Michigan: According to a new study, children in critical care miss days to weeks of school while their parents skip work to care for them.
The study was published in the journal 'JAMA Open Network Journal.' During the six months after discharge, two out of every three children in a research cohort of young patients requiring ICU care for critical illness missed school, with absences average two weeks but sometimes longer.
During the same time period, half of the primary caregivers were absent from work.
"Pediatric critical illness impacts a family's health and well-being not only during the child's treatment but after they leave the hospital and go home," said lead author Erin Carlton, M.D., a pediatric intensivist at University of Michigan Health C.S. Mott Children's Hospital.
"We know that missing that much school puts children at risk of worse academic achievements and other poor health outcomes later in life. Their families may also be at increased risk of economic hardship," she added.
Researchers looked at school and work absences in 960 children aged 0 to 18 who needed ICU treatment, including mechanical ventilation, after experiencing respiratory failure owing to pneumonia, sepsis, infections, transplant, asthma, or bronchiolitis.
The research was based on data from the multi-center RESTORE project, which focused on enhancing care and comfort for children in intensive care units and sustaining their physical and mental health after discharge between 2010 and 2015.
Approximately 70% of the nearly 400 students enrolled in school missed classes as a result of their hospitalisation. Over half of those who missed school met the criteria for chronic absenteeism.
Children with a pre-existing illness, as well as those who spent more time in the ICU, were more likely to have longer school absences.
Meanwhile, nearly 53 per cent of working parents and primary caregivers missed work during the post-discharge period and 20 per cent of siblings also missed school during the hospitalization itself.
"A child's acute illness impacts not only the child but also the whole family, including siblings and caregivers," Carlton said.
"We know that child and family health are closely connected with one always impacting the other. When the consequences of a child's illness spill over onto their family it can create a chain reaction-- affecting the child's recovery and worsening their overall health," she added.
Financial burdens from work absences and a caregiver's inability to return to work while caring for a child may also be detrimental, she said.
Further studies are needed to better understand the financial cost of missed work and the stress on families. Prior studies show parents worry about job loss or reduced wages when taking time off to care for a sick child and many don't qualify for some parental leave programs.
Parents with access to leave or paid benefits were more likely to miss work when needed by their child, suggesting awareness and access to family leave benefits may decrease this stress, previous research suggested.
"Given the magnitude of missed work found in our study and the hardships described by parents in prior studies, there is a great need for programs and policies to support and protect families during and after a child's hospitalization," Carlton said.
She said pediatric health providers must also seek strategies to improve transitions from the hospital to home and home to school.
"Our study shows the importance of studying ways to help children return to school after the ICU," she said.
"We need to commit to efforts to reduce barriers to school participation and absences to improve outcomes for children and their families following critical illness," Carlton concluded.
