{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:00:32Z","timestamp":1792461632478,"version":"4.5.0"},"reference-count":63,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Pediatric critical illness exposes family members to stressful experiences that may lead to subsequent psychological repercussions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To systematically review psychological outcomes among PICU survivors\u2019 family members.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA SOURCES<\/jats:title>\n                  <jats:p>Four medical databases (PubMed, Embase, CINAHL and PsycInfo) were searched from inception till October 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY SELECTION<\/jats:title>\n                  <jats:p>Studies reporting psychological disorders in family members of PICU patients with at least 3 months follow-up were included. Family members of nonsurvivors and palliative care patients were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA EXTRACTION<\/jats:title>\n                  <jats:p>Screening and data extraction was performed according to PRISMA guidelines. Data were pooled using a random-effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of 5360 articles identified, 4 randomized controlled trials, 16 cohort studies, and 2 cross-sectional studies were included (total patients = 55\u2009597; total family members = 97\u2009506). Psychological distress was reported in 35.2% to 64.3% and 40.9% to 53% of family members 3 to 6 months and 1 year after their child\u2019s PICU admission, respectively. Post-traumatic stress disorder was diagnosed in 10% to 48% of parents 3 to 9 months later. Parents that experienced moderate to severe anxiety and depression 3 to 6 months later was 20.9% to 42% and 6.1% to 42.6%, respectively. Uptake of mental counseling among parents was disproportionately low at 0.7% to 29%. Risk factors for psychiatric morbidity include mothers, parents of younger children, and longer duration of PICU stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>LIMITATIONS<\/jats:title>\n                  <jats:p>The majority of studies were on parents with limited data on siblings and second degree relatives.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>There is a high burden of psychological sequelae in family members of PICU survivors. Risk stratification to identify high-risk groups and early interventions are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2023-064210","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T08:08:23Z","timestamp":1719302903000},"source":"Crossref","is-referenced-by-count":22,"title":["Psychological Outcomes in Families of PICU Survivors: A Meta-Analysis"],"prefix":"10.1542","volume":"154","author":[{"given":"Michelle Shi Min","family":"Ko","sequence":"first","affiliation":[{"name":"aSingapore Health Services, SingHealth, Singapore"},{"name":"bDuke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Kit","family":"Lee","sequence":"additional","affiliation":[{"name":"aSingapore Health Services, SingHealth, Singapore"},{"name":"cFaculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, 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