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Emotional Experiences and Coping Strategies of Family Members of Critically Ill Patients.

Authors
  • Harlan, Emily A1
  • Miller, Jacquelyn2
  • Costa, Deena K3
  • Fagerlin, Angela4
  • Iwashyna, Theodore J5
  • Chen, Emily P2
  • Lipman, Kyra6
  • Valley, Thomas S7
  • 1 Department of Internal Medicine, University of Michigan, Ann Arbor, MI. Electronic address: [email protected]
  • 2 Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI.
  • 3 School of Nursing, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.
  • 4 Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT; Veterans Affairs Salt Lake City Center for Informatics Decision Enhancement and Surveillance (IDEAS), Salt Lake City, UT.
  • 5 Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; VA Center for Clinical Management Research, Ann Arbor, MI.
  • 6 Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
  • 7 Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
Type
Published Article
Journal
CHEST Journal
Publisher
Elsevier
Publication Date
Oct 01, 2020
Volume
158
Issue
4
Pages
1464–1472
Identifiers
DOI: 10.1016/j.chest.2020.05.535
PMID: 32454044
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Two out of three family members experience symptoms of posttraumatic stress, depression, or anxiety lasting for months after the ICU stay. Interventions aimed at mitigating these symptoms have been unsuccessful. To understand the emotional experiences of family members of critically ill patients and to identify coping strategies used by family members during the ICU stay. and Methods: As part of a mixed methods study to understand sources of distress among ICU family members, semistructured interviews were conducted with ICU family members. Family members completed surveys at the time of interview and at 90 days to assess for symptoms of depression, anxiety, and posttraumatic stress. Semistructured interviews and baseline surveys were conducted with 40 ICU family members; 78% of participants (n = 31) completed follow-up surveys at 90 days. At the time of interview, 65% of family members had symptoms of depression, anxiety, or posttraumatic stress. At 90 days, 48% of surveyed family members had symptoms of psychological distress. Three primary emotions were identified among ICU family members: sadness, anger, and fear. A diverse array of coping strategies was used by family members, including problem-solving, information seeking, avoidance/escape, self-reliance, support seeking, and accommodation. This study emphasizes similarities in emotions but diversity in coping strategies used by family members in the ICU. Understanding the relationship between ICU experiences, emotional responses, and long-term psychological outcomes may guide targeted interventions to improve mental health outcomes of ICU family members. Copyright © 2020 American College of Chest Physicians. All rights reserved.

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