UCSF

Symptom Experiences of Family Members of Intensive Care Unit Patients at High Risk of Dying

ABSTRACT

Objective: To describe the symptom experiences of family members of patients at high risk of dying in the intensive care unit and to assess risk factors associated with an increase in symptoms. Design: Prospective, cross-sectional, descriptive study. Setting: Three intensive care units at a tertiary medical center in the Western United States. Participants: A convenience sample of 74 family members of 74 ICU patients at high risk of dying participated in the study. Interventions: None. Measurements and Results: We assessed the results from several reliable and valid instruments of 74 family members 3-5 days after the patient's admission to the ICU. Overall the prevalence of symptoms was high, with over 56.8% of our sample having symptoms of traumatic stress, 79.7% having symptoms of anxiety and 70.3% having symptoms of depression. We also found that family members suffered from other symptoms such as tired, sadness, and poor appetite at moderate to severe levels of distress. Independent factors associated with an increase in severity of family members' symptoms included younger patient age, younger family member age, female gender of the family, and family member's race other than White. In addition, we found that the majority of the family members were coping and functioning at high levels during the ICU experience. Conclusions: Family members are important to patient care in the ICU. They are often required to participate in end of life decision making for the patient at high risk of dying. Family members in our study had high levels of psychological and physical symptoms, often at distressing levels. More support and understanding of family members' symptom experiences is needed in order to understand the long term effects of symptoms and to improve family centered care in the ICU.