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Volume 17 Supplement 4

Sepsis 2013

Open Access

Does the ICU experience predict psychological symptoms in relatives of patients with severe sepsis and end-of-life decisions?

  • Christiane Hartog1, 2,
  • Daniel Schwarzkopf2,
  • Helga Skupin1,
  • Björn Kabisch1,
  • Ruediger Pfeifer3,
  • Albrecht Guenther4 and
  • Konrad Reinhart1, 2
Critical Care201317(Suppl 4):P60

https://doi.org/10.1186/cc12959

Published: 5 November 2013

Keywords

Medical CareMultiple Linear RegressionSevere SepsisLinear Regression ModelEvent Scale

Background

Severe sepsis is the main cause of death in the ICU. Relatives are at risk for post-traumatic stress disorder (PTSD) or anxiety and depression [1]. The objective is to assess whether the ICU experience may predict these psychological symptoms of relatives at 90 days after the patient's death or discharge.

Materials and methods

Prospective observational study in four ICUs of one university hospital, including all patients with severe sepsis and end-of-life-decisions. At 90 days, the main relative was interviewed with the Impact of Event Scale (to measure PTSD), the Hospital Anxiety and Depression Scale and self-developed items on satisfaction with the ICU experience, including medical care and communication in general as well as specifically in the end-of-life context, and decision-making. Three multiple linear regression models were calculated to predict anxiety, depression and post-traumatic stress each.

Results

Eighty-four relatives were included. They were mostly female (74%), spouse (42%) or child (42%), median age was 57 years. Seventy-seven percent acted as proxies. After 90 days, 51% relatives were at risk for PTSD, 48% for anxiety and 33% for depression. Overall satisfaction with the ICU experience was high. Relatives' satisfaction with medical care and communication in general predicted lower anxiety (P = 0.025).

Conclusions

Relatives of patients with sepsis have a high psychological burden. Improving communication between ICU staff and relatives may reduce their symptoms of anxiety.

Declarations

Acknowledgements

Funded partly by the German Ministry of Education and Research (grant number 01 E0 1002). This investigation was part of a study to improve quality of end-of-life care in the ICU (trial registration NCT01247792).

Authors’ Affiliations

(1)
Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
(2)
Center for Sepsis Control & Care, Jena University Hospital, Jena, Germany
(3)
Department of Internal Medicine I, Jena University Hospital, Jena, Germany
(4)
Department of Neurology, Jena University Hospital, Jena, Germany

References

  1. Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B: Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med 2005, 171: 987-994. 10.1164/rccm.200409-1295OCView ArticlePubMedGoogle Scholar

Copyright

© Hartog et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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