{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T11:28:35Z","timestamp":1792927715591,"version":"4.5.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> PICU hospitalization can have a profound impact on child survivors and their families. There is limited research on children's long-term recovery within the context of the family following critical illness. This study aimed to explore children's and parents' perceptions of long-term psychological and behavioral responses within the context of the family one year following PICU hospitalization.<\/jats:p><jats:p><jats:bold>Materials and Methods:<\/jats:bold> Caring Intensively is a mixed methods multi-site prospective cohort study that aims to examine children's psychological and behavioral responses over a 3-year period following PICU hospitalization. In this study, part of the qualitative arm of Caring Intensively, an interpretive descriptive design was used to explore children's recovery one year post-discharge. Purposive sampling was used to select 17 families, including 16 mothers, 6 fathers, and 9 children. Semi-structured, audio-recorded interviews were conducted. Data were analyzed iteratively using the constant comparison method.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Families described efforts to readapt to routine life and find a new normal following PICU hospitalization. Finding a New Normal consisted of four major themes: (1) Processing PICU Reminders and Memories, (2) Changing Perceptions of Health and Illness, (3) We Are Not the Same, and (4) Altered Relationships. Participants described significant emotional and behavioral changes during the year following discharge. The psychological impact of individual family members' experiences led to changes in their sense of self, which affected family dynamics. PICU memories and reminders impacted participants' perceptions of childhood health and illness and resulted in increased vigilance. Parents and siblings demonstrated increased concern for the child survivor's health, and the experience of long absences and new or altered caregiving roles resulted in changes in relationships and family dynamics.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> PICU hospitalization impacted the psychological well-being of all family members as they sought to re-establish a sense of normalcy one year following discharge. Parent and child experiences and responses were closely interconnected. Findings highlight the importance of increased follow-up care aimed at supporting the family's psychological recovery.<\/jats:p>","DOI":"10.3389\/fped.2021.724155","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T05:24:55Z","timestamp":1630992295000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Family Members' Perceptions of Their Psychological Responses One Year Following Pediatric Intensive Care Unit (PICU) Hospitalization: Qualitative Findings From the Caring Intensively Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Janet E.","family":"Rennick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa M.","family":"Knox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie C.","family":"Treherne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Dryden-Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Stremler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine T.","family":"Chambers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsey","family":"McRae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale M.","family":"Stack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Dougherty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Fudge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsha","family":"Campbell-Yeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1097\/PCC.0b013e3181ce7427","article-title":"Three decades of pediatric intensive care: who was admitted, what happened in intensive care, and what happened afterward","volume":"11","author":"Namachivayam","year":"2010","journal-title":"Pediatr Crit Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1097\/PCC.0000000000000250","article-title":"Pediatric intensive care outcomes: development of new morbidities during pediatric critical care","volume":"15","author":"Pollack","year":"2014","journal-title":"Pediatr Crit Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1097\/00003246-199605000-00004","article-title":"PRISM III: an updated pediatric risk of mortality score","volume":"24","author":"Pollack","year":"1996","journal-title":"Crit Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.pedn.2019.10.013","article-title":"Impact of pediatric critical illness and injury on families: an updated systematic review","volume":"51","author":"Abela","year":"2020","journal-title":"J Pediatr Nurs."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e58","DOI":"10.1097\/PCC.0000000000001390","article-title":"Psychological and psychiatric outcomes following PICU admission: a systematic review of cohort studies","volume":"19","author":"Lopes-J\u00fanior","year":"2018","journal-title":"Pediatr Crit Care Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1097\/PCC.0000000000001476","article-title":"Conceptualizing post intensive care syndrome in children-the PICS-p framework","volume":"19","author":"Manning","year":"2018","journal-title":"Pediatr Crit Care Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1186\/1471-2431-14-276","article-title":"Children's psychological and behavioral responses following pediatric intensive care unit hospitalization: the caring intensively study","volume":"14","author":"Rennick","year":"2014","journal-title":"BMC Pediatr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jpeds.2017.12.084","article-title":"Life after critical illness in children-toward an understanding of pediatric post-intensive care syndrome","volume":"198","author":"Watson","year":"2018","journal-title":"J Pediatr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1097\/PCC.0000000000001985","article-title":"Parent medical traumatic stress and associated family outcomes after pediatric critical illness: a systematic review","volume":"20","author":"Yagiela","year":"2019","journal-title":"Pediatr Crit Care Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1093\/jpepsy\/jsj054","article-title":"An integrative model of pediatric medical traumatic stress","volume":"31","author":"Kazak","year":"2006","journal-title":"J Pediatr Psychol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1093\/jpepsy\/jsv074","article-title":"Systematic review: A reevaluation and update of the integrative (trajectory) model of pediatric medical traumatic stress","volume":"41","author":"Price","year":"2016","journal-title":"J Pediatr Psychol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1001\/archpediatrics.2010.10","article-title":"Psychiatric morbidity in pediatric critical illness survivors: a comprehensive review of the literature","volume":"164","author":"Davydow","year":"2010","journal-title":"Arch Pediatr Adolesc Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1097\/PCC.0b013e3182196a8f","article-title":"Posttraumatic stress disorder in children and their parents following admission to the pediatric intensive care unit: a review","volume":"13","author":"Nelson","year":"2012","journal-title":"Pediatr Crit Care Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1177\/1367493509102472","article-title":"Psychological outcomes in children following pediatric intensive care unit hospitalization: a systematic review of the research","volume":"13","author":"Rennick","year":"2009","journal-title":"J Child Health Care"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.1097\/PCC.0000000000000424","article-title":"Mental and physical well-being following admission to pediatric intensive care","volume":"16","author":"Als","year":"2015","journal-title":"Pediatr Crit Care Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e85","DOI":"10.1097\/PCC.0b013e3182712997","article-title":"Children's self-reported quality of life after intensive care treatment","volume":"14","author":"Colville","year":"2013","journal-title":"Pediatr Crit Care Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/nicc.12049","article-title":"Long-term psychosocial impact reported by childhood critical illness survivors: a systematic review","volume":"19","author":"Manning","year":"2014","journal-title":"Nurs Crit Care."},{"key":"B18","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1097\/PCC.0b013e31816c70d4","article-title":"Developing the Children's Critical Illness Impact Scale: capturing stories from children, parents, and staff","volume":"9","author":"Rennick","year":"2008","journal-title":"Pediatr Crit Care Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1177\/1367493517717078","article-title":"Stories of survival: children's narratives of psychosocial well-being following paediatric critical illness or injury","volume":"21","author":"Manning","year":"2017","journal-title":"J Child Health Care."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e208","DOI":"10.1097\/PCC.0000000000001894","article-title":"The effects of family functioning on the development of posttraumatic stress in children and their parents following admission to the pediatric intensive care unit","volume":"20","author":"Nelson","year":"2019","journal-title":"Pediatr Crit Care Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"S203","DOI":"10.1542\/peds.2006-0951B","article-title":"Impact of pediatric critical illness and injury on families: a systematic literature review","volume":"118","author":"Shudy","year":"2006","journal-title":"Pediatrics."},{"key":"B22","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.iccn.2011.12.002","article-title":"A 'biopsychosocial'model for recovery: a grounded theory study of families' journeys after a Paediatric Intensive Care Admission","volume":"28","author":"Atkins","year":"2012","journal-title":"Intens Crit Care Nurs"},{"key":"B23","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1055\/s-0040-1705132","article-title":"Families' experiences of life in the year after a child's critical illness: navigating the road to a \u201dnew normal\u201d","volume":"9","author":"Atkins","year":"2020","journal-title":"J Pediatr Intens. Care."},{"key":"B24","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell","year":"2017"},{"key":"B25","volume-title":"Interpretative Description","author":"Thorne","year":"2008"},{"key":"B26","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/(SICI)1098-240X(199704)20:2<169::AID-NUR9>3.0.CO;2-I","article-title":"Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge","volume":"20","author":"Thorne","year":"1997","journal-title":"Res Nurs Health."},{"key":"B27","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/0260-6917(91)90009-Y","article-title":"A method of analysing interview transcripts in qualitative research","volume":"11","author":"Burnard","year":"1991","journal-title":"Nurs Educ Today"},{"key":"B28","volume-title":"Basics of Qualitative Research Techniques","author":"Strauss","year":"1998"},{"key":"B29","volume-title":"NVivo","year":"2018"},{"key":"B30","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1037\/a0022711","article-title":"Beyond constant comparison qualitative data analysis: using NVivo","volume":"26","author":"Leech","year":"2011","journal-title":"School Psychol."},{"key":"B31","volume-title":"Readme First for a User's Guide to Qualitative Methods","author":"Morse","year":"2002"},{"key":"B32","volume-title":"Qualitative Research Methods for the Social Sciences","author":"Berg","year":"2004"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/160940690400300101","article-title":"The analytic challenge in interpretive description","volume":"3","author":"Thorne","year":"2004","journal-title":"Int J Qual Methods."},{"key":"B34","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/1525822X05279903","article-title":"How many interviews are enough? An experiment with data saturation and variability","volume":"18","author":"Guest","year":"2006","journal-title":"Field Methods."},{"key":"B35","volume-title":"Nursing Research: Generating and Assessing Evidence for Nursing Practice","author":"Polit","year":"2008"},{"key":"B36","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/00004703-200206000-00002","article-title":"Children's psychological responses after critical illness and exposure to invasive technology","volume":"23","author":"Rennick","year":"2002"},{"key":"B37","first-page":"743","article-title":"PRISM III: an updated pediatric risk of mortality score","volume":"24","author":"Pollack","year":"1996"},{"key":"B38","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.iccn.2017.06.003","article-title":"Parents' experiences and the effect on the family two years after their child was admitted to a PICU-An interview study","volume":"43","author":"Terp","year":"2017","journal-title":"Intensive Crit Care Nurs."},{"key":"B39","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1097\/PCC.0000000000001096","article-title":"Systematic review of interventions to reduce psychiatric morbidity in parents and children after PICU admissions","volume":"18","author":"Baker","year":"2017","journal-title":"Pediatr Crit Care Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1111\/nicc.12405","article-title":"A review of interventions supporting parent's psychological well-being after a child's intensive care unit discharge","volume":"24","author":"Bedford","year":"2019","journal-title":"Nurs Crit Care."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/cc8826","article-title":"High stress during admission predicts the impact of a PICU follow-up clinic on parents' psychological outcome","volume":"14","author":"Colville","year":"2010","journal-title":"Crit Care."},{"key":"B42","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.iccn.2010.02.005","article-title":"Do parents benefit from the offer of a follow-up appointment after their child's admission to intensive care? An exploratory randomised controlled trial","volume":"26","author":"Colville","year":"2010","journal-title":"Intensive Crit Care Nurs."},{"key":"B43","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.iccn.2005.04.002","article-title":"Mothers' recollections of the Paediatric Intensive Care Unit: associations with psychopathology and views on follow up","volume":"22","author":"Colville","year":"2006","journal-title":"Intensive Crit Care Nurs."},{"key":"B44","doi-asserted-by":"publisher","first-page":"897627","DOI":"10.1155\/2014\/897627","article-title":"Joint paediatric and psychiatric follow-up for families following paediatric intensive care unit admission: an exploratory study","volume":"2014","author":"Gledhill","year":"2014","journal-title":"Adv Crit Care"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.724155\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T05:25:00Z","timestamp":1630992300000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.724155\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":44,"alternative-id":["10.3389\/fped.2021.724155"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.724155","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,7]]},"article-number":"724155"}}