Prognostic Conversations Between Parents and Physicians in the Pediatric Intensive Care Unit

Lauren Rissman*, Sabrina Derrington, Kelly N. Michelson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background Up to 80% of pediatric intensive care unit (PICU) patients experience new morbidities upon discharge. Patients and families rely on clear communication to prepare for post-PICU morbidities. Methods Surveys were given at PICU discharge to parents and attending physicians of patients who developed multiorgan dysfunction within 24 hours of PICU admission and whose parents completed an initial survey 5 to 10 days after PICU admission. Participants were asked about prognostic conversations regarding PICU mortality; patient post-PICU physical, cognitive, and psychological morbidities; and parent post-PICU psychological morbidities. Parents also indicated whether they wanted more prognostic information. Results Forty-nine parents and 20 PICU attending physicians completed surveys for 49 patients. Thirty parent (61%) and 29 physician (59%) surveys reported participating in any prognostic conversations. Concordance between parents and physicians about prognostic conversations was slight (κ = 0.19). Parent (n= 22; 45%) and physician (n=23; 47%) surveys most commonly reported prognostic conversations about post-PICU physical morbidities. Parents less commonly reported conversations about post-PICU cognitive morbidities (n=10; 20%). According to parents, bedside nurses and physicians provided most prognostic information; social workers (54%) most commonly discussed parent psychological morbidities. Twenty-six parents (53%) requested more prognostic information. Conclusions Most parents and physicians reported having prognostic conversations, primarily about post-PICU physical morbidities. More than half of parents wanted more information about potential post-PICU morbidities. More research is needed to understand how and when medical professionals should have prognostic conversations with parents.

Original languageEnglish (US)
Pages (from-to)118-126
Number of pages9
JournalAmerican Journal of Critical Care
Issue number2
StatePublished - Mar 1 2023

ASJC Scopus subject areas

  • Critical Care


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