title: Emotional distress, coping and adjustment in family members of neuroscience intensive care unit patients.
abstract: OBJECTIVE
  We evaluated emotional distress, coping strategy use, caregiver adjustment, and the relationship among these variables in family members (FMs) of patients hospitalized in a neuroscience intensive care unit (NSICU).
  
  
  METHODS
  Fifty-one primary relatives of NSICU patients were administered the Brief Symptom Inventory (BSI) and an abbreviated version of the COPE within 2 days of admission to the NSICU, just prior to patient discharge from the unit, and approximately 30 days after patient discharge (follow-up). FMs' adjustment to the role of caregiver was also evaluated at follow-up with the Caregiver Appraisal Scale (CAS).
  
  
  RESULTS
  BSI emotional distress levels were higher than those of the nonpatient normative sample at patient admission, but, except for anxiety, were within a standard deviation of the mean of the said group; with the exception of anxiety they declined to below nonpatient normative levels at follow-up. Females' distress levels were higher than those of males'. FMs' use of both problem-focused and emotion-focused coping strategies increased from admission through follow-up. Emotional distress was unrelated to problem-focused coping but was associated with emotion-focused coping at admission and discharge, with use of denial as a coping strategy primarily accounting for this relationship. Extent of use of both problem-focused and emotion-focused coping at admission was associated with better caregiver adjustment at follow-up, but over time only increases in problem-focused coping were associated with better subsequent caregiver adjustment.
  
  
  CONCLUSIONS
  Findings suggest that interventions fostering increased use of problem-focused coping and sense of control will be effective in lowering FM distress level and enhancing subsequent adjustment in the role of caregiver.
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284-2018, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Wartella
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Auerbach
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Ward
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009488:Neurosciences / Q000379:methods*; D011795:Surveys and Questionnaires; D055815:Young Adult