title: Risk of post-traumatic stress symptoms in family members of intensive care unit patients.
abstract: BACKGROUND
  Intensive care unit (ICU) admission of a relative is a stressful event that may cause symptoms of post-traumatic stress disorder (PTSD).
  
  
  OBJECTIVE
  Factors associated with these symptoms need to be identified.
  
  
  METHODS
  For patients admitted to 21 ICUs between March and November 2003, we studied the family member with the main potential decision-making role.
  
  
  METHODS
  Ninety days after ICU discharge or death, family members completed the Impact of Event Scale (which evaluates the severity of post-traumatic stress reactions), Hospital Anxiety and Depression Scale, and 36-item Short-Form General Health Survey during a telephone interview. Linear regression was used to identify factors associated with the risk of post-traumatic stress symptoms.
  
  
  RESULTS
  Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life.
  
  
  CONCLUSIONS
  Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions. Research is needed to investigate PTSD rates and to devise preventive and early-detection strategies.
authors.affiliation: Service de Réanimation Médicale, Hôpital Saint-Louis, Paris, France. elie.azoulay@sls.ap-hop-paris.fr
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pochard
authors.forename: Nancy
authors.initials: N
authors.lastname: Kentish-Barnes
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.forename: Jérôme
authors.initials: J
authors.lastname: Aboab
authors.forename: Christophe
authors.initials: C
authors.lastname: Adrie
authors.forename: Djilali
authors.initials: D
authors.lastname: Annane
authors.forename: Gérard
authors.initials: G
authors.lastname: Bleichner
authors.forename: Pierre Edouard
authors.initials: PE
authors.lastname: Bollaert
authors.forename: Michael
authors.initials: M
authors.lastname: Darmon
authors.forename: Thomas
authors.initials: T
authors.lastname: Fassier
authors.forename: Richard
authors.initials: R
authors.lastname: Galliot
authors.forename: Maité
authors.initials: M
authors.lastname: Garrouste-Orgeas
authors.forename: Cyril
authors.initials: C
authors.lastname: Goulenok
authors.forename: Dany
authors.initials: D
authors.lastname: Goldgran-Toledano
authors.forename: Jan
authors.initials: J
authors.lastname: Hayon
authors.forename: Mercé
authors.initials: M
authors.lastname: Jourdain
authors.forename: Michel
authors.initials: M
authors.lastname: Kaidomar
authors.forename: Christian
authors.initials: C
authors.lastname: Laplace
authors.forename: Jérôme
authors.initials: J
authors.lastname: Larché
authors.forename: Jérôme
authors.initials: J
authors.lastname: Liotier
authors.forename: Laurent
authors.initials: L
authors.lastname: Papazian
authors.forename: Catherine
authors.initials: C
authors.lastname: Poisson
authors.forename: Jean
authors.initials: J
authors.lastname: Reignier
authors.forename: Fayçal
authors.initials: F
authors.lastname: Saidi
authors.forename: Benoît
authors.initials: B
authors.lastname: Schlemmer
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003142:Communication; D016638:Critical Illness; D003657:Decision Making; D003863:Depression / Q000453:epidemiology; D005163:Factor Analysis, Statistical; D005192:Family Health; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D026706:Paternalism; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*