Objectives: 

To determine the effect of daily written updates on the satisfaction and psychologic symptoms of families of ICU patients.

Design: 

Randomized controlled trial.

Setting: 

Single, urban academic medical center.

Subjects: 

Surrogates of nondecisional, critically ill adults with high risk of mortality (n = 252) enrolled from June 2019 to January 2021.

Interventions: 

Usual communication with the medical team with or without written communication detailing the suspected cause and management approach of each ICU problem, updated each day.

Measurements and Main Results: 

Participants completed surveys at three time points during the ICU stay: enrollment (n = 252), 1 week (n = 229), and 2 weeks (n = 109) after enrollment. Satisfaction with care was measured using the Critical Care Family Needs Inventory (CCFNI). The presence of anxiety, depression, and acute stress were assessed using the Hospital Anxiety and Depression Scale (HADS) and Impact of Events Scale Revised (IES-R). CCFNI, HADS, and IES-R scores were similar among participants assigned to the intervention group and control group upon enrollment and during the first week after enrollment (p > 0.05). From enrollment to the second week after enrollment, there was an improvement in CCFNI and HADS scores among participants assigned to the intervention group versus the control group. At week 2, CCFNI scores were significantly lower among participants in the intervention group versus the control group, indicating greater satisfaction with care: 15.1 (95% CI, 14.2–16.0) versus 16.4, (95% CI, 15.5–17.3); p = 0.04. In addition, 2 weeks after enrollment, the odds of symptoms of anxiety, depression, and acute stress among participants assigned to the intervention versus control group were 0.16 (95% CI, 0.03–0.82; p = 0.03); 0.15 (95% CI, 0.01–1.87; p = 0.14); and 0.27 (95% CI, 0.06–1.27; p = 0.10), respectively.

Conclusions: 

Written communication improved satisfaction and the emotional well-being of families of critically ill patients, supporting its use as a supplement to traditional communication approaches.

中文翻译：

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危重患者家庭日常书面护理总结：一项随机对照试验

目标： 

确定每日书面更新对 ICU 患者家属满意度和心理症状的影响。

设计： 

随机对照试验。

环境： 

单一的城市学术医疗中心。

主题： 

从 2019 年 6 月至 2021 年 1 月招募的非决定性、高死亡率危重成人 ( n = 252) 的代理人。

干预： 

与医疗团队的日常沟通，有或没有书面沟通，详细说明每个 ICU 问题的可疑原因和管理方法，每天更新。

测量和主要结果： 

参与者在入住 ICU 期间的三个时间点完成了调查：入组 ( n = 252)、入组后 1 周 ( n = 229) 和 2 周 ( n = 109)。使用重症监护家庭需求量表 (CCFNI) 衡量对护理的满意度。使用医院焦虑和抑郁量表 (HADS) 和修订的事件影响量表 (IES-R) 评估焦虑、抑郁和急性压力的存在。入组时和入组后第一周分配到干预组和对照组的参与者的 CCFNI、HADS 和 IES-R 评分相似（p> 0.05)。从入组到入组后的第二周，与对照组相比，分配到干预组的参与者的 CCFNI 和 HADS 评分有所改善。在第 2 周，干预组参与者的 CCFNI 评分显着低于对照组，表明对护理的满意度更高：15.1（95% CI，14.2-16.0）对 16.4（95% CI，15.5-17.3）；p = 0.04。此外，入组后 2 周，干预组与对照组的参与者出现焦虑、抑郁和急性压力症状的几率为 0.16（95% CI，0.03-0.82；p = 0.03）；0.15（95% CI，0.01–1.87；p = 0.14）；和 0.27 (95% CI, 0.06–1.27; p = 0.10)。

结论： 

书面沟通提高了重症患者家属的满意度和情绪健康，支持将其用作传统沟通方式的补充。