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

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 90days 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 90days. 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.