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. 2021 Apr 26;3(4):e0409.
doi: 10.1097/CCE.0000000000000409. eCollection 2021 Apr.

Posttraumatic Stress Disorder Symptom Trajectories in ICU Family Caregivers

Blair Wendlandt  1 , Yi Tang Chen  2 , Feng-Chang Lin  3 , Mark Toles  4 , Bradley Gaynes  1 , Laura Hanson  1 , Shannon Carson  1
Affiliations

Posttraumatic Stress Disorder Symptom Trajectories in ICU Family Caregivers

Blair Wendlandt et al. Crit Care Explor. .

Abstract

To use latent class growth analysis to identify posttraumatic stress disorder symptom trajectories in ICU family caregivers.

Design: Prospective cohort study.

Setting: The medical ICU at a tertiary-care center in the United States.

Participants: Adult patients experiencing acute cardiorespiratory failure (defined as requiring at least one of the following: 1) vasopressors, 2) noninvasive positive pressure ventilation, 3) high-flow nasal cannula, or 4) mechanical ventilation) were enrolled in a pair with their primary family caregivers.

Measurements and main results: Participants were enrolled within the first 48 hours of ICU admission. Family caregiver posttraumatic stress disorder symptoms were measured using the Impact of Events Scale-Revised at four time points: at enrollment, shortly after ICU discharge, and at 3 and 6 months after ICU discharge. The data were examined using latent class growth analysis to identify posttraumatic stress disorder symptom trajectories. Two distinct symptom trajectories were identified: a persistently high trajectory, characterized by high posttraumatic stress disorder symptoms at initial assessment, which remained elevated over time, and a persistently low trajectory, characterized by low posttraumatic stress disorder symptoms at initial assessment, which remained low over time. Approximately two-thirds of caregivers belonged to the persistently high trajectory, and one-third of caregivers belonged to the persistently low trajectory.

Conclusions: Using latent class growth analysis to measure 6-month ICU family caregiver posttraumatic stress disorder symptom trajectories, we identified two distinct trajectories (persistently low and persistently high). A larger cohort study is warranted to further delineate posttraumatic stress disorder trajectories in this population, with the ultimate goal of targeting high-risk caregivers for interventions to reduce psychologic distress and improve long-term caregiver outcomes.

Keywords: acute cardiorespiratory failure; family caregivers; intensive care unit; latent class growth analysis; posttraumatic stress disorder.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow diagram. LOS = length of stay.
Figure 2.
Figure 2.
Group trajectory plot of family caregiver posttraumatic stress disorder symptom trajectories. IES-R = Impact of Events Scale-Revised.
See this image and copyright information in PMC

References

    1. Li L, Nelson JE, Hanson LC, et al. . How surrogate decision-makers for patients with chronic critical illness perceive and carry out their role. Crit Care Med. 2018; 46:699–704 - PMC - PubMed
    1. Matt B, Schwarzkopf D, Reinhart K, et al. . Relatives’ perception of stressors and psychological outcomes—results from a survey study. J Crit Care. 2017; 39:172–177 - PubMed
    1. Alfheim HB, Hofsø K, Småstuen MC, et al. . Post-traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study. Intensive Crit Care Nurs. 2019; 50:5–10 - PubMed
    1. Davidson JE, Aslakson RA, Long AC, et al. . Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Crit Care Med. 2017; 45:103–128 - PubMed
    1. Prescott HC, Iwashyna TJ, Blackwood B, et al. . Understanding and enhancing sepsis survivorship. Priorities for research and practice. Am J Respir Crit Care Med. 2019; 200:972–981 - PMC - PubMed