression, and physiological reactivity to trauma-related events.
In addition to general hyperarousal symptoms, children may complain of stomachaches and headaches.
There have been many summaries and reviews of research published regarding the effects of hospitalization with these children. Findings indicate that the experience is, indeed, stressful and that children may experience fear phenomena, regression, sadness, separation anxiety, withdrawal, sleep disturbances, and aggressive behaviors. There was a positive correlation between PTSD symptoms in parents and
PTSD symptoms in the child,
length of admission and
perceived threat of illness to the child’s life.
In PICU admissions cause greater disruption to a child’s life, with longer admissions, greater time off school and more paediatric out-patient contacts and hospital re-admissions in the 6–12 months after discharge.