Psychological distress, social support, and family satisfaction among family members of non‐COVID‐19 critical care patients: A cross‐sectional study

Abstract

Purpose: This study aims to explore the associations among psychological distress, perceived social support, and family satisfaction among family members of non-COVID-19 intensive care unit (ICU) patients during the COVID-19 pandemic. Design:A cross-sectional study. Methods: Family members of patients with at least 48 h in the ICU and without a COVID-19 diagnosis were screened between January and March 2021. For enrolled ICU family members, five questionnaires for perceived stress (Perceived Stress Scale), anxiety symptoms (General Anxiety Disorder-7), depressive symptoms (Patient Health Questionnaire-9), perceived social support (Medical Outcomes Study Social Support Survey), and family satisfaction (Family Satisfaction with Care in the Intensive Care Unit-24) were administered by phone either in English or Spanish language. Sociodemographic and patient clinical data were also collected. Data were analyzed using descriptive statistics, Pearson's correlations, Mann-Whitney U, and Fisher's exact tests. Findings: Of 87 eligible ICU family members, 63 were enrolled (72.4%); 27% of the sample presented with clinically significant symptoms of anxiety, 25.4% with depression, and 76.2% had a high perception of social support. ICU family members with low/fair perceived social support reported statistically significantly higher perceived stress and lower family satisfaction. Perceived stress was negatively correlated with family satisfaction. Clinically significant symptoms of anxiety and depression were not statistically associated with family satisfaction or perceived social support. Conclusions: While ICU admission-related stress may undermine family satisfaction, perceived social support may be positively associated with the way that ICU family members of non-COVID-19 patients evaluate the quality of care in the ICU. Knowing the factors that influence family satisfaction in the ICU may assist stakeholders and policy developers to improve family-centered care in the hospital setting. Clinical Relevance: Early screening for psychological distress and social support levels during admission should be included in updates of visiting and communication policies in the ICU. Prompt identification of family members at risk of a poor ICU experience may enhance efforts to support them, particularly in acute care settings where

Family satisfaction with intensive care unit communication during the COVID‐19 pandemic: a prospective multicentre Australian study Family Satisfaction – COVID ICU

“…Our findings were comparable to a recent single‐centre study of 63 family members of non–COVID‐19 critically ill patients, who had a mean FS‐ICU/total of 70.5 (SD, 18.6). 27 In contrast, a recent study from Portugal found an overall family satisfaction of more than 80% during the pandemic. 24 This study was, however, different from our study.…”

“… 27 Moreover, instrumental social support activities, such as childcare or assistance with daily chores, may have been limited because of social isolation caused by the stage 4 restrictions across Melbourne. 27 Full personal protective equipment donned by HCWs could have masked verbal and nonverbal cues, contributing to lower family satisfaction. 7 , 28 The lack of HCW support due to time constraints 8 could have resulted in insufficient opportunities for families to raise their concerns and/or acquire satisfactory answers.…”

“…Mean FS‐ICU/dm scores were lower than the mean FS‐IC/care score observed in previous studies. 12 , 22 , 27 This might be attributable to the time constraints experienced while using virtual communication, unlike face‐to‐face meetings. Families felt that they were not included as much as they should have been in the decision‐making process pertaining to management goals during such critical times when they were under tremendous emotional stress.…”

“… 24 , 27 In addition, survey responses are difficult to predict and beyond our control despite adequate reminders. We hypothesize the following reasons for the poor response rate: (i) stress of having a loved one in the ICU; (ii) stage 4 lockdown in Melbourne meant that people could only travel up to 5 km and those with post offices further away may not have been able to post the completed paper‐based surveys; (iii) much older NOK may not have been tech‐savvy to complete the online survey and (iv) social isolation could have left ICU family members without much social support with less time to obtain regular updates of their loved ones 27 or respond to the survey. This limits our interpretation of findings; however, we can only speculate whether higher response rates improved family satisfaction.…”

Association between psychosocial factors and satisfaction with communication in family members of intensive care unit patients during COVID-19 pandemic: An exploratory cross-sectional study

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