Factors Affecting Psychological Distress in Family Caregivers of Critically Ill Patients: A Qualitative Study

Abstract

Background Family caregivers often experience psychological distress during a critical care hospitalization, potentially compromising their ability to function effectively in a supportive role. A better understanding of the sources of family caregiver distress is needed to inform strategies to mitigate its development and impact. Objective To explore sources of family caregiver psychological distress during a critical care hospitalization and how caregivers’ experiences may differ by their anxiety level. Methods Forty adult family members of patients receiving mechanical ventilation for more than 72 hours in 2 intensive care units at an academic medical center were interviewed. A qualitative directed content analysis was done. Experiences were compared by anxiety level group, defined using the Hospital Anxiety and Depression Scale: anxiety (n = 15), borderline anxiety (n = 11), and low anxiety (n=14). Results Most family members (32%) were adult children; no major demographic differences were noted across anxiety groups. Among caregivers in the anxiety group, salient factors included early unknowns around critical illness, health care team processes, care decisions made, financial and housing concerns, family dysfunction, and new responsibilities. In general, low-anxiety family caregivers did not express their concerns using language of distress but rather expressed emotion and disappointment and often took action to process their concerns. Conclusions Factors influencing family caregiver distress during the critical care stay were wide-ranging and varied by level of anxiety. The findings highlight several key areas and potential interventions to reduce psychological distress, especially among caregivers with anxiety.

Exploring the Influence of Decisionmaking Style and Financial Status of Cancer Patients on Varied Cultural Aspects of Decision Process

“…Regardless of contextual factors, the findings indicate that patient’s agency was consistently low for conditions of paternalistic decision-making, wherein doctors solely bear decision responsibilities (Davies & Parker, 2022). In a study, Blok et al (2023) interviewed 40 family caregivers of patients undergoing life-assistive treatment. They found that ‘anxious family caregivers’ expressed distress due to ‘lack of information about health care system processes’ (Blok et al, 2023, p. 25).…”

“…In a study, Blok et al (2023) interviewed 40 family caregivers of patients undergoing life-assistive treatment. They found that ‘anxious family caregivers’ expressed distress due to ‘lack of information about health care system processes’ (Blok et al, 2023, p. 25). Similarly, those in borderline anxiety group reported that ‘not understanding the reasons for the medical team’s care decisions contributed to their distress’ (Blok et al, 2023, p. 26).…”

“…They found that ‘anxious family caregivers’ expressed distress due to ‘lack of information about health care system processes’ (Blok et al, 2023, p. 25). Similarly, those in borderline anxiety group reported that ‘not understanding the reasons for the medical team’s care decisions contributed to their distress’ (Blok et al, 2023, p. 26). Such studies suggest that since shared decision-making promotes open communication (Guadalajara et al, 2022), there is an increased patients’ and family caregivers’ participation in the treatment process (Lincoln et al, 2023) and lower treatment anxiety (Blok et al, 2023).…”

“…Conversely, patients with higher socioeconomic status and greater literacy levels were more actively involved in the decision process (Datta et al, 2017;Harding et al, 2022). Such findings indicate that contextual constraints of the patients and family caregivers are fused with and inevitably shape their decision-making style (Blok et al, 2023;Datta et al, 2017;Ram Prakash & Lingam, 2021;Zafar & Peppercorn, 2023).…”

O Cuidado Emocional De Familiares E Cuidadores De Pessoas Com Câncer No Hospital

“…Essa situação leva ao desgaste devido à sobrecarga gerada pelo estresse que envolve a hospitalização, podendo acarretar diversas implicações negativas para o acompanhante, já que ele participa intensamente da vida e do sofrimento do paciente por conta da doença e tratamento. Por conta disso, o acompanhante tende a renunciar à sua individualidade, sofrendo prejuízos em seu cotidiano, podendo inclusive adoecer e ter seu julgamento e sua capacidade de cuidar afetados (Block et al, 2023;Rocha et al, 2020;Bianchin et al, 2015;Delalibera et al, 2015;Monteiro & Lang, 2015).…”