Psychosocial and adaptive behavior functioning in children following pediatric intensive care unit hospitalization: prospective cohort study

Abstract Background With increasing survival rates following pediatric intensive care unit (PICU) hospitalization, assessing functional outcomes is imperative. We compared children’s psychosocial and adaptive functioning six weeks and six months after discharge from the PICU with children hospitalized in a general ward. Methods This prospective observational cohort study followed 100 children aged 2 to 11 years after PICU and ward discharge (control group) for six months. The two groups were compared for psychosocial and adaptive functioning using the Behavioral Assessment System for Children, Third Edition (BASC-3) parent report scale. Parents also completed the Parenting Stress Index-Short Form scale to assess parenting stress. Multivariate regression analysis adjusted for demographics, PICU-related factors, and parental stress was used to investigate the potential variables associated with children’s psychosocial and adaptive functioning six weeks and six months after PICU discharge. Results Our findings indicated that children experienced greater psychosocial problems and worse adaptive functioning up to six months after PICU discharge than children after ward discharge, P < 0.05. The number of intervention procedures and parental stress were common factors associated with impaired psychosocial and adaptive functioning post-PICU discharge. Six months after PICU discharge, younger age and length of stay were associated with psychosocial problems, while internalizing and externalizing problems were associated with poorer adaptive functioning, P < 0.05. Conclusion Given the impact of PICU experience on children’s psychosocial and adaptive outcomes, it is crucial to implement psychological assessments with a follow-up plan extended longitudinally after PICU discharge. This study underscores the need to integrate adaptive behavior assessment in children’s psychological evaluation to identify significant deficits, develop relevant behavioral management plans, and monitor their progress.