CITATION
Warren, A. M., Rainey, E. E., Weddle, R. J., Bennett, M., Roden-Foreman, K., & Foreman, M. L. (2016). The intensive care unit experience: Psychological impact on family members of patients with and without traumatic brain injury. Rehabilitation Psychology, 61(2), 179-185. http://dx.doi.org/10.1037/rep0000080
SUMMARY
While in the hospital, the ICU experience can be one of stress and emotional turmoil for both the patient and their family members. During this time of confusion and tribulation, family members must concurrently cope with their experience of the event, while also attending to others (e.g., children, relatives, friends, and coworkers), work, household responsibilities, amongst other demands. Thus, the purpose of the present study was twofold: 1) To examine the differences in psychological symptoms endorsed by family members with patients in the ICU at the time of hospitalization and 3 months later, and 2) to evaluate the differences between said families, dependent up the patients reason for hospital admission; whether due to traumatic brain injury (TBI) or illness other than TBI. The sample of family members (n = 82) was comprised of primarily parents, spouses, and children. Forty were family members of patients that sustained a TBI, and 42 were family members of non-TBI patients. The Patient Health Questionnaire 8-Item (PHQ-8) was used to measure depression, and the Primary Care PTSD Screen (PC-PTSD) measured symptoms of posttraumatic stress (PTS). At baseline, 39% of the total sample screened positive for depressive symptoms, dropping to 20% at the 3-month follow up. The authors analyzed the change in depressive symptoms from baseline to 3 months within the two groups and found a statistically significant decrease of symptoms in the non-TBI group, with an insignificant change in the TBI group. In regards to PTS symptoms, 24.3% of the total sample screened positive at baseline, while 17% screened positive at the 3-month follow-up. Upon analyzing the change in PTS symptoms from baseline to 3 months within the two groups, again, there was a statistically significant decrease of symptoms endorsed by non-TBI group, with an insignificant change in the TBI group. The authors conclude that psychological distress is more likely to continue for TBI families than non-TBI families between the ICU and 3 months later. This study highlights the importance of early psychological intervention in aim to decrease the initial depressive and PTS symptoms experienced by family members in the ICU.
Table 1. Symptomology Endorsed: Group Differences at Baseline and 3-Month Follow-Up.
| Baseline | 3-Month Follow-Up | |
|---|---|---|
| TBI Family Members | 45% Depressed, 23% PTS | 28% Depressed, 25% PTS |
| Non-TBI Family Members | 12% Depressed, 10% PTS | 33% Depressed, 26% PTS |
I CHOOSE THIS ARTICLE because it calls attention to the importance of psychological intervention and support for the family members of patients as early as possible. Additionally, the findings of this article assert the necessity of rehabilitation psychologists’ involvement in the multidisciplinary team at the patient’s entrance into the hospital. Lastly, I think this article calls for the development of more effective interventions for family members of TBI patients.
THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was chosen by Lucas D. Driskell,
MS, Nova Southeastern University, College of Psychology; Member of Div. 22 Science Committee