{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:21:42Z","timestamp":1791512502586,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:00:00Z","timestamp":1759622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:00:00Z","timestamp":1759622400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Admission to a paediatric intensive care unit (PICU) is a significant event with potential long\u2010term effects on family dynamics. Although Post\u2010Intensive Care Syndrome in paediatrics (PICS\u2010p) is well recognised, the effects of PICU admission on family functioning are not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study sought to characterise family functioning in a cohort from the PICU following discharge and to investigate the impact of PICS\u2010p sequelae on family dynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We conducted a caregiver\u2010reported cross\u2010sectional survey of a single\u2010centre cohort in Brisbane, Australia. Caregivers of PICU survivors were invited to participate by mail from March to August 2018. Parents completed the survey and returned it in a pre\u2010paid envelope. Descriptive and bivariate analyses examined family functioning and its associations with PICU\u2010related factors, child\u2010related outcomes and caregiver\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 204 caregivers participated, with a median follow\u2010up of 25\u2009months post\u2010PICU discharge. Most families demonstrated healthy functioning, with 97% scoring above the threshold for balance on the Circumplex Model. Poor family functioning was reported in 26 families, with enmeshment being the most common dysfunction. Weak to moderate associations were observed between family functioning and caregiver\u2010related factors, particularly post\u2010traumatic stress (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u2009\u22120.32) and mental illness (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u2009\u22120.43). Child distress in those under 5\u2009years was also associated with poorer family functioning (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u2009\u22120.44). Persistent behavioural changes in caregivers, particularly sleep disturbances and reduced energy levels, were reported up to 48\u2009months post\u2010discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Whilst most families maintained healthy functioning after PICU, a subset faced ongoing challenges. Caregiver mental health and child distress were significant predictors of poorer family outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>These findings highlight the necessity for targeted interventions to support families after PICU, including regular psychosocial screening and customised psychoeducational resources to enhance resilience and promote family well\u2010being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70182","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:37:18Z","timestamp":1759732638000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Family Functioning and Parent Behavioural Changes Post\u2010Admission to the Paediatric Intensive Care Unit: A Single\u2010Centre Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-5155","authenticated-orcid":false,"given":"Karina R.","family":"Charles","sequence":"first","affiliation":[{"name":"School of Nursing, Centre for Healthcare Transformation Queensland University of Technology  Brisbane Queensland Australia"},{"name":"Paediatric Intensive Care Unit Queensland Children's Hospital  Brisbane Queensland Australia"},{"name":"Children's Intensive Care Research Program, Child Health Research Centre The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Dow","sequence":"additional","affiliation":[{"name":"School of Nursing, Centre for Healthcare Transformation Queensland University of Technology  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A.","family":"Schults","sequence":"additional","affiliation":[{"name":"Children's Intensive Care Research Program, Child Health Research Centre The University of Queensland  Brisbane Queensland Australia"},{"name":"School of Nursing, Midwifery and Social Work The University of Queensland  Brisbane Queensland Australia"},{"name":"Herston Infectious Diseases Institute, Metro North Health  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Stocker","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Anthony","sequence":"additional","affiliation":[{"name":"School of Nursing, Centre for Healthcare Transformation Queensland University of Technology  Brisbane Queensland Australia"},{"name":"Paediatric Intensive Care Unit Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6551-9098","authenticated-orcid":false,"given":"Jessicah","family":"Minogue","sequence":"additional","affiliation":[{"name":"School of Nursing, Centre for Healthcare Transformation Queensland University of Technology  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen S.","family":"Gibbons","sequence":"additional","affiliation":[{"name":"Children's Intensive Care Research Program, Child Health Research Centre The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0984-9559","authenticated-orcid":false,"given":"Debbie","family":"Long","sequence":"additional","affiliation":[{"name":"School of Nursing, Centre for Healthcare Transformation Queensland University of Technology  Brisbane Queensland Australia"},{"name":"Paediatric Intensive Care Unit Queensland Children's Hospital  Brisbane Queensland Australia"},{"name":"Children's Intensive Care Research Program, Child Health Research Centre The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,5]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Australian and New Zealand Paediatric Intensive Care Registry Activity Report 2019","author":"ANZICS Centre for Outcome and Resource 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