Post-traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study

Alfheim, Hanne Birgit; Hofsø, Kristin; Småstuen, Milada Cvancarova; Tøien, Kirsti; Rosseland, Leiv Arne; Rustøen, Tone

doi:10.1016/j.iccn.2018.05.007

Cited by 81 publications

(82 citation statements)

References 44 publications

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“…Posttraumatic stress was more prevalent in our sample than previously reported, whereas anxiety and depression occurred in a similar proportion of family members compared to other studies (9,(35)(36)(37). The higher rate of posttraumatic stress might be due to the fact that data were collected relatively shortly after ICU discharge or death, when the rami cations of critical illness are still acute (1,19,20). Moreover, different cut-off levels have been used for the HADS and IES-R, which makes comparisons across studies more di cult (10,13).…”

Section: Discussionsupporting

confidence: 44%

“…Previous research has identi ed that female gender, younger age, and lower education levels are associated with depression, and to a lesser extent with anxiety and stress at some point within the rst six months post-ICU (3, 9, 18-22, 37, 47). Being a spouse or an adult child has also been found to be associated with higher levels of psychological distress (1,8,19,37). However, no clear pattern is evident in terms of the exact outcome predicted, and ndings vary among studies.…”

Section: Discussionmentioning

confidence: 99%

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Factors Influencing Post-icu Psychological Distress in Family Members of Critically Ill Patients: A Linear Mixed-effects Model

Naef

Felten

Ernst

2020

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Background: Adverse responses to critical illness, such as symptoms of depression, anxiety or posttraumatic stress, are relatively common among family members. The role of risk factors, however, remains insufficiently understood, but may be important to target those family members most in need for support. We therefore examined the association of patient-, family member- and care-related factors with post-ICU psychological distress in family members in a general population of critical ill patients.Methods: We conducted a prospective, single-centre observational study in a twelve-bed surgical ICU in a 900-bed University Hospital in Switzerland. Participants were family members of patients treated in ICU who completed the Family Satisfaction in ICU-24 Survey, the Hospital Anxiety Depression Scale, Impact of Event Scale-Revised-6, and a demographic form within the first three months of their close other’s ICU stay. Data were analysed using linear mixed-effects models, with depression, anxiety, and posttraumatic stress as outcome measures. Results: A total of 214 family members (53% return rate) returned a completed questionnaire. We found that higher levels of satisfaction were significantly associated with lower levels of depression, anxiety and posttraumatic stress. There was no statistically significant association between family member characteristics and any measure of psychological distress. Among the included patient characteristics, younger patient age was associated with higher levels of depression and anxiety, and patient death was associated with higher levels of depression and posttraumatic stress.Conclusions: Our results suggest that satisfaction with ICU care is strongly associated with family well-being post-ICU. Family members of younger patients and of those who die seem to be most at risk for psychological distress, requiring specific support, whereas family member characteristics may have less relevance.

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Factors Influencing Post-icu Psychological Distress in Family Members of Critically Ill Patients: A Linear Mixed-effects Model

Naef

Felten

Ernst

2020

Preprint

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“…Various studies have investigated the emotional stress and needs of family members in the ICU. A recent study has shown family (16). Authors recommend that health care professionals must support family members' hope.…”

Section: Discussionmentioning

confidence: 99%

“…Azoulay et al (22) found that the doctor should spend more time with relatives when providing information, which should be consistent and clear to improve satisfaction (16). Satisfaction is affected from the difference between the expectation and the meeting these expectations in reality.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Family Satisfaction Level at Erciyes University Medical Faculty Intensive Care Units with a Validated Survey

Turhan¹

2020

Erciyes Med J

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This study aims to investigate the validity and reliability of the FS-ICU 24 survey in the Turkish language, to evaluate the satisfaction of ICU patients' relatives, and to determine the factors affecting satisfaction. Materials and Methods: In this study, the Turkish version was prepared based on the FS-ICU 24 survey applied to the relatives of ICU patients (Anesthesiology, Internal Medicine, General Surgery and Neurosurgery) at the Erciyes University in the Faculty of Medicine between April 2015 and June 2015. The Turkish version was tested and proven to be reliable and valid. Relatives of patients that were hospitalized for at least 48 hours, who had visited the patient at least once, were included. In this study, 369 surveys were completed. Results: FS-ICU 24 survey was found reliable and valid in Turkish. Patients' relatives were unsatisfied with physical conditions, waiting room setting and frequency of communication with nurses the most. The relatives were highly satisfied with the skills and competency of ICU doctors/nurses, setting of the ICU, completeness of treatment provided. Among the intensive care unit departments, there were not any statistically significantly different satisfaction results (p>0.05). The satisfaction level was found to decrease with increasing education levels and increasing duration of hospitalization (p<0.05). The satisfaction in the group who knew the diagnosis was higher (p<0.05). Conclusion: Even though the general satisfaction level of the patients' relatives was high, satisfaction level can be increased by improving physical factors, such as the waiting room setting, and by training on the communication skills of all staff that have contact with the patients' relatives on communication skills.

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“…A study in parents and spouses of burn survivors showed a prevalence rate of 52% at admission, which decreased to 25% at 6 to 8 months postburn [8, see also 9]. In the intensive care unit (ICU) literature, prevalence rates of acute PTSD symptoms ranged between 14% and 72%, decreasing to 23.6% to 36.2% at 12 months and 14% at 24 months [10][11][12][13][14]. However, no burn or ICU studies are available that document PTSD symptom trajectories exclusively in partners, even though differences in PTSD symptom levels between partners, parents and other relatives have been reported [3,10,15].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Course of Posttraumatic Stress Disorder Symptoms in Partners of Burn Survivors

Dam

Schoot

Geenen

et al. 2020

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BackgroundPartners of burn survivors may develop posttraumatic stress disorder (PTSD) symptoms in the aftermath of the burn event. This longitudinal study examined the prevalence, course and potential predictors of partners’ PTSD symptoms up to 18 months postburn.MethodsParticipants were 111 partners of adult burn survivors. In a multicenter study, PTSD symptoms were assessed with the Impact of Event Scale-Revised (IES-R) during hospitalization of the burn survivor, and subsequently at 3, 6, 12 and 18 months postburn. Partners’ appraisal of threat to the burn survivor’s life, anger, guilt and level of rumination were assessed in the hospital as potential predictors of (long-term) PTSD symptoms in an exploratory piecewise latent growth model.ResultsAt the time of hospitalisation, 30% of the partners reported acute PTSD symptoms in the clinical range, which decreased to 4% at 18 months postburn. Higher acute PTSD symptoms were related to the presence of perceived life threat and higher levels of anger, guilt, and rumination. Over time, mean levels of PTSD symptoms decreased, especially in partners with high levels of acute PTSD symptoms, perceived life threat and rumination. From 3 months onward, PTSD symptoms decreased less in partners of more severely burned survivors. At 18 months postburn, higher levels of PTSD symptoms were related to more severe burn injuries and initial perception of life threat.ConclusionsOne in three partners of burn survivors reported clinical levels of acute PTSD symptoms shortly after the hospital admission, of which the majority recovered over time. This study showed that perceived life threat, feelings of anger and guilt, and rumination may indicate the presence of acute PTSD symptoms, whereas more severe burns and initial perception of life threat predict long-term PTSD symptom levels. The results highlight the need to offer psychological help to partners to alleviate acute elevated stress levels, which in turn may enhance the quality of support partners can provide to the burn survivor.

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Post-traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study

Cited by 81 publications

References 44 publications

Factors Influencing Post-icu Psychological Distress in Family Members of Critically Ill Patients: A Linear Mixed-effects Model

Factors Influencing Post-icu Psychological Distress in Family Members of Critically Ill Patients: A Linear Mixed-effects Model

Evaluation of Family Satisfaction Level at Erciyes University Medical Faculty Intensive Care Units with a Validated Survey

The Prevalence and Course of Posttraumatic Stress Disorder Symptoms in Partners of Burn Survivors

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