Lower perceived social support is significantly associated with elevated levels of psychological distress in racially and ethnically diverse close family members of cardiac arrest survivors

Abstract

Background: Poor perceived social support has been associated with worse psychological distress in close family members after their loved one's hospitalization with prolonged mechanical ventilation, but never been tested after cardiac arrest.

Methods: Close family members of consecutive cardiac arrest patients hospitalized at an academic tertiary care center were recruited before hospital discharge, and perceived social support was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS). Indicators of psychological distress were administered via telephone at 1 month after cardiac arrest. Multivariate linear regressions were used to estimate the associations between MSPSS total score and total Patient Health Questionnaire-8 (PHQ-8) score (primary outcome) and total PTSD (PCL-5) and generalized anxiety (GAD-2) scores, after adjusting for previously known covariates.

Results: Of 102 close family members (mean age 52 ± 15 years, 70% female, 40% non-Hispanic white, 21% Black, 33% Hispanic/Latinx, 22% with pre-existing psychiatric illness) with complete data, the mean PHQ-8 total score at a median duration of 28.5 days (interquartile range 10-63 days) from cardiac arrest was 7± 6, and the mean MSPSS score was 69 ± 15. Lower perceived social support was significantly associated with elevated levels of depressive symptoms in univariate (β=-0.11; p<0.01) and after adjusting for age, sex, race/ethnicity, and previous psychiatric history (β=-0.11; p<0.01). Similar inverse associations were seen with 1 month PTSD and generalized anxiety symptoms as secondary outcomes.

Conclusions: Close family members of cardiac arrest survivors' perception of poor social support during hospitalization is associated with increased levels of depressive symptoms at 1 month. Longitudinal studies understanding the temporal associations between social support and psychological distress are warranted.