The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours

Abstract

OBJECTIVES: To identify the psychologic impact of admission to the ICU on the relatives of critically ill patients, the influence of coping, and the factors involved. DESIGN: We performed a cohort study with repeated measures evaluation using descriptive and comparative bivariate and multivariate analyses. SETTINGS: An adult ICU of a third-level complexity hospital. PATIENTS: The family members of patients (maximum of three per patient) staying longer than 3 days. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Psychologic impact was assessed using two subgroups of psychologic distress: anxiety (by the State-Trait Anxiety Inventory) and depression (by the Beck Depression Inventory). Satisfaction and coping were assessed by the Critical Care Family Needs Inventory and the Brief Coping Orientations to Problems Experienced Inventory, respectively. We included 104 family members; psychologic distress was high at admission (72% had anxiety, 45% had depression, and 42% had both) but decreased at discharge (34% had anxiety, 23% had depression, and 21% had both). The risk factors related to psychologic impact were severity (anxiety: Acute Physiology and Chronic Health Evaluation score ≥ 18 points: relative risk [RR], 2; 95% CI, 1–4; p = 0.03), invasive mechanical ventilation (anxiety: RR, 1.9; 95% CI, 1–3.6; p = 0.04), recent psychotropic medication use by relatives (depression: RR, 1.6; 95% CI, 1–2.9; p = 0.05), a restrictive visiting policy (anxiety: RR, 5.7; 95% CI, 2–10.4; p = 0.002), no emotion-focused coping strategy (anxiety: strategy < 11 points, RR, 6.1; 95% CI, 1.2–52; p = 0.01), and functional impairment (depression: Barthel index ≤ 60 points, RR, 7.4; 95% CI, 1.7–26.3; p = 0.01). CONCLUSIONS: The psychologic impact from admission to the ICU on family members is high. Visiting hours is the main modifiable factor to reduce the impact.

Indoor CO2 monitoring in a surgical intensive care unit under visitation restrictions during the COVID-19 pandemic

“…Thus, suspension of ICU visitation as a routine measure to improve IAQ may not be feasible. In addition, given the spatial variations and wide variability in ICU visitation policies in different hospitals (44,45), introducing an efficient IAQ surveillance program using a technologically mature, cost-effective real-time CO 2 detection system appears more practical. Real-time CO 2 levels represent the interactions between the efficacy of the air-conditioning system and the dynamics of occupancy number and other possible sources.…”

An Exploration of the Supportive Care Needs of Caribbean Families of Critically Ill Adults

“…The critical care setting has an influence on the well-being of both patients and families (Verderber et al, 2021). For example, the trauma of a critical care admission can provoke psychological distress (Iglesias et al, 2022), which, in turn, can leave family members feeling particularly vulnerable and helpless. This phenomenon may be marked by an increased desire of family members to be close to their loved one during this time (Imanipour et al, 2019).…”

The Needs of Critical Care Unit Patient's Family Members in East Cost Malaysia: A Cross-Sectional Study

“…Although family members must deal with a loved one's critical illness, they must also adjust to the unfamiliar and daunting Intensive Care Unit (ICU) environment (Dijkstra et al, 2023). Significant distress among CCU family members is caused by the indeterminacy of CCU patients' state and prognosis, invasive mechanical ventilation, restrictive visiting policies, medication use by relatives, and maladaptive behavior of family members (Rückholdt et al, 2019;Iglesias et al, 2022). Family members suffer from psychological imbalance; they have moderate to high stress levels (Barth et al, 2016) and are exposed to the risk of anxiety, depression, and posttraumatic stress disorder (PTSD) (Abdul Halain et al, 2022;Iglesias et al, 2022).…”

“…Significant distress among CCU family members is caused by the indeterminacy of CCU patients' state and prognosis, invasive mechanical ventilation, restrictive visiting policies, medication use by relatives, and maladaptive behavior of family members (Rückholdt et al, 2019;Iglesias et al, 2022). Family members suffer from psychological imbalance; they have moderate to high stress levels (Barth et al, 2016) and are exposed to the risk of anxiety, depression, and posttraumatic stress disorder (PTSD) (Abdul Halain et al, 2022;Iglesias et al, 2022). These psychological challenges are significantly more frequent when the relative is a spouse or bereaved family member (Alsharari, 2019).…”