Introduction: Having a child admitted to the Pediatric Intensive Care Unit (PICU) can be a traumatic experience for caregivers, often resulting in acute stress disorder (ASD) or post-traumatic stress disorder (PTSD). While such impacts are well-documented globally, there is limited research from low- and middle-income countries (LMICs), where sociocultural and systemic stressors may differ significantly. This study assessed the frequency and predictors of ASD and PTSD among PICU parents in Pakistan to inform culturally relevant psychosocial interventions Methods: This prospective cohort study was conducted at Aga Khan University Hospital, Karachi, from August 31 to December 31, 2024. Eighty parents were enrolled. ASD was assessed at 48 hours post-admission using the 19-item Acute Stress Disorder Scale (ASDS); scores ≥35 indicated ASD. PTSD was assessed one month later using the 20-item PTSD Checklist for DSM-5 (PCL-5); scores ≥31 were considered clinically significant. Data was analyzed using Stata v15. Descriptive statistics and bivariate analysis (t-tests, chi-square) identified significant predictors (p < 0.05). Results: Of the respondents, 45.8% were mothers and 54.2% fathers. ASD and PTSD symptoms were prevalent. Positive predictors of stress included female gender, younger child age, precious pregnancy, repeated hospitalizations, trauma/infection-related admissions, new chronic diagnoses, and post-discharge dependence (e.g., tracheostomy, G-tube, PICC). Negative predictors included strong family support, religious beliefs, and a clear understanding of the child’s illness. A positive correlation was found between poor parental perception and higher ASD scores. Lower household income was associated with significantly higher ASD and PTSD scores. Additionally, parents with no formal education had the highest median ASD scores and the widest variability, whereas those with postgraduate education had the lowest and most consistent scores. Conclusions: This study highlights the substantial psychological burden among PICU caregivers in LMICs. Validated screening tools like ASDS and PCL-5, combined with targeted support for low-income and low-education families, are essential for improving caregiver resilience and long-term outcomes in pediatric critical care.
Ishaque et al. (Sun,) studied this question.