Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU

Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members. Families of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously...

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Vydáno v:	Chest Ročník 137; číslo 2; s. 280
Hlavní autoři:	Gries, Cynthia J, Engelberg, Ruth A, Kross, Erin K, Zatzick, Doug, Nielsen, Elizabeth L, Downey, Lois, Curtis, J Randall
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.02.2010
Témata:	Attitude to Death Depression - epidemiology Depression - etiology Depression - psychology Family - psychology Female Follow-Up Studies Humans Intensive Care Units Male Middle Aged Prevalence Prognosis Stress, Psychological - epidemiology Stress, Psychological - etiology Stress, Psychological - psychology United States - epidemiology United States
ISSN:	1931-3543, 1931-3543
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Abstract	Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members. Families of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously participated in a randomized trial. In the current study, we assessed these families for symptoms of posttraumatic stress disorder (PTSD) and depression with follow-up surveys. Outcomes included validated measures of PTSD (PTSD Checklist) and depressive (Patient Health Questionnaire) symptoms. Predictors included family member mental-health history, involvement in decision making, and demographics. Surveys were completed by 226 families. Response rate was 46% in the original randomized trial and 82% in this study. Prevalence (95% CI) of PTSD and depressive symptoms were 14.0% (9.7%-19.3%) and 18.4% (13.5%-24.1%), respectively. Family characteristics associated with increased symptoms included: female gender (PTSD, P = .020; depression, P = .005), knowing the patient for a shorter duration (PTSD, P = .003; depression, P = .040), and discordance between family members' preferences for decision making and their actual decision-making roles (PTSD, P = .005; depression, P = .049). Depressive symptoms were also associated with lower educational level (P = .002). Families with psychologic symptoms were more likely to report that access to a counselor (PTSD, P < .001; depression, P = .003) and information about spiritual services might have been helpful while the patient was in the ICU (PTSD, P = .024; depression, P = .029). Families demonstrated a high prevalence of psychologic symptoms after a death in the ICU. Characteristics associated with symptoms may help target interventions to reduce these symptoms. clinicaltrials.gov; Identifier: NCT00685893.
AbstractList	Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members.BACKGROUNDPatients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members.Families of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously participated in a randomized trial. In the current study, we assessed these families for symptoms of posttraumatic stress disorder (PTSD) and depression with follow-up surveys. Outcomes included validated measures of PTSD (PTSD Checklist) and depressive (Patient Health Questionnaire) symptoms. Predictors included family member mental-health history, involvement in decision making, and demographics.METHODSFamilies of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously participated in a randomized trial. In the current study, we assessed these families for symptoms of posttraumatic stress disorder (PTSD) and depression with follow-up surveys. Outcomes included validated measures of PTSD (PTSD Checklist) and depressive (Patient Health Questionnaire) symptoms. Predictors included family member mental-health history, involvement in decision making, and demographics.Surveys were completed by 226 families. Response rate was 46% in the original randomized trial and 82% in this study. Prevalence (95% CI) of PTSD and depressive symptoms were 14.0% (9.7%-19.3%) and 18.4% (13.5%-24.1%), respectively. Family characteristics associated with increased symptoms included: female gender (PTSD, P = .020; depression, P = .005), knowing the patient for a shorter duration (PTSD, P = .003; depression, P = .040), and discordance between family members' preferences for decision making and their actual decision-making roles (PTSD, P = .005; depression, P = .049). Depressive symptoms were also associated with lower educational level (P = .002). Families with psychologic symptoms were more likely to report that access to a counselor (PTSD, P < .001; depression, P = .003) and information about spiritual services might have been helpful while the patient was in the ICU (PTSD, P = .024; depression, P = .029).RESULTSSurveys were completed by 226 families. Response rate was 46% in the original randomized trial and 82% in this study. Prevalence (95% CI) of PTSD and depressive symptoms were 14.0% (9.7%-19.3%) and 18.4% (13.5%-24.1%), respectively. Family characteristics associated with increased symptoms included: female gender (PTSD, P = .020; depression, P = .005), knowing the patient for a shorter duration (PTSD, P = .003; depression, P = .040), and discordance between family members' preferences for decision making and their actual decision-making roles (PTSD, P = .005; depression, P = .049). Depressive symptoms were also associated with lower educational level (P = .002). Families with psychologic symptoms were more likely to report that access to a counselor (PTSD, P < .001; depression, P = .003) and information about spiritual services might have been helpful while the patient was in the ICU (PTSD, P = .024; depression, P = .029).Families demonstrated a high prevalence of psychologic symptoms after a death in the ICU. Characteristics associated with symptoms may help target interventions to reduce these symptoms.CONCLUSIONSFamilies demonstrated a high prevalence of psychologic symptoms after a death in the ICU. Characteristics associated with symptoms may help target interventions to reduce these symptoms.clinicaltrials.gov; Identifier: NCT00685893.TRIAL REGISTRATIONclinicaltrials.gov; Identifier: NCT00685893. Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members. Families of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously participated in a randomized trial. In the current study, we assessed these families for symptoms of posttraumatic stress disorder (PTSD) and depression with follow-up surveys. Outcomes included validated measures of PTSD (PTSD Checklist) and depressive (Patient Health Questionnaire) symptoms. Predictors included family member mental-health history, involvement in decision making, and demographics. Surveys were completed by 226 families. Response rate was 46% in the original randomized trial and 82% in this study. Prevalence (95% CI) of PTSD and depressive symptoms were 14.0% (9.7%-19.3%) and 18.4% (13.5%-24.1%), respectively. Family characteristics associated with increased symptoms included: female gender (PTSD, P = .020; depression, P = .005), knowing the patient for a shorter duration (PTSD, P = .003; depression, P = .040), and discordance between family members' preferences for decision making and their actual decision-making roles (PTSD, P = .005; depression, P = .049). Depressive symptoms were also associated with lower educational level (P = .002). Families with psychologic symptoms were more likely to report that access to a counselor (PTSD, P < .001; depression, P = .003) and information about spiritual services might have been helpful while the patient was in the ICU (PTSD, P = .024; depression, P = .029). Families demonstrated a high prevalence of psychologic symptoms after a death in the ICU. Characteristics associated with symptoms may help target interventions to reduce these symptoms. clinicaltrials.gov; Identifier: NCT00685893.
Author	Gries, Cynthia J Engelberg, Ruth A Nielsen, Elizabeth L Kross, Erin K Downey, Lois Zatzick, Doug Curtis, J Randall
Author_xml	– sequence: 1 givenname: Cynthia J surname: Gries fullname: Gries, Cynthia J email: jrc@u.washington.edu organization: University of Washington, Division of Pulmonary and Critical Care, Seattle, WA 98104, USA. jrc@u.washington.edu – sequence: 2 givenname: Ruth A surname: Engelberg fullname: Engelberg, Ruth A – sequence: 3 givenname: Erin K surname: Kross fullname: Kross, Erin K – sequence: 4 givenname: Doug surname: Zatzick fullname: Zatzick, Doug – sequence: 5 givenname: Elizabeth L surname: Nielsen fullname: Nielsen, Elizabeth L – sequence: 6 givenname: Lois surname: Downey fullname: Downey, Lois – sequence: 7 givenname: J Randall surname: Curtis fullname: Curtis, J Randall
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Snippet	Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with...
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SubjectTerms	Attitude to Death Depression - epidemiology Depression - etiology Depression - psychology Family - psychology Female Follow-Up Studies Humans Intensive Care Units Male Middle Aged Prevalence Prognosis Stress, Psychological - epidemiology Stress, Psychological - etiology Stress, Psychological - psychology United States - epidemiology
Title	Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU
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