Association Between Resilience and Family Member Psychologic Symptoms in Critical Illness

Abstract

Objective There are increased rates of depression, anxiety, and stress disorders in families of critically ill patients. Interventions directed at family members may help their ability to cope with this stress. Specifically, resilience is a teachable psychological construct describing a person’s ability to adapt to traumatic situations. Resilience can inherently assist individuals to diminish adverse psychological outcomes. Consequently, we determined the relationship between resilience and symptoms of depression, anxiety, and acute stress in family members of critically ill patients. Design This is a cross-section study. Setting Three medical intensive care units were screened by study staff. Patients Family members of ICU patients admitted for greater than 48 hours were approached for enrollment. Interventions The Connor-Davidson Resilience Scale (CD-RISC) was used to stratify family members as resilient or not-resilient. Measurements The Hospital Anxiety and Depression Scale (HADS), Impact of Evens Scale-Revised (IESR), and Family Satisfaction in the Intensive Care Unit (FS-ICU) were collected prior to ICU discharge to measure symptoms of depression, anxiety, and acute stress, as well as satisfaction with care. Main Results One-hundred and seventy family members were enrolled. Seventy-eight family members were resilient. Resilient family members had fewer symptoms of anxiety (14.2% vs 43.6%, p<0.001), depression (14.1% vs 44.9%, P< 0.001), and acute stress (12.7% vs 36.3%, p=0.001). Resilient family members were more satisfied with care in the ICU (76.7 vs 70.8, p=0.008). Resilience remained independently associated with these outcomes after adjusting for family member age and gender, as well as the patient’s need for mechanical ventilation. Conclusion When caring for the critically ill, resilient family members have fewer symptoms of depression, anxiety, and acute stress. Resilient families were generally better satisfied with the care delivered. These data suggest that interventions aimed at increasing resilience may improve a family member’s experience in the ICU.

Investigation of the association between family members’ satisfaction with patient care in the Intensive Care Unit, spirituality and resilience

“…This may be due to the fact that sons and daughters could not adapt to the critical situation (17). In contrast, Sottile et al (2016) found that resilience is not signi cantly related to gender (36).…”

“…Different results have been demonstrated bySottile et al (2016). They found that resilience is signi cantly associated with satisfaction from care and decision-making(36). Bailey et al (2010) did not nd either a signi cant correlation between perceived stress and satisfaction with care and decisionmaking(41).Only gender was found to be signi cantly associated with PSS-14 (p = 0.050).…”

“…25 and PSS-14 are not signi cantly related to overall satisfaction, satisfaction with care and decisionmaking. Different results have been demonstrated bySottile et al (2016). They found that resilience is signi cantly associated with satisfaction from care and decision-making(36).…”

“…Similarly,Chalkidi et al (2016) found that participant's age and relationship with the patient is not associated with satisfaction with care and decision-making. In contrast, Sottile et al (2016) demonstrated that spouses expressed more satisfaction than other relatives, while no correlation was found between satisfaction and age, gender and previous ICU experience(35,36).A signi cant negative correlation was found between CD-RISC-25 and PSS-14 (p<0.001). This may be due to the fact that resilient participants are able to adapt to stressful situations, use protective mechanisms, modify the risks and limit the negative effects.…”

“…This corroborates previous ndings. According toSottile et al (2016), individuals with high resilience score experience less stress symptoms(36). According to Min et al (2013) and…”