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Randomized Controlled Trial
. 2024 Oct;50(10):1614-1621.
doi: 10.1007/s00134-024-07577-3. Epub 2024 Aug 22.

Long-term effects of flexible visitation in the intensive care unit on family members' mental health: 12-month results from a randomized clinical trial

Jennifer Menna Barreto de Souza  1   2 , Aline Paula Miozzo  3 , Rosa da Rosa Minho Dos Santos  3 , Duane Mocellin  3 , Gabriela Soares Rech  3 , Geraldine Trott  3 , Gabriel Pozza Müller Estivalete  3 , Daniel Sganzerla  4 , Denise de Souza  3 , Regis Goulart Rosa #  3 , Cassiano Teixeira #  3   5
Affiliations
Randomized Controlled Trial

Long-term effects of flexible visitation in the intensive care unit on family members' mental health: 12-month results from a randomized clinical trial

Jennifer Menna Barreto de Souza et al. Intensive Care Med. 2024 Oct.

Abstract

Purpose: The aim of this study was to assess the effects of flexible intensive care unit (ICU) visitation on the 1-year prevalence of post-traumatic stress, anxiety and depression symptoms among family members of critically ill patients.

Methods: This is a long-term outcome analysis of a cluster-crossover randomized clinical trial that evaluated a flexible visitation model in the ICU (12 h/day) compared to a restrictive visitation model (median 1.5 h/day) in 36 Brazilian ICUs. In this analysis, family members were assessed 12 months after patient discharge from the ICU for the following outcomes: post-traumatic stress symptoms measured by the Impact Event Scale-6 and anxiety and depression symptoms measured by the Hospital Anxiety and Depression Scale.

Results: A total of 519 family members were analyzed (288 in the flexible visitation group and 231 in the restrictive visitation group). Three-hundred sixty-nine (71.1%) were women, and the mean age was 46.6 years. Compared to family members in the restrictive visitation group, family members in the flexible visitation group had a significantly lower prevalence of post-traumatic stress symptoms (21% vs. 30.5%; adjusted prevalence ratio [aPR], 0.91; 95% confidence interval [CI] 0.85-0.98; p = 0.01). The prevalence of anxiety (28.9% vs. 33.2%; aPR 0.93; 95% CI 0.72-1.21; p = 0.59) and depression symptoms (19.2% vs. 25%; aPR, 0.78; 95% CI 0.60-1.02; p = 0.07) did not differ significantly between the groups.

Conclusion: Flexible ICU visitation, compared to the restrictive visitation, was associated with a significant reduction in the 1-year prevalence of post-traumatic stress symptoms in family members.

Trial registration: ClinicalTrials.gov NCT02932358.

Keywords: Anxiety; Critical care; Depression; Family; Intensive care units; Post-traumatic stress disorder; Visitors to patients.

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References

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