Advancements in care for critically ill children have lowered mortality but increased morbidity in survivors. Post-intensive care syndrome (PICS) in children including their families (PICS-p) underscores the need for interventions to mitigate long-term effects. Early mobilization shows promising results in adults; however, evidence in pediatrics is limited. Enhanced parental involvement may contribute to improved long-term psychological outcomes. This pilot study examines the impact of an early mobilization program on parental stress and psychological health after admission on a pediatric intensive care unit (PICU). This single-center pilot study was conducted between 2021 and 2024 at the PICU of the Radboudumc University Hospital. Data of parents of patients admitted before (n = 45) and after (n = 45) implementation of an early mobilization bundle (December 2022) were compared. Parental psychological health outcomes were assessed using validated post-traumatic stress disorder (PTSD), burden scales, anxiety, and depression questionnaires, completed within 3–6 months after admission. Ninety patients were enrolled. There was no significant difference between pre- and post-intervention groups, but a trend towards lower parental experienced distress score (2.2 (IQR 0–8) vs 4.0 (IQR0-9) p 0.08) and lower depression scores in fathers (8.5 (IQR 8–15) vs 9.5 (8–32), p 0.07) in the post-intervention group was observed. Conclusion: Although no significant effect of early mobilization on parental psychological health was found, a trend towards a positive effect on the experienced distress scale and the paternal depression score emerged. A future nationwide study, on larger scale, is intended to further evaluate these findings.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> What is known: • Early mobilization in adult critical care improves patient recovery and reduces ICU-acquired weakness and improves physical and psychological outcomes. • In the pediatric critical care setting, early mobilization is considered safe and feasible, but research on long-term effects is limited. </entry> </row> <row> <entry nameend="c2" namest="c1"> What is new: • This study focuses on the long-term effects of early mobilization on parental psychological health. • Findings indicate no significant difference between pre- and post-intervention group, but a positive trend of early mobilization on experienced distress scale and paternal depression score. </entry> </row> </tbody> </tgroup> </Table>

Early mobilization in pediatric critical care and parental psychological outcomes 3–6 months after discharge—a pilot study

期刊论文
发表日期：

2026年1月8日

查看全文

Stijn van den Munckhof,
Emma Meijer,
Suus Litjens,
Erwin Ista,
Nienke M. Maas-van Schaaijk,
Annelies van Zwol

摘要

Advancements in care for critically ill children have lowered mortality but increased morbidity in survivors. Post-intensive care syndrome (PICS) in children including their families (PICS-p) underscores the need for interventions to mitigate long-term effects. Early mobilization shows promising results in adults; however, evidence in pediatrics is limited. Enhanced parental involvement may contribute to improved long-term psychological outcomes. This pilot study examines the impact of an early mobilization program on parental stress and psychological health after admission on a pediatric intensive care unit (PICU). This single-center pilot study was conducted between 2021 and 2024 at the PICU of the Radboudumc University Hospital. Data of parents of patients admitted before (n = 45) and after (n = 45) implementation of an early mobilization bundle (December 2022) were compared. Parental psychological health outcomes were assessed using validated post-traumatic stress disorder (PTSD), burden scales, anxiety, and depression questionnaires, completed within 3–6 months after admission. Ninety patients were enrolled. There was no significant difference between pre- and post-intervention groups, but a trend towards lower parental experienced distress score (2.2 (IQR 0–8) vs 4.0 (IQR0-9) p 0.08) and lower depression scores in fathers (8.5 (IQR 8–15) vs 9.5 (8–32), p 0.07) in the post-intervention group was observed. Conclusion: Although no significant effect of early mobilization on parental psychological health was found, a trend towards a positive effect on the experienced distress scale and the paternal depression score emerged. A future nationwide study, on larger scale, is intended to further evaluate these findings.

What is known:

• Early mobilization in adult critical care improves patient recovery and reduces ICU-acquired weakness and improves physical and psychological outcomes.

• In the pediatric critical care setting, early mobilization is considered safe and feasible, but research on long-term effects is limited.

What is new:

• This study focuses on the long-term effects of early mobilization on parental psychological health.

• Findings indicate no significant difference between pre- and post-intervention group, but a positive trend of early mobilization on experienced distress scale and paternal depression score.