To estimate changes in home participation among critically ill children in the first 6 months after discharge from a pediatric intensive care unit (
PICU), and to explore the effect of child, service, and environmental factors on change in home participation. Method
This was a prospective bi‐center, longitudinal cohort study. Caregivers of 180 children, aged 1 to 17 years, who were admitted into the
PICUfor at least 48 hours were included. Patient‐reported outcomes were used to capture caregivers’ perspectives of their child's participation and environmental supports for participation in home activities. Data were collected at enrollment, and 3 and 6 months after discharge. Results
There were no significant changes in home participation frequency or involvement, but involvement rates across time were moderated by functional status. Age significantly predicted participation frequency. Pre‐
PICUfunctional status and capabilities were significant predictors of participation frequency and involvement, and home environmental support significantly predicted home involvement. Interpretation
Results suggest relatively stable participation trajectories in the 6 months after
PICUadmission. Children with abnormal baseline function experienced a greater increase in home involvement after PICU. Rehabilitation interventions targeting functional capabilities and home environment may be viable approaches during the early phase of recovery. Environmental interventions may be more time‐efficient after PICUstay and merit further study. What this paper adds
Children's pre‐pediatric intensive care unit (PICU) functional status and capabilities impact their participation after critical illness.
Children's trajectories of home involvement may differ over time based on their pre‐PICU functional status.
Caregiver perceptions of environmental support impact a child's home involvement after discharge from a PICU.