IntroductionFamily members of critically ill patients often experience increased incidence of physical and mental health issues. One of the first ways family members suffer is by losing sleep. The purpose of this study is to understand sleep quality, levels of fatigue and anxiety, and factors contributing to poor sleep in adult family members of critically ill patients.MethodsA questionnaire was designed to evaluate sleep, fatigue and anxiety during the intensive care unit (ICU) admission. We incorporated three validated instruments: General Sleep Disturbance Scale (GSDS), Beck Anxiety Index (BAI) and Lee Fatigue Scale (NRS-F). Adult family members of patients in ICU for more than 24 hours were approached for questionnaire completion. Patient demographics were recorded.ResultsThe study population consisted of 94 respondents, (49.1 ± 12.9 years, 52.7% male); 43.6% were children and 21.3% were spouses of ICU patients. Sleep quality was rated as poor/very poor by 43.5% of respondents, and good/very good by 15.2%. The most common factors contributing to poor sleep were anxiety (43.6%), tension (28.7%) and fear (24.5%). Respondents' most common suggestions to improve sleep were more information regarding the patient's health (24.5%) and relaxation techniques (21.3%). Mean GSDS score was 38.2 ± 19.3, with 58.1% of respondents experiencing moderate to severe sleep disturbance. Mean BAI was 12.3 ± 10.2, with 20.7% of respondents experiencing moderate to severe anxiety. Mean NRS-F was 3.8 ± 2.5, with 57.6% of respondents experiencing moderate to high fatigue. Family members who spent one or more nights in the hospital had significantly higher GSDS, BAI and NRS-F scores. The patient's Acute Physiology and Chronic Health Evaluation (APACHE) II score at survey completion correlated significantly with family members' GSDS, BAI and NRS-F.ConclusionThe majority of family members of ICU patients experience moderate to severe sleep disturbance and fatigue, and mild anxiety.

Aim To describe the characteristics of consecutive attenders al a specialist clinic for vulval skin diseases and to detennine their medical, psychological and social outcome.Subjects Consecutive attenders at a specialist dermatology clinic. Measures Systematic recording of medical data, standard psychometric assessment and semi-structured interview.Results Patients generally described their symptoms as distressing and disabling and were very considerable u.sers of medical care, with which they were mainly dissatisfied. At follow up a sub.stantial proportion of patients reported improvement in their physical and psychological symptoms and there was general satisfaction with having attended a clinic with special and sympathetic interest.Conclusions Assessment and treatment by a sympathetic doctor with a special interest in vulval diseases was found to be helpful by most subjects whatever the physical outcome. Satisfaction was in contrast to their long histories of symptoms and generally unsatisfactory consultation with doctors. © 1997 Elsevier Science B.V.

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Family members wish to be present for ICU procedures, and there are no adverse psychological effects.