• Mallory B Smith, Leslie A Dervan, R Scott Watson, Robert T Ohman, J Elaine-Marie Albert, Eileen J Rhee, Monica S Vavilala, Frederick P Rivara, and Elizabeth Y Killien.
• Division of Pediatric Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.
• Pediatr Crit Care Me. 2023 Dec 1; 24 (12): 105310621053-1062.

ObjectivesTo determine factors associated with bedside family presence in the PICU and to understand how individual factors interact as barriers to family presence.DesignMixed methods study.SettingTertiary children's hospital PICU.SubjectsFive hundred twenty-three children of less than 18 years enrolled in the Seattle Children's Hospital Outcomes Assessment Program from 2011 to 2017.InterventionsNone.Measurements And Main ResultsQuantitative: Family was documented every 2 hours. Exposures included patient and illness characteristics and family demographic and socioeconomic characteristics. We used multivariable logistic regression to identify factors associated with presence of less than 80% and stratified results by self-reported race. Longer PICU length of stay (LOS), public insurance, and complex chronic conditions (C-CD) were associated with family presence of less than 80%. Self-reported race modified these associations; no factors were associated with lower bedside presence for White families, in contrast with multiple associations for non-White families including public insurance, C-CD, and longer LOS. Qualitative: Thematic analysis of social work notes for the 48 patients with family presence of less than 80% matched on age, LOS, and diagnosis to 48 patients with greater than or equal to 95% family presence. Three themes emerged: the primary caregiver's prior experiences with the hospital, relationships outside of the hospital, and additional stressors during the hospitalization affected bedside presence.ConclusionsWe identified sociodemographic and illness factors associated with family bedside presence in the PICU. Self-reported race modified these associations, representing racism within healthcare. Family presence at the bedside may help identify families facing greater disparities in healthcare access.Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

9 keywords...

hide…