title: Physical and mental health in patients and spouses after intensive care of severe sepsis: a dyadic perspective on long-term sequelae testing the Actor-Partner Interdependence Model.
abstract: OBJECTIVE
  To examine the physical and mental long-term consequences of intensive care treatment for severe sepsis in patients and their spouses under consideration of a dyadic perspective using the Actor-Partner Interdependence Model.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Patients and spouses who had requested advice from the German Sepsis Aid's National Helpline were invited to participate.
  
  
  METHODS
  We included 55 patients who survived severe sepsis and their spouses an average of 55 months after ICU discharge.
  
  
  RESULTS
  The Hospital Anxiety and Depression Scale, the Short Form-12 Health Survey, the Posttraumatic Stress Scale-10, and the Giessen Subjective Complaints List-24 were used. The Actor-Partner Interdependence Model was tested using multilevel modeling with the actor effect representing the impact of a person's posttraumatic stress symptoms on his or her own mental health-related quality of life and the partner effect characterized by the impact of a person's posttraumatic stress symptoms on his or her partner's mental health-related quality of life. A significant proportion of patients and spouses (26%-42%) showed clinically relevant scores of anxiety and depression; approximately two thirds of both, patients and spouses, reported posttraumatic stress symptoms defined as clinically relevant. Compared with normative samples, patients reported greater anxiety, poorer mental and physical health-related quality of life, and greater exhaustion; spouses had an impaired mental health-related quality of life and increased anxiety. Testing the Actor-Partner Interdependence Model revealed that posttraumatic stress symptoms were related to patients' (β = -0.71, 95% confidence interval -0.88 to -0.54) and spouses' (β = -0.62, 95% confidence interval -0.79 to -0.46) own mental health-related quality of life. Posttraumatic stress symptoms further influenced the mental health-related quality of life of the respective other (β = -0.18, 95% confidence interval -0.35 to -0.003 for patients; β = -0.15, 95% confidence interval -0.32 to 0.02 for spouses).
  
  
  CONCLUSIONS
  Interventions to treat posttraumatic stress symptoms after critical illness to improve mental health-related quality of life should not only include patients, but also consider spouses.
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany. jenny.rosendahl@med.uni-jena.de
authors.forename: Jenny
authors.initials: J
authors.lastname: Rosendahl
authors.forename: Frank M
authors.initials: FM
authors.lastname: Brunkhorst
authors.forename: Doreen
authors.initials: D
authors.lastname: Jaenichen
authors.forename: Bernhard
authors.initials: B
authors.lastname: Strauss
mesh_terms: D005260:Female; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018805:Sepsis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D018454:Spouses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000517:prevention & control; D017741:Survivors / Q000523:psychology*