Relatives' perception of stressors and psychological outcomes – Results from a survey study

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Purpose:To identify relevant stressors or resources of relatives of critically ill patients and explore their relationship with psychological outcomes.Materials and methods:Prospective mixed-method study performed in 4 multidisciplinary ICUs of an urban academic hospital. Main relatives of consecutive patients with severe sepsis were questioned after 90 days by structured interview. Quantitative data included demographic characteristics, ICU experience, Impact-of-Event Scale (posttraumatic stress) and Hospital Anxiety and Depression Scale (HADS); answers to open questions about stressors and resources were transcribed verbatim and analyzed by thematic analysis.Results:143/205 (70%) relatives participated. Satisfaction with communication and care was high. Experiencing a stressor predicted posttraumatic stress (p = 0.014) and anxiety (p = 0.019) after 90 days. Most common stressors were feelings of helplessness and uncertainty. The perception of being overburdened in the ICU predicted posttraumatic stress, anxiety and depression (all p ≤ 0.001); In addition, patient's death or survival with significant deterioration in quality of life compared to status before admission predicted depression (p = 0.016).Conclusions:Our study confirmed a high prevalence of PICS-F among relatives of critically ill patients. Feeling overburdened and experiencing acute stressors may be related to negative psychological outcomes. In future, vulnerable relatives might be identified by a single-item screening tool on feeling overburdened.HighlightsA high 90-day prevalence of post-intensive care symptoms among 143 relatives of critically ill patients was confirmed.Feeling overburdened and experiencing acute stressors may be potentially modifiable risk factors for PICS-F.Future studies should focus on stress and strategies to reduce stressful experiences of relatives.

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