Effects of psychosocial interventions on emotional health outcomes in parents within one year after paediatric intensive care: A systematic review and meta-analysis.

BACKGROUND: Post-intensive care syndrome in paediatrics affects the physical, cognitive, emotional, and social health of children and their families. Although psychosocial interventions are increasingly advocated, evidence regarding their effects on parental emotional health after paediatric intensive care unit (PICU) admission remains uncertain. OBJECTIVES: To determine the effects of psychosocial interventions on emotional health outcomes in parents of critically ill children within one year after PICU discharge. RESEARCH METHODOLOGY AND DESIGN: This systematic review and meta-analysis included randomised controlled trials (RCTs) evaluating psychosocial interventions for parents of children admitted to a PICU. Five databases were searched from inception to January 2026. Eight RCTs were included, and all eight contributed PICU-specific data to at least one meta-analysis. Outcomes included post-traumatic stress disorder (PTSD), depression, anxiety, and stress. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. SETTING: Studies were identified through searches of PubMed, EMBASE, the Cochrane Library, PsycINFO, and CINAHL from database inception to January 2026. MAIN OUTCOME MEASURES: Parental PTSD, depression, anxiety, and stress symptoms assessed within one year after PICU discharge. RESULTS: Eight RCTs involving 470 participants contributed PICU-specific data to the quantitative synthesis. Psychosocial interventions were associated with small reductions in PTSD symptoms (eight studies, n = 467; SMD = -0.30, 95% CI -0.53 to -0.07, p = 0.017) and depression symptoms (seven studies, n = 448; SMD = -0.13, 95% CI -0.24 to -0.02, p = 0.029). The pooled effect on anxiety was not statistically significant (eight studies, n = 470; SMD = -0.08, 95% CI -0.28 to 0.12, p = 0.380). General stress was reported by one study and was not pooled. CONCLUSION: Psychosocial interventions may produce small reductions in PTSD and depression symptoms in parents after their child's PICU admission, whereas the anxiety estimate remained compatible with benefit and no effect. Interpretation is limited by the small number and size of trials, variation in intervention characteristics, and risk of bias. IMPLICATIONS FOR CLINICAL PRACTICE: Accessible evidence-based psychoeducational support, distress screening with appropriate referral pathways, and planned follow-up may help address parental emotional distress after PICU admission. REGISTRATION: PROSPERO: CRD42023396042.