Purpose

During the coronavirus disease 2019 (COVID-19) pandemic, intensive care units (ICUs) around the world introduced virtual visiting to mediate the psychological impact of in-person visiting restrictions. Our objective was to evaluate levels of distress, depression, anxiety, and stress among family members experiencing virtual visits.

Methods

Multi-centre prospective observational study recruiting adult family members of critically ill patients in the United Kingdom (UK) using a bespoke virtual visiting solution (aTouchAway). We recruited participants and administered validated questionnaires digitally via their aTouchAway account. Prior to first virtual visit, participants completed the Distress Thermometer (score range 0–10) and the Depression, Anxiety and Stress Scale (DASS)-21. Following first and subsequent virtual visits, participants repeated the Distress Thermometer and completed the Discrete Emotions Questionnaire.

Results

We recruited 2166 adult family members of ICU patients in 37 UK hospitals. Most were grown up children (33%) or spouses/partners (23%). Most (91%) were ≤ 65 years. Mean (SD) pre-virtual-visit Distress Thermometer score was 7 (2.6) with 1349/2153 (62%) reporting severe distress. Pre-visit Distress Thermometer scores were associated with relationship type (spouse/partner OR 1.65, 95% CI 1.27–2.12) but not family member age, or length of ICU stay. Mean (SD) post-visit Distress Thermometer score provided by 762 (35%) participants was 1.6 (3.2) points lower than pre-visit (P < 0.001). Of participants experiencing multiple visits, 22% continued to report severe distress. Median (IQR) pre-visit DASS-21 score was 18 (2–42) (1754 participants). Severe-to-extremely severe depression, anxiety, or stress were reported by 249 (14%), 321 (18%), and 165 (9%) participants, respectively. Participants reported a range of emotions with reassurance being the most common, anger being the least.

Conclusion

Family members exposed to COVID-19 pandemic ICU visiting restrictions experienced severe distress. One fifth of family members reported severe-to-extremely sever anxiety or depression. Distress score magnitude and prevalence of severe distress decreased after undertaking one or more virtual visits.

中文翻译：

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COVID-19期间在重症监护室进行虚拟探视的家庭成员的心理困扰和发病率：一项观察性队列研究

目的

在 2019 年冠状病毒病 (COVID-19) 大流行期间，世界各地的重症监护病房 (ICU) 引入了虚拟探视，以缓解面对面探视限制带来的心理影响。我们的目标是评估经历虚拟探视的家庭成员的痛苦、抑郁、焦虑和压力水平。

方法

使用定制的虚拟访问解决方案 (aTouchAway) 在英国 (UK) 招募重症患者成年家庭成员的多中心前瞻性观察研究。我们招募了参与者并通过他们的 aTouchAway 帐户以数字方式管理经过验证的问卷。在第一次虚拟访问之前，参与者完成了痛苦温度计（分数范围 0–10）和抑郁、焦虑和压力量表 (DASS)-21。在第一次和随后的虚拟访问之后，参与者重复了痛苦温度计并完成了离散情绪问卷。

结果

我们在英国 37 家医院招募了 2166 名 ICU 患者的成年家庭成员。大多数是成年子女 (33%) 或配偶/伴侣 (23%)。大多数 (91%) ≤ 65 岁。平均 (SD) 虚拟访问前痛苦温度计得分为 7 (2.6)，其中 1349/2153 (62%) 报告严重痛苦。就诊前压力温度计评分与关系类型相关（配偶/伴侣 OR 1.65，95% CI 1.27–2.12），但与家庭成员年龄或 ICU 停留时间无关。762 名 (35%) 参与者提供的平均 (SD) 访问后痛苦温度计评分比访问前低 1.6 (3.2) 分（P < 0.001)。在经历多次访问的参与者中，22% 的人继续报告严重的痛苦。就诊前 DASS-21 评分中位数 (IQR) 为 18 (2–42)（1754 名参与者）。分别有 249 名 (14%)、321 名 (18%) 和 165 名 (9%) 参与者报告了严重到极度严重的抑郁、焦虑或压力。参与者报告了一系列情绪，其中安慰是最常见的，愤怒是最少的。

结论

暴露于 COVID-19 大流行 ICU 访问限制的家庭成员经历了严重的痛苦。五分之一的家庭成员报告有严重到极度严重的焦虑或抑郁。在进行一次或多次虚拟访问后，痛苦评分的严重程度和严重痛苦的发生率都会降低。