title: Care and caring in the intensive care unit: Family members' distress and perceptions about staff skills, communication, and emotional support.
abstract: OBJECTIVE
  Family members of intensive care unit (ICU) patients are sometimes highly distressed and report lower satisfaction with communication and emotional support from staff. Within a study of emotional responses to traumatic stress, associations between family distress and satisfaction with aspects of ICU care were investigated.
  
  
  METHODS
  In 29 family members of trauma patients who stayed in an ICU, we assessed symptoms of depression and posttraumatic stress disorder (PTSD) during ICU care. Later, family members rated staff communication, support, and skills and their overall satisfaction with ICU care.
  
  
  RESULTS
  Ratings of staff competence and skills were significantly higher than ratings of frequency of communication, information needs being met, and support. Frequency of communication and information needs being met were strongly related to ratings of support (rs = .75-.77) and staff skills (rs = .77-.85), and aspects of satisfaction and communication showed negative relationships with symptoms of depression (rs = -.31 to -.55) and PTSD (rs = -.17 to -.43).
  
  
  CONCLUSIONS
  Although satisfaction was fairly high, family member distress was negatively associated with several satisfaction variables. Increased understanding of the effects of traumatic stress on family members may help staff improve communication and increase satisfaction of highly distressed family members.
authors: National Center for Posttraumatic Stress Disorder and VA Palo Alto Health Care System, Department of Veterans Affairs, 795 Willow Road (334/NC-PTSD), Menlo Park, CA 94025, USA. Electronic address: eve.carlson@va.gov.
authors: Eve B
authors: EB
authors: Carlson
authors: Department of Surgery, Stanford University School of Medicine, 300 Pasteur Dr., A160 MC 5313, Stanford, CA 94305, USA.
authors: David A
authors: DA
authors: Spain
authors: National Center for Posttraumatic Stress Disorder and VA Palo Alto Health Care System, Department of Veterans Affairs, 795 Willow Road (334/NC-PTSD), Menlo Park, CA 94025, USA.
authors: Luma
authors: L
authors: Muhtadie
authors: National Center for Posttraumatic Stress Disorder and VA Palo Alto Health Care System, Department of Veterans Affairs, 795 Willow Road (334/NC-PTSD), Menlo Park, CA 94025, USA.
authors: Liz
authors: L
authors: McDade-Montez
authors: Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304, USA.
authors: Kathryn S
authors: KS
authors: Macia
mesh_terms: D000328:Adult; D003142:Communication; D003376:Counseling; D003422:Critical Care; D003863:Depression / Q000175:diagnosis; D004645:Empathy; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010465:Perception; D010549:Personal Satisfaction; D011368:Professional-Family Relations; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D013315:Stress, Psychological / Q000175:diagnosis
keywords: Depression; Family/psychology; Intensive care units/standards; Intensive care/psychology; PTSD; Satisfaction