Psychological crisis intervention for the family members of patients in a vegetative state

Abstract

OBJECTIVES:Family members of patients in a vegetative state have relatively high rates of anxiety and distress. It is important to recognize the problems faced by this population and apply psychological interventions to help them. This exploratory study describes the psychological stress experienced by family members of patients in a vegetative state. We discuss the effectiveness of a psychological crisis intervention directed at this population and offer suggestions for future clinical work.METHODS:A total of 107 family members of patients in a vegetative state were included in the study. The intervention included four steps: acquisition of facts about each family, sharing their first thoughts concerning the event, assessment of their emotional reactions and developing their coping abilities. The Symptom Check List-90 was used to evaluate the psychological distress of the participants at baseline and one month after the psychological intervention. Differences between the Symptom Check List-90 scores at the baseline and follow-up evaluations were analyzed.RESULTS:All participants in the study had significantly higher Symptom Check List-90 factor scores than the national norms at baseline. There were no significant differences between the intervention group and the control group at baseline. Most of the Symptom Check List-90 factor scores at the one-month follow-up evaluation were significantly lower than those at baseline for both groups; however, the intervention group improved significantly more than the control group on most subscales, including somatization, obsessive-compulsive behavior, depression, and anxiety.CONCLUSION:The results of this study indicate that the four-step intervention method effectively improves the mental health of the family members who received this treatment and lessens the psychological symptoms of somatization, obsessive-compulsive behavior, depression and anxiety.

Nursing interventions for adults following a mental health crisis: A systematic review guided by trauma‐informed principles

“…A brief, group psychological session for relatives of patients in a vegetative state was associated with a decrease in psychological symptoms such as somatization, obsessive–compulsive behaviour, depression, and anxiety compared to the control group who did not receive the intervention (Li & Xu ). The brief single‐session group intervention was in the format of a critical incident stress debriefing, which included participants describing what happened and their first thoughts concerning the event, discussing their emotional reactions, and receiving training to increase coping abilities (Li & Xu ). In another RCT, a teachable brief intervention for persons who attempted suicide was associated with greater patient satisfaction, improvement in motivation to address their problems, and significant improvements on reasons for living compared to the group who received usual care (O'Connor et al ).…”

“…The studies examined outcomes of patient satisfaction, readiness to change problematic behaviours, reasons for living and suicidal ideation, psychological symptoms, social role functioning, and interpersonal relationships. Components of brief intervention varied throughout the studies; however, brief crisis interventions that considered trauma‐informed principles had positive outcomes (Li & Xu ; O'Connor et al ), as opposed to brief crisis interventions that did not consider trauma‐informed principles (Van Oenen et al ). A brief, group psychological session for relatives of patients in a vegetative state was associated with a decrease in psychological symptoms such as somatization, obsessive–compulsive behaviour, depression, and anxiety compared to the control group who did not receive the intervention (Li & Xu ).…”

“…Components of brief intervention varied throughout the studies; however, brief crisis interventions that considered trauma‐informed principles had positive outcomes (Li & Xu ; O'Connor et al ), as opposed to brief crisis interventions that did not consider trauma‐informed principles (Van Oenen et al ). A brief, group psychological session for relatives of patients in a vegetative state was associated with a decrease in psychological symptoms such as somatization, obsessive–compulsive behaviour, depression, and anxiety compared to the control group who did not receive the intervention (Li & Xu ). The brief single‐session group intervention was in the format of a critical incident stress debriefing, which included participants describing what happened and their first thoughts concerning the event, discussing their emotional reactions, and receiving training to increase coping abilities (Li & Xu ).…”

“…The teachable moment brief intervention involved a functional assessment, crisis planning, and discussion of further outpatient mental health services (O'Connor et al ). Overall, the studies that examined brief interventions for crisis events utilized trauma‐informed principles of ensuring psychological safety, establishing a collaborative relationship (O'Connor et al ), and offering training to increase coping abilities (Li & Xu ; O'Connor et al ).…”

The care-givers of patients with persistent vegetative state have a terrible life: the result of a qualitative study

“…In this regard, another study in China showed that the psychological interventions reduces anxiety and enhance coping power of PVS caregivers (33). We believe the caregivers of PVS patients should be visited periodically by clinicians, and underwent some psychological and physical supports in the hospitals.…”