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Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units

Wood, Dora; Geoghegan, Sophie; Ramnarayan, Padmanabhan; Davis, Peter J.; Tume, Lyvonne; Pappachan, John V.; Goodwin, Sarah; Wray, Jo

Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units Thumbnail


Authors

Dora Wood

Sophie Geoghegan

Padmanabhan Ramnarayan

Peter J. Davis

Lyvonne Tume Lyvonne.Tume@uwe.ac.uk
Associate Professor in Child Health

John V. Pappachan

Sarah Goodwin

Jo Wray



Abstract

Purpose: In the United Kingdom, critically ill adolescents are treated in either adult or pediatric intensive care units (AICUs or PICUs). This study explores staff perspectives on where and how best to care for this distinct group. Materials and Methods: Semistructured interviews were conducted with 12 members of staff (3 medical, 6 nursing, and 3 allied health professionals) working in 4 ICUs; 2 general hospital AICUs and 2 tertiary centre–based PICUs in England. Interviews were audio-recorded, transcribed, and analyzed using framework analysis. Findings: One overarching theme was identified, reflecting staff understanding of the term “adolescent,” and this was linked to 2 further themes, each of which had several subthemes. “Needs of the critically ill adolescent” included medical needs, dignity and privacy, issues around consent, and the impact of intensive care admission. “Implications for staff” included managing parental presence and lack of familiarity, and emotional impact, of dealing with this patient group. Some of these factors are currently better accommodated in adult settings. Conclusions: Decision-making about the place of care should take into account the individual circumstances of the patient (e.g., nature of their medical condition and previous experiences, maturity, family preference) and not be based only on age at admission. We should work across disciplines to ensure we can discover, and consistently deliver, best practice to meet the needs of critically ill adolescents.

Citation

Wood, D., Geoghegan, S., Ramnarayan, P., Davis, P. J., Tume, L., Pappachan, J. V., …Wray, J. (2020). Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units. Journal of Intensive Care Medicine, 35(11), 1271-1277. https://doi.org/10.1177/0885066619856573

Journal Article Type Article
Acceptance Date May 22, 2019
Online Publication Date Jun 12, 2019
Publication Date Nov 1, 2020
Deposit Date May 24, 2019
Publicly Available Date May 24, 2019
Journal Journal of Intensive Care Medicine
Print ISSN 0885-0666
Electronic ISSN 1525-1489
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 35
Issue 11
Pages 1271-1277
DOI https://doi.org/10.1177/0885066619856573
Keywords critical care, adolescent, staff, qualitative, intensive care units, paediatric
Public URL https://uwe-repository.worktribe.com/output/846753
Additional Information Additional Information : © 2019. Reprinted by permission of SAGE Publications

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Copyright Statement
Wood, D., Geoghegan, S., Ramnarayan, P., Davis, P. J., Tume, L., Pappachan, J. V., …Wray, J. (2020). Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units. Journal of Intensive Care Medicine, 35(11), 1271-1277. Copyright (c) 2020 Sage. https://doi.org/10.1177/0885066619856573


Where should critically ill adolescents receive care? A qualitative interview-based study of perspectives of staff working in Adult and Paediatric Intensive Care Units (404 Kb)
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Licence
http://creativecommons.org/licenses/by-nc-nd/4.0/

Publisher Licence URL
http://www.rioxx.net/licenses/all-rights-reserved

Copyright Statement
Wood, D., Geoghegan, S., Ramnarayan, P., Davis, P. J., Tume, L., Pappachan, J. V., …Wray, J. (2020). Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units. Journal of Intensive Care Medicine, 35(11), 1271-1277. Copyright (c) 2020 Sage. https://doi.org/10.1177/0885066619856573







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