Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. 1536-1546 (doi:10.1542/10.1542/peds.2004-1149)
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The Impact of Severe Respiratory Syncytial Virus on the Child, Caregiver, and Family During Hospitalization and Recovery

Nancy Kline Leidy, PhD*, Mary Kay Margolis, MPH, MHA*, James P. Marcin, MD, MPH{ddagger}, Jennifer A. Flynn, MSPH*, Lorry R. Frankel, MD§, Susan Johnson, RN, MPH||, Diane Langkamp, MD, MPH and Eric A. F. Simoes, MD, DCH#

* MEDTAP Institute at UBC, Bethesda, Maryland
{ddagger} University of California, Davis, Children's Hospital, Sacramento, California
§ Stanford University at Packard Children's Hospital, Stanford, California
|| University of Alabama, Birmingham, Alabama
Akron Children's Hospital, Akron, Ohio
# University of Colorado Health Sciences Center and the Children's Hospital, Denver, Colorado

Objective. To quantify the magnitude of child, caregiver, and family distress associated with hospitalization for severe respiratory syncytial virus (RSV) and the posthospitalization recovery period.

Design. A prospective study of 46 RSV-hospitalized infants and children ≤30 months of age with a history of prematurity (gestational age of ≤35 weeks) and 45 age-matched control subjects was performed. RSV group data were gathered during hospitalization and on days 4, 14, 21, and 60 after discharge; control group data were collected at the end of the RSV season and 60 days thereafter.

Main Outcome Measures. RSV severity; caregiver's rating of the child's health (100-point rating) and functional status (Functional Status IIR); caregiver health, stress (7-point rating), and anxiety (Spielberger State Anxiety Inventory); and family health and functioning (Family Adaptability and Cohesion Evaluation Scale II) were recorded.

Results. The mean age of the sample was 10.2 months; 51% of the subjects were male. The average duration of hospital stay for the RSV group was 5.8 ± 8 days. Most patients received supplemental oxygen (76%) and were monitored for apnea (60%). The mean age of the caregivers (93% mothers) was 29 years. During hospitalization, the RSV-infected patients' health and functional status were significantly poorer than those of control subjects. Caregivers of RSV-infected children reported more stress, greater anxiety, poorer health, and poorer family health and functioning. As long as 60 days after discharge, caregivers of RSV-infected children reported the children's health as significantly poorer and were personally more anxious, compared with control subjects.

Conclusions. RSV-related hospitalization creates significant distress for infants and children, caregivers, and families, with some effects extending as long as 60 days after discharge.

Key Words: respiratory syncytial virus • hospitalization • distress • anxiety • caregiver • burden of illness

Abbreviations: RSV, respiratory syncytial virus

Accepted Oct 18, 2004.


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