Prevalence and outcomes of caregiving after prolonged (> or =48 hours) mechanical ventilation in the ICU.
OBJECTIVE
(1) To estimate caregiver support required by patients 2 months after prolonged (at least 48 h) mechanical ventilation (MV) in an ICU; (2) to describe caregiver burden, caregiver depressive symptomatology, and caregiver limitations in activities; and (3) to investigate factors related to depressive symptoms at 2 months in caregivers.


METHODS
Prospective cohort study.


METHODS
Caregivers of 115 patients who received prolonged MV in an ICU.


METHODS
Sociodemographics, employment status, hours spent providing care, help from paid caregiving sources, caregiver burden, and caregiver depressive symptoms.


RESULTS
The proportion of patients who survived at least 2 months and required caregiver support was 74.8%. The average age of caregivers was 52.9 years (SD, 14.2), 76.5% were women, and more than half were spouses (52.2%). Only 33 of the caregivers (28.7%) were working, and 30.3% had to reduce their time spent at work to provide care to the patient. The prevalence of risk of clinical depression (defined as Center for Epidemiological Studies depression scale [CES-D] score > or =16) among caregivers was 33.9%. The mean caregiver CES-D score was 13.2 (SD, 11; median, 10). Multiple linear regression analysis showed that higher CES-D score was associated with more hours per day helping with patients' activities of daily living and instrumental activities of daily living (p = 0.003).


CONCLUSIONS
Two months after being placed on MV for at least 48 h, a high proportion of patients need caregiver support. Approximately 34% of caregivers are at risk of clinical depression. Many caregivers report lifestyle changes and burden when providing care for the patients.
Im
KyungAh
K
Epidemiology Data Center, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 Desoto Street, 127 Parran Hall, Pittsburgh, PA 15261, USA. im@edu.pitt.edu
Belle
Steven H
SH
Schulz
Richard
R
Mendelsohn
Aaron B
AB
Chelluri
Lakshmipathi
L
D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D003266:Continuity of Patient Care; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy; D018570:Risk Assessment; D013315:Stress, Psychological; D013997:Time Factors