Adverse responses to critical illness, such as symptoms of depression, anxiety or posttraumatic stress, are relatively common among family members. The role of risk factors, however, remains insufficiently understood, but may be important to target those family members most in need for support. We therefore examined the association of patient-, family member- and care-related factors with post-ICU psychological distress in family members in a general population of critical ill patients. We conducted a prospective, single-centre observational study in a twelve-bed surgical ICU in a 900-bed University Hospital in Switzerland. Participants were family members of patients treated in ICU who completed the Family Satisfaction in ICU-24 Survey, the Hospital Anxiety Depression Scale, Impact of Event Scale-Revised-6, and a demographic form within the first 3 months after their close other’s ICU stay. Data were analysed using linear mixed-effects models, with depression, anxiety, and posttraumatic stress as outcome measures. A total of 214 family members (53% return rate) returned a completed questionnaire. We found that higher levels of satisfaction were significantly associated with lower levels of depression, anxiety and posttraumatic stress. There was no statistically significant association between family member characteristics and any measure of psychological distress. Among the included patient characteristics, younger patient age was associated with higher levels of depression, and patient death was associated with higher levels of depression and posttraumatic stress. Our results suggest that satisfaction with ICU care is strongly associated with family well-being post-ICU. Family members of younger patients and of those who die seem to be most at risk for psychological distress, requiring specific support, whereas family member characteristics may have less relevance.

中文翻译：

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重症患者家属ICU后心理困扰的影响因素：线性混合效应模型


对危重疾病的不良反应，例如抑郁、焦虑或创伤后应激症状，在家庭成员中相对常见。然而，风险因素的作用仍未得到充分了解，但对于针对最需要支持的家庭成员来说可能很重要。因此，我们研究了患者、家庭成员和护理相关因素与普通危重患者家庭成员的 ICU 后心理困扰之间的关系。我们在瑞士一所拥有 900 个床位的大学医院的 12 个外科 ICU 中进行了一项前瞻性、单中心观察性研究。参与者是在 ICU 接受治疗的患者的家庭成员，他们在 ICU-24 调查中完成了家庭满意度调查、医院焦虑抑郁量表、事件影响量表 - 修订版 - 6 以及其他亲密患者入住 ICU 后 3 个月内的人口统计表。使用线性混合效应模型分析数据，以抑郁、焦虑和创伤后应激作为结果测量。共有 214 名家庭成员（回收率 53%）返回了完整的调查问卷。我们发现，较高的满意度与较低的抑郁、焦虑和创伤后应激水平显着相关。家庭成员特征与任何心理困扰指标之间不存在统计学上的显着关联。在纳入的患者特征中，患者年龄较小与抑郁程度较高相关，患者死亡与抑郁和创伤后应激程度较高相关。我们的结果表明，对 ICU 护理的满意度与 ICU 后的家庭幸福感密切相关。 年轻患者和死亡患者的家庭成员似乎最有可能遭受心理困扰，需要特定的支持，而家庭成员特征的相关性可能较小。