Risk of Post-Traumatic Stress Symptoms in Family Members of Intensive Care Unit Patients

Service de Réanimation Médicale, Hôpital Saint-Louis, Paris, France.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 11.99). 06/2005; 171(9):987-94. DOI: 10.1164/rccm.200409-1295OC
Source: PubMed

ABSTRACT Intensive care unit (ICU) admission of a relative is a stressful event that may cause symptoms of post-traumatic stress disorder (PTSD).
Factors associated with these symptoms need to be identified.
For patients admitted to 21 ICUs between March and November 2003, we studied the family member with the main potential decision-making role.
Ninety days after ICU discharge or death, family members completed the Impact of Event Scale (which evaluates the severity of post-traumatic stress reactions), Hospital Anxiety and Depression Scale, and 36-item Short-Form General Health Survey during a telephone interview. Linear regression was used to identify factors associated with the risk of post-traumatic stress symptoms.
Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life.
Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions. Research is needed to investigate PTSD rates and to devise preventive and early-detection strategies.

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Available from: Michel Kaidomar, Aug 25, 2015
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    • "La confrontation ré guliè re a ` la mort, aux dé cisions de limitations thé rapeutiques, mais aussi a ` la souffrance des patients et a ` celle de leur famille interroge sur les capacité s d'adaptation des soignants de ré animation face a ` ces multiples sources de stress et a ` leur impact e ´ motionnel. Peu de recherches ont abordé l'impact psychologique spé cifique du travail en ré animation sur les soignants et les rares e ´ tudes mené es en service de ré animation ont plutô t mis l'accent sur les consé quences psychologiques d'un sé jour en ré animation sur les patients ou sur les familles avec l'importance des e ´ vé nements iatrogè nes [3] [4] et des complications psychiatriques pouvant survenir aprè s une hospitalisation en ré animation [5] [6]. Des e ´ tudes ont, toutefois, mis l'accent sur l'e ´ puisement professionnel des soignants de ré animation ; Embriaco et al. [7] montrent que les mé decins de ré animation sont particuliè rement exposé s au stress du fait des nombreuses confrontations a ` la mort des patients et aux dé cisions de fin de vie. "
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