Navigating the Aftermath: Parent Reflections on Care After Out-of-Hospital Cardiac Arrest

Abstract

Background Children who experience an Out of Hospital Cardiac Arrest (OHCA) face high risks of death and chronic morbidity. Their families often endure significant psychological distress during and after hospitalization. While early Pediatric Palliative Care (PPC) integration improves outcomes for other serious illness populations, it is rarely utilized following OHCA. PPC may offer critical support during this traumatic experience, yet parental perspectives on its role remain under-explored. Objective To describe parent experiences after their child’s OHCA and explore their perspectives on PPC involvement. Methods We conducted semi-structured interviews with parents of children who experienced an OHCA and were hospitalized for over 24 hours at a single-center tertiary Pediatric Intensive Care Unit (PICU) between 2018–2024. We purposely sampled parents of survivors, non-survivors, as well as those who did and did not receive PPC services. Interviews explored the support parents received during PICU hospitalization, the transition home, and their impressions of PPC involvement. Results We completed 14 parent interviews, 12 (85%) were mothers. Among their children, 8 (57%) survived and 6 (43%) died. PPC was involved in the care of six children (43%). Thematic analysis is ongoing., Early themes include emotional and logistical challenges during PICU hospitalization, burden of medical decision-making, unclear prognostic communication, and difficulty in the transition home for both bereaved parents and parents of children with acquired medical complexity. All parents were supportive of PPC involvement and shared varied opinions on optimal timing for initial consultation. Conclusions Parents identified multiple unmet needs during and after hospitalization for OHCA. While PPC was universally seen as beneficial, its timing and integration require thoughtful consideration. These findings support the development of structured, family-centered PPC models in post-OHCA care to improve continuity, communication, and family support. Source: https://www.jpsmjournal.com/article/S0885-3924%2826%2900605-6/fulltext