title: Relatives' perception of stressors and psychological outcomes - Results from a survey study.
abstract: To identify relevant stressors or resources of relatives of critically ill patients and explore their relationship with psychological outcomes.
  
  
  
  Prospective mixed-method study performed in 4 multidisciplinary ICUs of an urban academic hospital. Main relatives of consecutive patients with severe sepsis were questioned after 90days by structured interview. Quantitative data included demographic characteristics, ICU experience, Impact-of-Event Scale (posttraumatic stress) and Hospital Anxiety and Depression Scale (HADS); answers to open questions about stressors and resources were transcribed verbatim and analyzed by thematic analysis.
  
  
  
  143/205 (70%) relatives participated. Satisfaction with communication and care was high. Experiencing a stressor predicted posttraumatic stress (p=0.014) and anxiety (p=0.019) after 90days. Most common stressors were feelings of helplessness and uncertainty. The perception of being overburdened in the ICU predicted posttraumatic stress, anxiety and depression (all p≤0.001); In addition, patient's death or survival with significant deterioration in quality of life compared to status before admission predicted depression (p=0.016).
  
  
  
  Our study confirmed a high prevalence of PICS-F among relatives of critically ill patients. Feeling overburdened and experiencing acute stressors may be related to negative psychological outcomes. In future, vulnerable relatives might be identified by a single-item screening tool on feeling overburdened.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07743 Jena, Germany; Center for Sepsis Control & Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Matt
authors.affiliation: Center for Sepsis Control & Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. Electronic address: Daniel.Schwarzkopf@med.uni-jena.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schwarzkopf
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07743 Jena, Germany; Center for Sepsis Control & Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. Electronic address: Konrad.Reinhart@med.uni-jena.de.
authors.forename: Konrad
authors.initials: K
authors.lastname: Reinhart
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07743 Jena, Germany; Center for Sepsis Control & Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. Electronic address: Christian.Koenig2@med.uni-jena.de.
authors.forename: Christian
authors.initials: C
authors.lastname: König
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07743 Jena, Germany; Center for Sepsis Control & Care (CSCC), Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. Electronic address: Christiane.Hartog@med.uni-jena.de.
authors.forename: Christiane S
authors.initials: CS
authors.lastname: Hartog
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D003142:Communication; D016638:Critical Illness / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010465:Perception; D011446:Prospective Studies; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Anxiety; Depression; End-of-life care; Family; Posttraumatic stress; Quality of life; Sepsis