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Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care

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Abstract

Objective

To evaluate the effectiveness of the provision of information in the form of a rehabilitation program following critical illness in reducing psychological distress in the patients’ close family.

Design

Randomised controlled trial, blind at follow-up with final assessment at 6 months.

Setting

Two district general hospitals and one teaching hospital.

Patients and participants

The closest family member of 104 recovering intensive care unit (ICU) patients.

Interventions

Ward visits, ICU clinic appointments at 2 and 6 months. Relatives and patients received the rehabilitation program at 1 week after ICU discharge. The program comprised a 6-week self-help manual containing information about recovery from ICU, psychological information and practical advice.

Measurements and results

Psychological recovery of relatives was assessed by examining the rate of depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms by 6 months after ICU. The proportion of relatives scoring in the range >19 on the Impact of Events Scale (cause for concern) was high in both groups at 49% at 6 months. No difference was shown in the rate of depression, anxiety, or PTSD-related symptoms between the study groups.

Conclusion

A high incidence of psychological distress was evident in relatives. Written information concerning recovery from ICU provided to the patient and their close family did not reduce this. High levels of psychological distress in patients were found to be correlated with high levels in relatives.

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References

  1. Jones C, Griffiths RD (1995) Social support and anxiety levels in relatives of critically ill patients. Br J Intensive Care:44–47

    Google Scholar 

  2. Pérez-San Gregorio MA, Blanco-Picabia A, Murillo-Cabezas F, Dominguez-Roldán JM, Sánchez B, Nùñez-Roldán A (1992) Psychological problems in the family members of gravely traumatised patients admitted into an intensive care unit. Intensive Care Med 18:278–281

    PubMed  Google Scholar 

  3. Jones C, Macmillan RR, Griffiths RD (1994) Providing psychological support to patients after critical illness. Clin Intensive Care 5:176–179

    CAS  PubMed  Google Scholar 

  4. Hentinen M (1983) Need for instruction and support of the wives of patients with myocardial infarction. J Adv Nursing 8:519–524

    CAS  Google Scholar 

  5. Thompson DR, Meddis R (1990) Wives responses to counselling early after myocardial infarction. J Psychosom Res 34:249–258

    Article  CAS  PubMed  Google Scholar 

  6. Jones C, Skirrow P, Griffiths RD, Humphris G, Ingleby S, Eddleston J et al. (2003) Rehabilitation after critical illness: a randomised, controlled trial. Critical Care Med 31:2456–2461

    Google Scholar 

  7. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370

    CAS  PubMed  Google Scholar 

  8. Spielberger CD, Gorsuch RL, Lushene R (1970) State-Trait Anxiety Inventory Manual. Consulting Psychologists Press, Palo Alto, California, 1:20

  9. Horowitz M, Wilner N, Alvarez W (1979) Impact of events scale: a measure of subjective stress. Psychosom Med 41:209–218

    CAS  PubMed  Google Scholar 

  10. Ware JE, Sherbourne CD (1992) The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    PubMed  Google Scholar 

  11. Jones C (2001) Rehabilitation Following critical illness, support for patients. PhD thesis, University of Liverpool, Liverpool, UK, pp 154–156

  12. Jones C, Humphris G, Griffiths RD (1998) Psychological morbidity following critical illness: the rationale for care after intensive care. Clin Intensive Care 9:199–205

    Google Scholar 

  13. Cohen J (1969) Statistical power analysis for the behavioural sciences. Academic Press, New York

  14. Hollis S, Campbell F (2000) What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J 319:670–674

    Google Scholar 

  15. Horowitz M (1986) “Dosing” of trauma: stress response syndromes. Jason Aronson, Northvale, New Jersey, pp 30–33

  16. Mayou R, Foster A, Williamson B (1978) The psychological and social effects of myocardial infarction on wives. Br Med J 1:699–701

    CAS  PubMed  Google Scholar 

  17. Thompson DR, Cordle CJ (1988) Support of wives of myocardial infarction patients. J Adv Nursing 13:223–228

    CAS  Google Scholar 

  18. Ehlers A, Clark DM (2000) A cognitive model of posttraumatic stress disorder. Behav Res Therapy 38:319–345

    Article  CAS  Google Scholar 

  19. Wilkinson CB, Vera B (1989) Clinical responses to disaster. In: Gist R, Lubin B (eds) Psychological aspects of disaster. Wiley, New York, pp 233–265

  20. Foa EB, Davidson JRT, Frances A (1999) The Expert Consensus Guideline Series: treatment of posttraumatic stress disorder. J Clin Psychol 60 (Suppl 16):1–75

    Google Scholar 

  21. Department of Health (2000) Comprehensive critical care. Department of Health, London, p 23

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Correspondence to Christina Jones.

Appendix

Appendix

The topics addressed in ICU Recovery Manual are as follows: Anxiety; Assessing your life style; Changes in appearance; Depression; Exercises; Feeling jittery; Feeling down; Food; Getting fit again; Getting out and about; Information—after intensive care; Living alone; Medicines; Mobility; Mood changes; Nightmares; Overworking; Panic attacks; Phobias; Relaxation; Sex after serious illness; Sleeping; Smoking; Stress; Stress in marriage; Tiredness; Where to go from here?; Where to start; Worrying.

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Jones, C., Skirrow, P., Griffiths, R.D. et al. Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med 30, 456–460 (2004). https://doi.org/10.1007/s00134-003-2149-5

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  • DOI: https://doi.org/10.1007/s00134-003-2149-5

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