Postintensive care syndrome-family in Intensive Care Units: “What is it in the name?” A Scoping Definitive Review

Abstract

Aim: In this review, we sought to succinctly review what Postintensive care syndrome is, it's risk factors, consequences, assessment, diagnosis, prevention and treatment among family members of intensive care patients. Background:The proportion of family members caring for a patient in intensive care units is expected to proportionally increase with increase in utilization of intensive care units due to various reasons. Subsequently, unfavorable physical, psychosocial responses due to exposure to complications following admission of a family member in intensive care due to critical illness will consequently increase among family members. These unfavorable family responses to critical illness have been termed "Postintensive care syndrome-family (PICS-F)." Postintensive care syndrome-family encompasses: anxiety, acute stress disorder, post-traumatic stress, depression and complicated grief. Healthcare providers as well as family members need to be knowledgeable on the extent, diagnosis, prevention and outcomes of these sequelae. Relationship to the patient, younger patients, prior experience of ICU, low economic status, length of ICU stay, unmet self-care, communication needs and distance from the hospital seem to predispose family members to PICS-F. Longer distance from hospital and higher resilience seem to protect family members from PICS-F. Prevention of PICS-F includes: effective family-ICU staff communication, enhancing resilience and coping, post discharge planning and follow-up interventions. Conclusion:results highlight the importance of acknowledging experiences of family members having a patient admitted in intensive care unit. Healthcare professionals need to have insights into this phenomenon and optimally intervene to prevent these physiological and psychosocial sequelae.

Stress, anxiety, depression and basic hope in family members of patients hospitalised in intensive care units – preliminary report

“…During the stay of a close relative in the ICU, nearly 90% of relatives reported a very high level of stress and about 38% and 33% experienced high levels of anxiety and depression, respectively. This is consistent with numerous international studies, which estimated a high level of stress in family members of patients treated in the ICU from 40% to 55% [ 2 – 7 , 18 ], anxiety from 30% to 80%, and depression from 30 to 94% [ 2 – 7 , 19 , 20 ]. Such strong reactions might increase the risk of disorders defined as ACD and PTSD.…”

Evaluating the Feasibility and Efficacy of a Pediatric Intensive Care Unit Diary

“…In addition, PICS not only affects ICU survivors but also amplifies the burden for their families. Family members face challenging changes as they are trying to navigate the responsibilities of balancing their personal needs and providing a continuum of care for the patients 10,11. Parents provide support for the patient during hospitalization and rehabilitation but may suffer from fatigue as well as symptoms of anxiety, depression, PTSD, and complicated grief 7,10,12,13.…”

“…Family members face challenging changes as they are trying to navigate the responsibilities of balancing their personal needs and providing a continuum of care for the patients 10,11. Parents provide support for the patient during hospitalization and rehabilitation but may suffer from fatigue as well as symptoms of anxiety, depression, PTSD, and complicated grief 7,10,12,13. Thus, the definition of PICS has been broadened to include family members, which is termed as PICS-Family (PICS-F) 7.…”

“…10,11 Parents provide support for the patient during hospitalization and rehabilitation but may suffer from fatigue as well as symptoms of anxiety, depression, PTSD, and complicated grief. 7,10,12,13 Thus, the definition of PICS has been broadened to include family members, which is termed as PICS-Family (PICS-F). 7 More than one-third of family members or caregivers experience signs and symptoms of depression, and nearly 70% show signs and symptoms of anxiety.…”