The parent perspective on paediatric delirium and an associated care bundle: A qualitative study

Author:

Stenkjaer Rikke Louise1ORCID,Egerod Ingrid2ORCID,Moszkowicz Mala34,Collet Marie Oxenbøll2,Weis Janne1,Ista Erwin5,Greisen Gorm1,Herling Suzanne Forsyth6

Affiliation:

1. Department of Intensive Care for Infants and Toddlers Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

2. Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

3. Child and Adolescent Mental Health Copenhagen University Hospital—Mental Health Services CPH Copenhagen Denmark

4. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

5. Division of Pediatric Intensive Care, Department of Neonatal and Pediatric Intensive Care, Erasmus MC‐Sophia Children's Hospital University Medical Center Rotterdam Rotterdam The Netherlands

6. Department of Neuroanaesthesiology, Neuroscience Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

Abstract

AbstractAimsTo explore how parents experienced their child with delirium and how parents viewed our delirium management bundle.DesignWe conducted a qualitative exploratory descriptive study using semi‐structured individual or dyad interviews.MethodsTwelve semi‐structured interviews with 16 parents of 12 critically ill children diagnosed with delirium in a paediatric intensive care unit were conducted from October 2022 to January 2023 and analysed through a reflexive thematic analysis.FindingsWe generated five themes: (1) knowing that something is very wrong, (2) observing manifest changes in the child, (3) experiencing fear of long‐term consequences, (4) adding insight to the bundle, and (5) family engagement.ConclusionThe parents in our study were able to observe subtle and manifest changes in their child with delirium. This caused fear of lasting impact. The parents regarded most of the interventions in the delirium management bundle as relevant but needed individualization in the application. The parents requested more information regarding delirium and a higher level of parent engagement in the care of their child during delirium.ImpactThis paper contributes to understanding how parents might experience delirium in their critically ill child, how our delirium management bundle was received by the parents, and their suggestions for improvement. Our study deals with critically ill children with delirium, their parents, and staff working to prevent and manage paediatric delirium (PD) in the paediatric intensive care unit.Reporting MethodThe consolidated criteria for reporting qualitative research guidelines were used to ensure the transparency of our reporting.Patient or Public ContributionNo patient or public contribution to the research design.What does this Paper Contribute to the Wider Global Community? ‐ It increases awareness of the parent's perspective on PD in critically ill children. ‐ It shows how PD might affect parents, causing negative emotions such as distress, frustration, and fear of permanent damage. ‐ It shows that the parents in our study, in addition to the care bundle, requested more information on delirium and more involvement in the care of their delirious child.

Funder

Novo Nordisk Fonden

Rigshospitalet

Publisher

Wiley

Subject

General Nursing

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