The Association between Therapeutic Alliance and Parental Health Outcomes following a Child's Death in the Pediatric Intensive Care Unit

Content Provider	Scilit
Author	Suttle, Markita Hall, Mark W. Pollack, Murray M. Berg, Robert A. McQuillen, Patrick S. Mourani, Peter M. Sapru, Anil Carcillo, Joseph A. Startup, Emily Holubkov, Richard Dean, Jonathan Michael Notterman, Daniel A. Meert, Kathleen L.
Copyright Year	2021
Description	Therapeutic alliance reflects the strength and quality of the physician–patient/family relationship. We investigated the association between therapeutic alliance and bereaved parents' mental health and perceived overall health following their child's death in a pediatric intensive care unit (PICU). Bereaved parents were surveyed 6 months after their child's death in a PICU affiliated with the Collaborative Pediatric Critical Care Research Network. Parents were evaluated for complicated grief, depression, and post-traumatic stress using the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire (PHQ-8), and the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), respectively. Overall health was evaluated using a single item. Therapeutic alliance between parents and their deceased child's PICU physicians was assessed using the Human Connection scale (HCS). Two hundred and thirty-five parents of 158 deceased children completed surveys. Mean ICG score was 34.4 ± 14.9 with 142 (60.4%) parents screening positive for complicated grief. Mean PHQ-8 score was 9.1 ± 6.2 with 102 (43.4%) screening positive for at least moderate depression. Mean SPRINT score was 14.6 ± 8.2 with 122 (51.9%) screening positive for post-traumatic stress disorder. Overall health was perceived as fair for 47 (20.0%) parents and poor for 10 (4.3%). Using multivariable modeling, higher HCS score (greater therapeutic alliance) was significantly associated with lower (better) ICG score (−0.23, 95% CI −0.42, −0.04, p = 0.018). HCS score was not significantly associated with PHQ-8, SPRINT, or overall health scores. We conclude that bereaved parents experience a high level of adverse mental health symptoms including complicated grief, depression, and post-traumatic stress symptoms. Greater therapeutic alliance with PICU physicians may lessen symptoms of complicated grief during bereavement.
Related Links	http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1727179.pdf
ISSN	21464618
DOI	10.1055/s-0041-1727179
Journal	Journal of Pediatric Intensive Care
Language	English
Publisher	Georg Thieme Verlag KG
Publisher Date	2021-05-17
Access Restriction	Open
Subject Keyword	Journal: Journal of Pediatric Intensive Care Pediatrics and Child Health Therapeutic Alliance Post-traumatic Stress Disorder Pediatric Intensive Care Unit
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health