Early predictors of post-hospital adjustment problems in critically Ill young children


  • Leigh Small,

    Corresponding author
    1. Arizona State University College of Nursing, Tempe, AZ
    • Center for Improving Health Outcomes in Children, Teens, & Families, PO Box 873008, Tempe, AZ 85287-3008.
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    • Assistant Professor of Nursing.

  • Bernadette Mazurek Melnyk

    1. Arizona State University College of Nursing, Tempe, AZ
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    • Dean and Distinguished Foundation Professor of Nursing.

  • A special note of appreciation is included to Dr. M. Aten and Dr. L. Alpert-Gillis for their significant contributions to this study.

  • The data for this study were gathered as part of a grant funded by the National Institutes of Health/National Institute of Nursing Research R01 # NR05077-01 awarded to the second author.


Toddlers and preschool children have been identified as being at risk for post-hospital behavioral sequelae, especially when confronted with an unanticipated intensive care unit (ICU) hospitalization. The purpose of this predictive secondary analysis was to determine demographic and clinical variables that could be assessed early during hospitalization to predict internalizing and externalizing behaviors and negative behavioral change of 2- to 7-year-old children at 3 and 6 months following an unanticipated critical care hospitalization (n = 163 mother-child dyads). The children's behavioral predilections prior to hospitalization (i.e., internalizing or externalizing behaviors) and sex, as well as elevated maternal state anxiety, marital status, and level of emotional care giving by mothers, significantly predicted child internalizing and externalizing behavior and post-hospitalization behavior changes. Results suggest several risk factors that predispose children to poor outcomes following an unanticipated hospitalization that could be targeted for intervention to improve children's emotional and behavioral health. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29: 622–635, 2006