Caregiver burden and emotional wellbeing in informal caregivers to ICU survivors-A prospective cohort study.

PICS PICS-F anxiety caregiver burden critical care depression informal caregivers intensive care unit posttraumatic stress psychological

Journal

Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270

Informations de publication

Date de publication:
Jan 2022
Historique:
revised: 07 06 2021
received: 03 12 2020
accepted: 03 09 2021
pubmed: 29 9 2021
medline: 27 1 2022
entrez: 28 9 2021
Statut: ppublish

Résumé

Informal caregivers to intensive care unit (ICU) survivors may develop post-intensive care syndrome family (PICS-F), including depression, anxiety and post-traumatic stress (PTS). Our primary aim was to investigate associations between caregiver burden in informal caregivers cohabiting with ICU survivors and patients' physical and psychological outcomes. A prospective, multicentre cohort study in four ICUs in Sweden. Adults cohabiting with ICU patients included in a previous study were eligible for inclusion. Three months post-ICU, informal caregivers received questionnaires assessing caregiver burden, health-related quality of life (HRQL) and symptoms of depression, anxiety and PTS. In parallel, patients reported their three-month physical and psychological status via validated questionnaires. The primary outcome of this study was to compare caregiver burden in informal caregivers to patients with and without adverse physical and psychological outcomes 3 months post-ICU. Secondary outcomes were correlations between caregiver burden and informal caregivers' mental HRQL. Among 62 included informal caregivers, 55 (89%) responded to the follow-up questionnaires. Caregiver burden was higher among informal caregivers to patients with an adverse outcome, compared to informal caregivers to patients without an adverse outcome, caregiver burden scale score mean (±standard deviation) 52 (11) and 41 (13) respectively (p = 0.003). There was strong negative correlation between caregiver burden and informal caregivers' mental HRQL (r Informal caregivers to ICU survivors with adverse physical or psychological outcome experience a higher caregiver burden. A higher caregiver burden correlates with worse caregiver mental HRQL. ICU follow-up programs should consider screening and follow-up of informal caregivers for mental health problems.

Sections du résumé

BACKGROUND BACKGROUND
Informal caregivers to intensive care unit (ICU) survivors may develop post-intensive care syndrome family (PICS-F), including depression, anxiety and post-traumatic stress (PTS). Our primary aim was to investigate associations between caregiver burden in informal caregivers cohabiting with ICU survivors and patients' physical and psychological outcomes.
METHODS METHODS
A prospective, multicentre cohort study in four ICUs in Sweden. Adults cohabiting with ICU patients included in a previous study were eligible for inclusion. Three months post-ICU, informal caregivers received questionnaires assessing caregiver burden, health-related quality of life (HRQL) and symptoms of depression, anxiety and PTS. In parallel, patients reported their three-month physical and psychological status via validated questionnaires. The primary outcome of this study was to compare caregiver burden in informal caregivers to patients with and without adverse physical and psychological outcomes 3 months post-ICU. Secondary outcomes were correlations between caregiver burden and informal caregivers' mental HRQL.
RESULTS RESULTS
Among 62 included informal caregivers, 55 (89%) responded to the follow-up questionnaires. Caregiver burden was higher among informal caregivers to patients with an adverse outcome, compared to informal caregivers to patients without an adverse outcome, caregiver burden scale score mean (±standard deviation) 52 (11) and 41 (13) respectively (p = 0.003). There was strong negative correlation between caregiver burden and informal caregivers' mental HRQL (r
CONCLUSION CONCLUSIONS
Informal caregivers to ICU survivors with adverse physical or psychological outcome experience a higher caregiver burden. A higher caregiver burden correlates with worse caregiver mental HRQL. ICU follow-up programs should consider screening and follow-up of informal caregivers for mental health problems.

Identifiants

pubmed: 34582048
doi: 10.1111/aas.13988
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

94-102

Subventions

Organisme : Supported by grants provided by Region Stockholm/ALF
ID : 0000
Organisme : Stiftelsen Olle Engkvist Byggmästare
ID : 0000

Informations de copyright

© 2021 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Références

Ågård AS, Egerod I, Tønnesen E, Lomborg K. From spouse to caregiver and back: a grounded theory study of post-intensive care unit spousal caregiving. J Adv Nurs. 2015;71:1892-1903.
The national alliance for caregiving. [www document] https://www.caregiving.org/wp-content/uploads/2021/01/full-report-caregiving-in-the-united-states-01-21.pdf [accessed on 2021-02-21 2021]
Marra A, Pandharipande PP, Girard TD, et al. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness. Crit Care Med. 2018;46:1393-1401.
Needham DM, Davidson J, Cohen H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med. 2012;40:502-509.
van Beusekom I, Bakhshi-Raiez F, de Keizer NF, Dongelmans DA, van der Schaaf M. Reported burden on informal caregivers of ICU survivors: a literature review. Crit Care. 2016;20:16.
Johnson CC, Suchyta MR, Darowski ES, et al. Psychological sequelae in family caregivers of critically III intensive care unit patients. A Systematic Review. Ann Am Thorac Soc. 2019;16:894-909.
Douglas SL, Daly BJ, Kelley CG, O'Toole E, Montenegro H. Impact of a disease management program upon caregivers of chronically critically ill patients. Chest. 2005;128:3925-3936.
Im K, Belle SH, Schulz R, Mendelsohn AB, Chelluri L. Prevalence and outcomes of caregiving after prolonged (> or =48 hours) mechanical ventilation in the ICU. Chest. 2004;125:597-606.
de Miranda S, Pochard F, Chaize M, et al. Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: a multicenter study. Crit Care Med. 2011;39:112-118.
Anderson WG, Arnold RM, Angus DC, Bryce CL. Posttraumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Intern Med. 2008;23:1871-1876.
Milton A, Schandl A, Soliman I, et al. ICU discharge screening for prediction of new-onset physical disability-A multinational cohort study. Acta Anaesthesiol Scand. 2020;64:789-797.
Milton A, Schandl A, Soliman IW, et al. Development of an ICU discharge instrument predicting psychological morbidity: a multinational study. Intensive Care Med. 2018;44:2038-2047.
Orwelius L, Nilsson M, Nilsson E, et al. The Swedish RAND-36 Health Survey - reliability and responsiveness assessed in patient populations using Svensson’s method for paired ordinal data. J Patient Rep Outcomes. 2018;2:4.
Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61-65.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-370.
Twigg E, Humphris G, Jones C, Bramwell R, Griffiths RD. Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients. Acta Anaesthesiol Scand. 2008;52:202-208.
Elmståhl S, Dahlrup B, Ekström H, Nordell E. The association between medical diagnosis and caregiver burden: a cross-sectional study of recipients of informal support and caregivers from the general population study ‘Good Aging in Skåne’, Sweden. Aging Clin Exp Res. 2018;30:1023-1032.
Elmstahl S, Malmberg B, Annerstedt L. Caregiver's burden of patients 3 years after stroke assessed by a novel caregiver burden scale. Arch Phys Med Rehabil. 1996;77:177-182.
Hsieh YW, Wang CH, Wu SC, Chen PC, Sheu CF, Hsieh CL. Establishing the minimal clinically important difference of the Barthel Index in stroke patients. Neurorehabil Neural Repair. 2007;21:233-238.
Jones C, Skirrow P, Griffiths RD, et al. Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med. 2004;30:456-460.
Douglas SL, Daly BJ. Caregivers of long-term ventilator patients: physical and psychological outcomes. Chest. 2003;123:1073-1081.
Fumis RR, Ranzani OT, Martins PS, Schettino G. Emotional disorders in pairs of patients and their family members during and after ICU stay. PLoS One. 2015;10:e0115332.
Ditlevsen DN, Elklit A. The combined effect of gender and age on post-traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder? Ann Gen Psychiatry. 2010;9:32.
Kessler RC, Birnbaum H, Bromet E, Hwang I, Sampson N, Shahly V. Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R). Psychol Med. 2010;40:225-237.
Statistics NIo. European Survey of Health in Spain 2014. Prevalence of active depressive disorders by sex and age group. Population aged 15 years old and over. 2014. [www document] https://www.ine.es/jaxi/Datos.htm?path=/t15/p420/a2014/p04/l1/&file=12007.px [accessed on 20210601 2021]
Johansson R, Carlbring P, Heedman Å, Paxling B, Andersson G. Depression, anxiety and their comorbidity in the Swedish general population: point prevalence and the effect on health-related quality of life. PeerJ. 2013;1:e98.
Rees J, Clarke MG, Waldron D, O'Boyle C, Ewings P, MacDonagh RP. The measurement of response shift in patients with advanced prostate cancer and their partners. Health Qual Life Outcomes. 2005;3:21.
Choi J, Sherwood PR, Schulz R, et al. Patterns of depressive symptoms in caregivers of mechanically ventilated critically ill adults from intensive care unit admission to 2 months postintensive care unit discharge: a pilot study. Crit Care Med. 2012;40:1546-1553.
Haines KJ, Denehy L, Skinner EH, Warrillow S, Berney S. Psychosocial outcomes in informal caregivers of the critically ill: a systematic review. Crit Care Med. 2015;43:1112-1120.
Hwang DY, Yagoda D, Perrey HM, et al. Anxiety and depression symptoms among families of adult intensive care unit survivors immediately following brief length of stay. J Crit Care. 2014;29:278-282.
Schmidt M, Azoulay E. Having a loved one in the ICU: the forgotten family. Curr Opin Crit Care. 2012;18:540-547.
Azoulay E, Pochard F, Kentish-Barnes N, Group FS. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005;171:987-994.
Alfheim HB, Hofsø K, Småstuen MC, Tøien K, Rosseland LA, Rustøen T. Post-traumatic stress symptoms in family caregivers of intensive care unit patients: a longitudinal study. Intensive Crit Care Nurs. 2019;50:5-10.
Haines KJ, Denehy L, Skinner EH, Warrillow S, Berney S. Psychosocial outcomes in informal caregivers of the critically Ill: a systematic review. Crit Care Med. 2015.
Fowler RA, Sabur N, Li P, et al. Sex-and age-based differences in the delivery and outcomes of critical care. CMAJ. 2007;177:1513-1519.

Auteurs

Anna Milton (A)

Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden.
Department of Perioperative Medicine and Intensive care, Karolinska University Hospital, Stockholm, Sweden.

Anna Schandl (A)

Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden.

Ing-Marie Larsson (IM)

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Ewa Wallin (E)

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Johanna Savilampi (J)

Department of Anaesthesiology and Intensive care, Örebro University Hospital, Örebro, Sweden.

Katarina Meijers (K)

Department of Anaesthesiology and Intensive care, Södersjukhuset, Stockholm, Sweden.

Eva Joelsson-Alm (E)

Department of Anaesthesiology and Intensive care, Södersjukhuset, Stockholm, Sweden.

Matteo Bottai (M)

Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden.

Peter Sackey (P)

Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH