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J Pediatr Intensive Care 2024; 13(01): 063-074
DOI: 10.1055/s-0041-1736547
Original Article

“I Didn't Realize How Hard It Was Going to Be Just Transitioning Back into Life”: A Qualitative Exploration of Outcomes for Survivors of Pediatric Septic Shock

Jonna D. Clark
1   Department of Pediatrics, Division of Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, Washington, United States
2   Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, Seattle, Washington, United States
3   Division of Pediatric Critical Care Medicine, University of Washington, Seattle Children's Research Institute, Seattle, Washington, United States
,
Stephanie A. Kraft
1   Department of Pediatrics, Division of Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, Washington, United States
2   Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, Seattle, Washington, United States
,
Leslie A. Dervan
3   Division of Pediatric Critical Care Medicine, University of Washington, Seattle Children's Research Institute, Seattle, Washington, United States
,
Jane L. Di Gennaro
3   Division of Pediatric Critical Care Medicine, University of Washington, Seattle Children's Research Institute, Seattle, Washington, United States
,
Jill Hurson
4   Medable, Inc., New York, New York, United States
,
Robert S. Watson
3   Division of Pediatric Critical Care Medicine, University of Washington, Seattle Children's Research Institute, Seattle, Washington, United States
5   Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, United States
,
Jerry J. Zimmerman
3   Division of Pediatric Critical Care Medicine, University of Washington, Seattle Children's Research Institute, Seattle, Washington, United States
,
Kathleen L. Meert
6   Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University (formerly affiliated with Wayne State University), Detroit, Michigan, United States
,
for the Life After Pediatric Sepsis Evaluation (LAPSE) Investigators › Author Affiliations Funding This qualitative study was funded by Seattle Children's Research Institute, Center for Clinical and Translational Research, Pediatric Pilot Fund PI Jonna Clark and Seattle Children's Research Institute, Center for Clinical and Translational Research, Faculty Research Support Fund PI Jerry Zimmerman. Life After Pediatric Sepsis was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services ( Grant No.: R01HD073362), and was supported, in part, by the following cooperative agreements: UG1HD050096, UG1HD049981, UG1HD049983, UG1HD063108, UG1HD083171, UG1HD083166, UG1HD083170, U10HD050012, U10HD063106, and U01HD049934.
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Abstract

Recovery following pediatric critical illness is multifaceted and complex. While most critically ill children survive, many experience morbidities in physical, emotional, cognitive, and social function. We aimed to deeply explore and describe the multidimensional impact of pediatric septic shock for affected children and their families at the granular level using exploratory qualitative methodology. We performed semistructured telephone interviews of adolescents and caregivers of children admitted with community-acquired septic shock to two tertiary pediatric intensive care units in the United States. Interviews were conducted within two years of hospital admission, and were recorded, transcribed, and analyzed using thematic analysis. Two adolescents and 10 caregivers were interviewed. Participants described meaningful and long-lasting outcomes of septic shock on multiple dimensions of their lives. The adolescents and caregivers described substantial negative consequences on physical health and function which resulted in increased medical complexity and heightened caregiver vigilance. The physical impact led to substantial psychosocial consequences for both the child and family, including social isolation. Most caregivers expressed that septic shock was transformational in their lives, with some caregivers describing posttraumatic growth. This preliminary study provides a novel, granular view of the multidimensional impact of septic shock in pediatric patients and their families. Exploring these experiences through qualitative methodology provides greater insight into important patient and family outcomes. Deeper understanding of these outcomes may support the development of meaningful interventions to improve quality of life for children and their families following critical illness.

Keywords

critical care - pediatric - sepsis - quality of life - outcomes

Previous Presentation

Limited aspects of this manuscript have previously been presented in abstract form at the 2018 Society of Critical Care Medicine Annual Congress.


* The appendix A is a list of (LAPSE) Investigators.


Supplementary Material



Publication History

Received: 01 July 2021

Accepted: 04 September 2021

Article published online:
22 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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