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A supported psychoeducational intervention to improve family mental health following discharge from paediatric intensive care: feasibility and pilot randomised controlled trial
  1. Lorraine C Als1,
  2. Simon Nadel2,3,
  3. Mehrengise Cooper2,3,
  4. Bea Vickers4,
  5. M Elena Garralda1
  1. 1Centre for Mental Health, Imperial College London, London, UK
  2. 2Department of Paediatric Intensive Care, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
  3. 3Department of Medicine, Imperial College London, London, UK
  4. 4Adolescent Assertive Outreach Team, South West London and St George's Mental Health NHS Trust, London, UK
  1. Correspondence to Dr Lorraine C Als; l.als{at}imperial.ac.uk

Abstract

Objective To assess feasibility and pilot a supported psychoeducational tool to improve parent and child mental health following discharge from a paediatric intensive care unit (PICU), in preparation for a large randomised controlled trial (RCT).

Design Feasibility assessment and single-centre, parallel group, pilot RCT. A concealed computer generated list was used to randomise participants, with an allocation of 2:1 in favour of the intervention.

Setting A PICU in an acute care hospital in London, UK.

Participants 31 parents of children aged 4–16 years-old admitted to PICU.

Intervention Parents received a psychoeducational tool supported by a telephone call. The psychoeducational tool outlined the possible psychological reactions in children and parents alongside management advice. The telephone call addressed each family's postdischarge experience, reinforced the psychoeducational material and encouraged parents to put into practice the advice given.

Main outcome measures The primary outcome was the number of feasibility criteria successfully met (linked to the intervention and the study design). Secondary outcomes were questionnaire data collected at 3–6-month follow-up assessing mental health in parents and children.

Results 31 parents were randomised (intervention n=22; treatment as usual, TAU n=9). 23 parents were included in the analysis of secondary outcomes (intervention n=17; TAU n=6). 3 (of 6) intervention and 1 (of 6) study design feasibility criteria were fully met. All unmet criteria could be addressed with minor or significant modifications to the protocol. At follow-up there was a tendency for parents who received the intervention to report lower post-traumatic stress symptoms in themselves and fewer emotional and behavioural difficulties in their children than TAU parents. This needs to be explored in a fully powered trial.

Conclusions This feasibility and pilot RCT provided valuable information on the intervention and trial design for a full RCT.

Trials registration number NCT01737021; Results.

  • MENTAL HEALTH
  • Clinical trials < THERAPEUTICS

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