Predictors of Symptoms of Posttraumatic Stress and Depression in Family Members After Patient Death in the ICU
Background: Patientsâ 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. Methods: Families of patients dying in the ICU or within 30 h of ICU discharge in 11 ho...
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| Veröffentlicht in: | Chest 2010-02, Vol.137 (2), p.280-287 |
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| creator | GRIES, Cynthia J ENGELBERG, Ruth A KROSS, Erin K ZATZICK, Doug NIELSEN, Elizabeth L DOWNEY, Lois CURTIS, J. Randall |
| description | Background: Patientsâ 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.
Methods: 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.
Results: 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 membersâ 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).
Conclusions: 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.
Trial registration: clinicaltrials.gov; Identifier: NCT00685893. |
| doi_str_mv | 10.1378/chest.09-1291 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2816640</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733696207</sourcerecordid><originalsourceid>FETCH-LOGICAL-c522t-cd35dbd212c1a85177ab7fff6d6058e17ed9a47b62c0ffbe2049d61d68f5a2f33</originalsourceid><addsrcrecordid>eNpVkUtv1DAUhS0EotPCki3yBrFK60dixxukaqClUhEjla4tx4_GlRMPtgOaf4-nMyqw8rXu53OP7wHgHUbnmPL-Qo82l3MkGkwEfgFWWFDc0K6lL8EKIUwaygQ5Aac5P6J6x4K9BidYcEa6VqzAvEnWeF1iyjA6eLebtiVOT_Um5lKSWiZVvIZ3JdmcoZoN_Gy3-9rHGfoZXqnJhx38ZqfBVpFLV2yCm_rGzqWiqox7qowW3qzv34BXToVs3x7PM3B_9eXH-mtz-_36Zn152-iOkNJoQzszGIKJxqrvMOdq4M45Zhjqeou5NUK1fGBEI-cGS1ArDMOG9a5TxFF6Bj4ddLfLMFmjq5ekgtwmP6m0k1F5-X9n9qN8iL8k6TFjLaoCH48CKf5c6orl5LO2IajZxiVLTuteGUG8ks2B1CnmnKx7noKR3EcknyKSSMh9RJV__6-1v_Qxkwp8OAIqaxVcUrP2-ZkjpG05YW3lLg7c6B_G3z5ZmScVQpWlh5GPcUmzCtWDJPVjiP4B1Yut7g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733696207</pqid></control><display><type>article</type><title>Predictors of Symptoms of Posttraumatic Stress and Depression in Family Members After Patient Death in the ICU</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>GRIES, Cynthia J ; ENGELBERG, Ruth A ; KROSS, Erin K ; ZATZICK, Doug ; NIELSEN, Elizabeth L ; DOWNEY, Lois ; CURTIS, J. Randall</creator><creatorcontrib>GRIES, Cynthia J ; ENGELBERG, Ruth A ; KROSS, Erin K ; ZATZICK, Doug ; NIELSEN, Elizabeth L ; DOWNEY, Lois ; CURTIS, J. Randall</creatorcontrib><description>Background: Patientsâ 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.
Methods: 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.
Results: 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 membersâ 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).
Conclusions: 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.
Trial registration: clinicaltrials.gov; Identifier: NCT00685893.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.09-1291</identifier><identifier>PMID: 19762549</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: American College of Chest Physicians</publisher><subject>Adult and adolescent clinical studies ; Anxiety disorders. Neuroses ; Attitude to Death ; Biological and medical sciences ; Cardiology. Vascular system ; Depression ; Depression - epidemiology ; Depression - etiology ; Depression - psychology ; Family - psychology ; Female ; Follow-Up Studies ; Humans ; Intensive Care Units ; Male ; Medical sciences ; Middle Aged ; Mood disorders ; Original Research ; Pneumology ; Post-traumatic stress disorder ; Prevalence ; Prognosis ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Stress, Psychological - epidemiology ; Stress, Psychological - etiology ; Stress, Psychological - psychology ; United States - epidemiology</subject><ispartof>Chest, 2010-02, Vol.137 (2), p.280-287</ispartof><rights>2015 INIST-CNRS</rights><rights>2010 American College of Chest Physicians 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-cd35dbd212c1a85177ab7fff6d6058e17ed9a47b62c0ffbe2049d61d68f5a2f33</citedby><cites>FETCH-LOGICAL-c522t-cd35dbd212c1a85177ab7fff6d6058e17ed9a47b62c0ffbe2049d61d68f5a2f33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22447264$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19762549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GRIES, Cynthia J</creatorcontrib><creatorcontrib>ENGELBERG, Ruth A</creatorcontrib><creatorcontrib>KROSS, Erin K</creatorcontrib><creatorcontrib>ZATZICK, Doug</creatorcontrib><creatorcontrib>NIELSEN, Elizabeth L</creatorcontrib><creatorcontrib>DOWNEY, Lois</creatorcontrib><creatorcontrib>CURTIS, J. Randall</creatorcontrib><title>Predictors of Symptoms of Posttraumatic Stress and Depression in Family Members After Patient Death in the ICU</title><title>Chest</title><addtitle>Chest</addtitle><description>Background: Patientsâ 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.
Methods: 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.
Results: 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 membersâ 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).
Conclusions: 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.
Trial registration: clinicaltrials.gov; Identifier: NCT00685893.</description><subject>Adult and adolescent clinical studies</subject><subject>Anxiety disorders. Neuroses</subject><subject>Attitude to Death</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Depression</subject><subject>Depression - epidemiology</subject><subject>Depression - etiology</subject><subject>Depression - psychology</subject><subject>Family - psychology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mood disorders</subject><subject>Original Research</subject><subject>Pneumology</subject><subject>Post-traumatic stress disorder</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Stress, Psychological - epidemiology</subject><subject>Stress, Psychological - etiology</subject><subject>Stress, Psychological - psychology</subject><subject>United States - epidemiology</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkUtv1DAUhS0EotPCki3yBrFK60dixxukaqClUhEjla4tx4_GlRMPtgOaf4-nMyqw8rXu53OP7wHgHUbnmPL-Qo82l3MkGkwEfgFWWFDc0K6lL8EKIUwaygQ5Aac5P6J6x4K9BidYcEa6VqzAvEnWeF1iyjA6eLebtiVOT_Um5lKSWiZVvIZ3JdmcoZoN_Gy3-9rHGfoZXqnJhx38ZqfBVpFLV2yCm_rGzqWiqox7qowW3qzv34BXToVs3x7PM3B_9eXH-mtz-_36Zn152-iOkNJoQzszGIKJxqrvMOdq4M45Zhjqeou5NUK1fGBEI-cGS1ArDMOG9a5TxFF6Bj4ddLfLMFmjq5ekgtwmP6m0k1F5-X9n9qN8iL8k6TFjLaoCH48CKf5c6orl5LO2IajZxiVLTuteGUG8ks2B1CnmnKx7noKR3EcknyKSSMh9RJV__6-1v_Qxkwp8OAIqaxVcUrP2-ZkjpG05YW3lLg7c6B_G3z5ZmScVQpWlh5GPcUmzCtWDJPVjiP4B1Yut7g</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>GRIES, Cynthia J</creator><creator>ENGELBERG, Ruth A</creator><creator>KROSS, Erin K</creator><creator>ZATZICK, Doug</creator><creator>NIELSEN, Elizabeth L</creator><creator>DOWNEY, Lois</creator><creator>CURTIS, J. Randall</creator><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100201</creationdate><title>Predictors of Symptoms of Posttraumatic Stress and Depression in Family Members After Patient Death in the ICU</title><author>GRIES, Cynthia J ; ENGELBERG, Ruth A ; KROSS, Erin K ; ZATZICK, Doug ; NIELSEN, Elizabeth L ; DOWNEY, Lois ; CURTIS, J. Randall</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-cd35dbd212c1a85177ab7fff6d6058e17ed9a47b62c0ffbe2049d61d68f5a2f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult and adolescent clinical studies</topic><topic>Anxiety disorders. Neuroses</topic><topic>Attitude to Death</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Depression</topic><topic>Depression - epidemiology</topic><topic>Depression - etiology</topic><topic>Depression - psychology</topic><topic>Family - psychology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mood disorders</topic><topic>Original Research</topic><topic>Pneumology</topic><topic>Post-traumatic stress disorder</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Stress, Psychological - epidemiology</topic><topic>Stress, Psychological - etiology</topic><topic>Stress, Psychological - psychology</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GRIES, Cynthia J</creatorcontrib><creatorcontrib>ENGELBERG, Ruth A</creatorcontrib><creatorcontrib>KROSS, Erin K</creatorcontrib><creatorcontrib>ZATZICK, Doug</creatorcontrib><creatorcontrib>NIELSEN, Elizabeth L</creatorcontrib><creatorcontrib>DOWNEY, Lois</creatorcontrib><creatorcontrib>CURTIS, J. Randall</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GRIES, Cynthia J</au><au>ENGELBERG, Ruth A</au><au>KROSS, Erin K</au><au>ZATZICK, Doug</au><au>NIELSEN, Elizabeth L</au><au>DOWNEY, Lois</au><au>CURTIS, J. Randall</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Symptoms of Posttraumatic Stress and Depression in Family Members After Patient Death in the ICU</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>137</volume><issue>2</issue><spage>280</spage><epage>287</epage><pages>280-287</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Background: Patientsâ 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.
Methods: 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.
Results: 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 membersâ 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).
Conclusions: 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.
Trial registration: clinicaltrials.gov; Identifier: NCT00685893.</abstract><cop>Northbrook, IL</cop><pub>American College of Chest Physicians</pub><pmid>19762549</pmid><doi>10.1378/chest.09-1291</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult and adolescent clinical studies Anxiety disorders. Neuroses Attitude to Death Biological and medical sciences Cardiology. Vascular system Depression Depression - epidemiology Depression - etiology Depression - psychology Family - psychology Female Follow-Up Studies Humans Intensive Care Units Male Medical sciences Middle Aged Mood disorders Original Research Pneumology Post-traumatic stress disorder Prevalence Prognosis Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry 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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