title: ICU versus Non-ICU Hospital Death: Family Member Complicated Grief, Posttraumatic Stress, and Depressive Symptoms.
abstract: BACKGROUND
  Family members of patients who die in an ICU are at increased risk of psychological sequelae compared to those who experience a death in hospice.
  
  
  OBJECTIVE
  This study explored differences in rates and levels of complicated grief (CG), posttraumatic stress disorder (PTSD), and depression between family members of patients who died in an ICU versus a non-ICU hospital setting. Differences in family members' most distressing experiences at the patient's end of life were also explored.
  
  
  METHODS
  The study was an observational cohort. Subjects were next of kin of 121 patients who died at a large, Midwestern academic hospital; 77 died in the ICU. Family members completed measures of CG, PTSD, depression, and end-of-life experiences.
  
  
  RESULTS
  Participants were primarily Caucasian (93%, N = 111), female (81%, N = 98), spouses (60%, N = 73) of the decedent, and were an average of nine months post-bereavement. Forty percent of family members met the Inventory of Complicated Grief CG cut-off, 31% met the Impact of Events Scale-Revised PTSD cut-off, and 51% met the Center for Epidemiologic Studies Depression Scale depression cut-off. There were no significant differences in rates or levels of CG, PTSD, or depressive symptoms reported by family members between hospital settings. Several distressing experiences were ranked highly by both groups, but each setting presented unique distressing experiences for family members.
  
  
  CONCLUSIONS
  Psychological distress of family members did not differ by hospital setting, but the most distressing experiences encountered at end of life in each setting highlight potentially unique interventions to reduce distress post-bereavement for family members.
authors.affiliation: 1 Department of Psychiatry, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.|2 Department of Internal Medicine, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.
authors.forename: Danielle R
authors.initials: DR
authors.lastname: Probst
authors.affiliation: 2 Department of Internal Medicine, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.
authors.forename: Jillian L
authors.initials: JL
authors.lastname: Gustin
authors.affiliation: 2 Department of Internal Medicine, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.
authors.forename: Lauren F
authors.initials: LF
authors.lastname: Goodman
authors.affiliation: 2 Department of Internal Medicine, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.
authors.forename: Amanda
authors.initials: A
authors.lastname: Lorenz
authors.affiliation: 1 Department of Psychiatry, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.|2 Department of Internal Medicine, Division of Palliative Medicine, Wexner Medical Center, The Ohio State University , Columbus, Ohio.
authors.forename: Sharla M
authors.initials: SM
authors.lastname: Wells-Di Gregorio
mesh_terms: D003863:Depression / Q000453:epidemiology*; D005190:Family / Q000523:psychology*; D005260:Female; D006117:Grief; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*