Clinical trial NCT02144779: Family Communication and Support in the Pediatric Intensive Care Unit
Official title: Improving Family Outcomes With a Communication Intervention in the Pediatric ICU
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Reducing Post Traumatic Stress
Lead sponsor: Seattle Children's Hospital
Sponsor class: OTHER
First posted: 2014-05-22
Enrollment: 220
Sex: ALL
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This project is evaluating the effect of a standardized communication intervention in the pediatric intensive care unit (PICU) on long-term distress of family members of children in the PICU for 5 days or longer. The study hypothesis is that intervention families will have lower (better) acute stress disorder scores when their child is discharged from the PICU and lower (better) post-traumatic stress disorder scores at 3-month follow-up, as compared to the control group families. The investigators will recruit 220 families (110 in each of the control and intervention groups). Families who are randomized to the intervention group will receive routine visits from members of the PACT (palliative care) team at least three times/week to address psychosocial needs, keep families informed about their child's health status, and offer emotional and instrumental support and resources. Families in the control group will receive usual care in the PICU. The intervention will end whenever the child is discharged from the PICU, which usually happens within 3 weeks of enrollment. The investigators will assess family outcomes at discharge from the PICU and 90 days after study enrollment. The investigators will conduct two additional activities to learn more about the processes of care for those in both the intervention and control groups. First, during the intervention, the investigators will recruit 30 families (15 in each group) and ask permission to audio-record the family care conferences to assess communication styles and gain greater insight into the differences in practice with or without the participation of the intervention team. The investigators will obtain additional consent from participants in these family conferences who are not otherwise enrolled in the study. Second, after completion of the 3-month follow-up interview, a sub-sample of a different 30 families (again, 15 in each group) will be invited to participate in qualitative interviews to debrief about their experience in the study and the intervention (for those in that group). This will be a one-time interview scheduled within 60 days of recruitment for this part of the project.


Eligibility criteria: Inclusion Criteria:

* age 18 years or older
* actively involved in the life of the patient receiving care; and
* functionally fluent in English or Spanish.

Exclusion Criteria:

* discharge plan in place for patient before day 4
* previously received palliative care
* patient placed on extracorporeal membrane oxygenation (ECMO)
* no prior admission to ICU for same hospitalization

Primary outcomes:
measure: Post Traumatic Stress Disorder
timeFrame: 90 days after baseline
Secondary outcomes:
measure: Acute Stress Disorder
timeFrame: Baseline, and up to 90 days after
measure: Communication Satisfaction
timeFrame: Baseline, and up to 90 days after
measure: Conflict
timeFrame: Baseline and up to 90 days after
Other outcomes:
measure: Mental Health Symptoms
timeFrame: Baseline and up to 90 days after
measure: Family Relationship
timeFrame: Baseline and up to 90 days after
measure: Social Support
timeFrame: Baseline and up to 90 days after
Locations:
city: Seattle
country: United States
facility: Seattle Childrens Hospital
state: Washington
Study officials:
affiliation: Seattle Childrens Hospital
name: Ross Hays, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Doorenbos A, Lindhorst T, Starks H, Aisenberg E, Curtis JR, Hays R. Palliative care in the pediatric ICU: challenges and opportunities for family-centered practice. J Soc Work End Life Palliat Care. 2012;8(4):297-315. doi: 10.1080/15524256.2012.732461.
citation: Doorenbos AZ, Starks H, Bourget E, McMullan DM, Lewis-Newby M, Rue TC, Lindhorst T, Aisenberg E, Oman N, Curtis JR, Hays R; Seattle Ethics in ECLS (SEE) Consortium; Clark JD, Baden HP, Brogan TV, Di Gennaro JL, Mazor R, Roberts JS, Turnbull J, Wilfond BS. Examining palliative care team involvement in automatic consultations for children on extracorporeal life support in the pediatric intensive care unit. J Palliat Med. 2013 May;16(5):492-5. doi: 10.1089/jpm.2012.0536. Epub 2013 Mar 29.
citation: Iwata M, Han S, Hays R, Doorenbos AZ. Predictors of Depression and Anxiety in Family Members 3 Months After Child's Admission to a Pediatric ICU. Am J Hosp Palliat Care. 2019 Oct;36(10):841-850. doi: 10.1177/1049909119859517. Epub 2019 Jun 30.
citation: Starks H, Doorenbos A, Lindhorst T, Bourget E, Aisenberg E, Oman N, Rue T, Curtis JR, Hays R. The Family Communication Study: A randomized trial of prospective pediatric palliative care consultation, study methodology and perceptions of participation burden. Contemp Clin Trials. 2016 Jul;49:15-20. doi: 10.1016/j.cct.2016.05.004. Epub 2016 Jun 1.