Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. A prospective multicenter study
Humans; Intensive Care Units; Patient Discharge; Adult; Prevalence; Prospective Studies; Aged; Middle Aged; Death; Age Factors; Severity of Illness Index; Risk Factors; Family/psychology; ICU Decision Making; Depression/epidemiology/psychology; Anxiety/epidemiology/psychology
STUDY OBJECTIVES: More than two thirds of family members visiting intensive care unit (ICU) patients have symptoms of anxiety or depression during the first days of hospitalization. Identifying determinants of these symptoms would help caregivers support families at patient discharge or when death is imminent. DESIGN AND SETTING: Prospective multicenter study including 78 ICUs (1184 beds) in France. PARTICIPANTS: Family members completed the Hospital Anxiety and Depression Scale on the day of patient discharge or death to allow evaluation of the prevalence and potential factors associated with symptoms of anxiety and depression. RESULTS: Three hundred fifty-seven patients were included in the study, and 544 family members completed the Hospital Anxiety and Depression Scale. Symptoms of anxiety and depression were found in 73.4% and 35.3% of family members, respectively; 75.5% of family members and 82.7% of spouses had symptoms of anxiety or depression (P = .007). Symptoms of depression were more prevalent in family members of nonsurvivors (48.2%) than of survivors (32.7%) (P = .008). The multivariate model identified 3 groups of factors associated with symptoms: (1) patient-related: severity as assessed by the Simplified Acute Physiology Score II (odds ratio [OR] 1.017 per point) and patient age (OR 0.984 per year) predicted anxiety, and Simplified Acute Physiology Score II (OR, 1.015 per point), patient death (OR 2.092), and patient age (OR 0.981) predicted depression; (2) family-related: the spouse predicted anxiety (OR 2.085); and (3) ICU-related: a room with more than 1 bed (OR 1.539) predicted depression. CONCLUSION: The prevalence of symptoms of anxiety and depression remains high at the end of the ICU stay, whether the patient is well enough to be discharged or is near death.
2005
Pochard F; Darmon M; Fassier T; Bollaert PE; Cheval C; Coloigner M; Merouani A; Moulront S; Pigne E; Pingat J; Zahar JR; Schlemmer B; Azoulay E; French FAMIREA study group
Journal Of Critical Care
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.jcrc.2004.11.004" target="_blank" rel="noreferrer">10.1016/j.jcrc.2004.11.004</a>
Half the family members of intensive care unit patients do not want to share in the decision-making process: a study in 78 French intensive care units
Female; Humans; Male; Intensive Care Units; Adult; Attitude to Health; Attitude of Health Personnel; Logistic Models; Prospective Studies; Aged; Middle Aged; Multivariate Analysis; Consumer Satisfaction; Depression; Anxiety; decision making; Family/psychology; ICU Decision Making; France
OBJECTIVE: To evaluate the opinions of intensive care unit staff and family members about family participation in decisions about patients in intensive care units in France, a country where the approach of physicians to patients and families has been described as paternalistic. DESIGN: Prospective multiple-center survey of intensive care unit staff and family members. SETTING: Seventy-eight intensive care units in university-affiliated hospitals in France. PATIENTS: We studied 357 consecutive patients hospitalized in the 78 intensive care units and included in the study starting on May 1, 2001, with five patients included per intensive care unit. INTERVENTIONS: We recorded opinions and experience about family participation in medical decision making. Comprehension, satisfaction, and Hospital Anxiety and Depression Scale scores were determined in family members. MEASUREMENTS AND MAIN RESULTS: Poor comprehension was noted in 35% of family members. Satisfaction was good but anxiety was noted in 73% and depression in 35% of family members. Among intensive care unit staff members, 91% of physicians and 83% of nonphysicians believed that participation in decision making should be offered to families; however, only 39% had actually involved family members in decisions. A desire to share in decision making was expressed by only 47% of family members. Only 15% of family members actually shared in decision making. Effectiveness of information influenced this desire. CONCLUSION: Intensive care unit staff should seek to determine how much autonomy families want. Staff members must strive to identify practical and psychological obstacles that may limit their ability to promote autonomy. Finally, they must develop interventions and attitudes capable of empowering families.
2004
Azoulay E; Pochard F; Chevret S; Adrie C; Annane D; Bleichner G; Bornstain C; Bouffard Y; Cohen Y; Feissel M; Goldgran-Toledano D; Guitton C; Hayon J; Iglesias E; Joly LM; Jourdain M; Laplace C; Lebert C; Pingat J; Poisson C; Renault A; Sanchez O; Selcer D; Timsit JF; LeGall JR; Schlemmer B; FAMIREA Study Group
Critical Care Medicine
2004
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/01.ccm.0000139693.88931.59" target="_blank" rel="noreferrer">10.1097/01.ccm.0000139693.88931.59</a>