(797) Assessment of Psychosocial Risk and Acute Stress Disorder in Parents of PICU Patients

Introduction: Up to 50% of parents of children admitted to the pediatric intensive care unit (PICU) develop psychological morbidity. Psychosocial risk factors, independent of the events during a PICU admission, may influence parental post-PICU psychological outcomes. This study assessed the feasibility of screening for parental psychosocial risk at PICU admission and obtained preliminary data about the association between parental psychosocial risk and acute stress disorder (ASD).

Methods: This prospective, observational study at an urban academic PICU enrolled English and Spanish-speaking parents of patients ( < 18 years, PICU stay ≥72 hours). Parents completed 2 surveys: the Psychosocial Assessment Tool (PAT) within 72 hours of admission, and the ASD Scale 7 to 10 days post-admission or at discharge, whichever came first. The PAT, a parent report screener of family psychosocial risk assesses family structure and resources, social support, parent stress reactions, child and sibling problems, and family beliefs. The PAT score provides a three-tiered risk determination (Universal, Targeted, Clinical). The ASD Scale, a 14-item self-administered questionnaire, indicates ASD presence. Patient clinical data was collected via the electronic health record. We assessed the feasibility of completing the PAT screening tool by calculating completion rates. We assessed the association between psychosocial risk and ASD by calculating the percentage of parents with ASD who scored in the highest tier of psychosocial risk (Targeted or Clinical).

Results: Between March and July of 2024, we enrolled 40 parents (31 mothers, 9 fathers), 38 (95%) completed the PAT, and 31 (78%) completed both surveys. 5 (13%) parents were Spanish speaking and 20 (53%) reported financial hardship. 17 (45%) of patients had a complex chronic condition. 20 parents (53%) scored in the targeted or clinical risk tier. 5 parents (16%) met clinical criteria for ASD, all of whom screened into the highest tiers of psychosocial risk.

Conclusions: Screening parents on PICU admission for psychosocial risk is feasible. All parents with ASD screened into the highest tiers of psychosocial risk. In future work, utilizing a larger sample size, we will employ more advanced statistical methods to examine the association between psychosocial risk factors and ASD.