Impact of a prolonged surgical critical illness on patients' families.
BACKGROUND
Long-term effects on patients' families after a prolonged stay in a surgical intensive care unit are unclear. We hypothesized that illnesses requiring more than 7 days' stay in the surgical intensive care unit would have significant, long-lasting effects on patients' families that would be related to patients' functional outcome.


METHODS
All patients who stayed in the general surgery intensive care unit 7 days or more between July 1, 1996, and June 30, 1997, were enrolled. A total of 128 patients met the entry criteria, and families of surviving patients were interviewed at baseline and 1, 3, 6, and 12 months later. Maximum dysfunction/impact was compared with patients' functional outcome.


RESULTS
Significant disturbances in the families' lives occurred throughout the 12 months of this study. Almost 60% of responding families provided a moderate or large amount of caregiving between 1 and 9 months after a prolonged illness, 44.9% had to quit work after 1 month, and more than 36.7% of families had lost savings after 1 year. Some families moved to a less expensive home, delayed educational plans, or delayed medical care for another family member.


CONCLUSIONS
An acute surgical illness that results in a prolonged stay in an intensive care unit has a substantial effect on patients' families that is maximal between 1 and 3 months and parallels the patient's functional outcome. Systems that provide support to both patients and their families should be emphasized in the hospital and after discharge.
Swoboda
Sandra M
SM
School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Lipsett
Pamela A
PA
D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D017281:Cost of Illness; D016638:Critical Illness / Q000191:economics* / Q000523:psychology*; D005260:Female; D006701:Home Nursing / Q000191:economics* / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D013514:Surgical Procedures, Operative; D013997:Time Factors; D014481:United States