Coping Strategies and Psychosocial Resource Needs Reported by Families of Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (RP423)

Outcomes. 1. Identify the most common coping strategies used by family caregivers of patients recovering from severe acute brain injury and coma 2. List the desired psychosocial resources most commonly reported by family caregivers Importance. Family caregivers of comatose patients with severe acute brain injury (SABI) are at high risk of developing psychological distress in the months after patient discharge from the neurointensive care unit (neuroICU). Understanding their coping strategies and perceptions of needed support are crucial in designing effective future family support interventions. Objective(s). To understand common coping strategies used by family caregivers of SABI patients recovering from coma in neuroICUs and what psychosocial resources are most desired by these caregivers. Method(s). 15 primary caregivers of SABI patients comatose for more than 24 hours and in need of a tracheostomy or feeding tube were interviewed at the time of neuroICU discharge. Participants were recruited as a convenience sample from 6 US centers. A codebook was developed from interview transcripts by 9 study team members. Using NVivo software, two members then independently coded each transcript, refined the codebook, and resolved coding discrepancies. Results. Fourteen of 15 caregivers provided demographic data; 13 (92.9%) were female, 5 (35.7%) were racial minorities, and 9 (64.3%) reported less than 4 years of college. Six of the 15 (40.0%) patients had recovered to a Glasgow Coma Scale score of 9 or higher at the time of interview. The most common coping strategies included avoidance or denial of the situation, reliance on family and social support, and attempts to self-cultivate positive emotions. Desired resources included materials that provide educational information about recovery from SABI and connections with family caregivers with prior experience in similar situations. Conclusion(s). Many caregivers of SABI patients cope by avoidance and denial or reliance on their existing personal social networks. Future interventions should consider combining education about coma recovery with creation of peer networks. Impact. Few current resources for psychosocial support exist for caregivers of SABI patients. Designing effective interventions requires paying attention to their preferred means of psychosocial support.