Intensive Care Based Interventions to Reduce Family Member Stress Disorders: A Systematic Review of the Literature

Abstract

Background Increasing awareness of the emotional impact of an Intensive Care Unit (ICU) hospitalization on patients and their families has led to a rise in studies seeking to mitigate Post Intensive Care Syndrome (PICS) for both groups. In efforts to decrease symptoms of anxiety and depression, ICUs have implemented a variety of programs to reduce family distress. Methods We conducted a systematic review of experimental studies which aimed to reduce stress related disorders in family members after the experience of having a patient admitted to the ICU. Multiple databases were searched for randomized controlled trials or nonrandomized comparative trials which targeted family members or surrogate decision makers. A total of 17 studies were identified for inclusion in the review representing 3471 participants. Results We describe those interventions which we qualitatively assigned as “not passive,” or those which actively engaged the family to express themselves, as more likely to be successful in both the available pediatric and adult literature than interventions which we identified as “passive.” Studies which described active engagement of family members demonstrated comparative improvements in symptoms of depression, anxiety, and PTSD, as well as reduced hospital costs in the case of two studies. Discussion This review may serve to aid in the development of future interventions targeted at reducing family stress and PICS following an ICU hospitalization.

One Year Later: Family Members of Patients with COVID-19 Experience Persistent Symptoms of Posttraumatic Stress Disorder

“…These findings provide insights into the development of persistent and transient PTSD symptoms that may help develop interventions to identify and address these symptoms. Prior studies aimed at minimizing PTSD symptoms among family members of ICU patients have demonstrated the positive impact of soliciting family expression, including proactive and structured family conferences ( 1 ), the use of nurse facilitators ( 3 ), and family participation in bedside care ( 32 ). Although existing literature suggests that the active engagement of family members in patient care offers some protection against persistent stress symptoms, the realities of the visitation restrictions and the COVID-19 pandemic resulted in a regression to passive involvement for many.…”

Intensivnachsorge-Ambulanz – Nachsorge kritisch kranker Patienten – Eine Aufgabe für die Pneumologie?

“…Unklar ist, welche Maßnahmen betroffenen Familienmitgliedern helfen können. Erprobt wurden u. a. das Führen von sIntensivtagebüchern, das Halten von Familienkonferenzen und Sprechstunden, in denen sich Angehörige gezielt über ihre Sor-gen äußern dürfen [42]. Das Fehlen von klaren Konzepten spricht auch hier für einen notwendigen Forschungsbedarf.…”

Novel Definitions of Wellness and Distress among Family Caregivers of Patients with Acute Cardiorespiratory Failure: A Qualitative Study

“…Emerging evidence in noncaregiving populations suggests that PTSSs are just one component of a much broader range of physical and psychological outcomes following trauma, which may include wellness in addition to distress ( 23 – 25 ). To date, ICU caregiver outcomes have been described mostly by quantitative measures of negative psychological symptoms, which, in addition to PTSSs, can include depression, anxiety, and complicated grief ( 26 , 27 ).…”