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Cited by 114Cancer survivorship and careFamily and Patient Care in Intensive Care UnitsTraumatic Brain Injury Research

The DOI matches its Crossref record; 45 of the 46 references it cites were found in a registry or an index.

Feasibility and Efficacy of a Resiliency Intervention for the Prevention of Chronic Emotional Distress Among Survivor-Caregiver Dyads Admitted to the Neuroscience Intensive Care Unit: A Randomized Clinical Trial

Open access
Vranceanu, Ana-Maria, Bannon, Sarah, Mace, Ryan, Lester, Ethan, Meyers, Emma, Gates, Melissa, Popok, Paula, Lin, Ann, Salgueiro, Danielle, Tehan, Tara, Macklin, Eric, Rosand, Jonathan·2020·JAMA Network Open
DOI 10.1001/jamanetworkopen.2020.20807PMC PMC7557506
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Abstract

Importance: To our knowledge, there are no evidence-based interventions to prevent chronic emotional distress (ie, depression, anxiety, and posttraumatic stress [PTS]) in critical care survivors and their informal caregivers. Objective: To determine the feasibility and preliminary effect of the novel dyadic resiliency intervention Recovering Together (RT) on reducing symptoms of depression, anxiety, and PTS among hospitalized patients and their informal caregivers. Design, Setting, and Participants: This single-blind, pilot randomized clinical trial of RT vs an educational control was conducted among 58 dyads in which either the survivor or caregiver endorsed clinically significant symptoms of depression, anxiety, or PTS. The study was conducted in the neuroscience intensive care unit at Massachusetts General Hospital. Data were collected from September 2019 to March 2020. Interventions: Both RT and control programs had 6 sessions (2 at bedside and 4 via live video after discharge), and both survivor and caregiver participated together. Main Outcomes and Measures: The primary outcomes were feasibility of recruitment and intervention delivery, credibility, and satisfaction. The secondary outcomes included depression and anxiety (measured by the Hospital Depression and Anxiety Scale), PTS (measured by the PTSD Checklist-Civilian Version), and intervention targets (ie, mindfulness, measured by the Cognitive and Affective Mindfulness Scale-Revised; coping, measured by the Measure of Current Status-Part A; and dyadic interpersonal interactions, measured by the Dyadic Relationship Scale). Main outcomes and targets were assessed at baseline, 6 weeks, and 12 weeks. Results: The 58 dyads were randomized to RT (29 dyads [50.0%]; survivors: mean [SD] age, 49.3 [16.7] years; 9 [31.0%] women; caregivers: mean [SD] age, 52.4 [14.3] years; 22 [75.9%] women) or control (29 dyads [50.0%]; survivors: mean [SD] age, 50.3 [16.4] years; 12 [41.3%] women; caregivers, mean [SD] age, 52.1 [14.9], 17 [58.6%] women). Feasibility (recruitment [76%], randomization [100%], and data collection [83%-100%]), adherence (86%), fidelity (100%; κ = 0.98), satisfaction (RT: 57 of 58 [98%] with scores >6; control: 58 of 58 [100%] with scores >6), credibility (RT: 47 of 58 [81%] with scores >6; control: 46 of 58 [80%] with scores >6), and expectancy (RT: 49 of 58 [85%] with scores >13.5; 51 of 58 [87%] with scores >13.5) exceeded benchmarks set a priori. Participation in RT was associated with statistically and clinically significant improvement between baseline and postintervention in symptoms of depression (among survivors: -4.0 vs -0.6; difference, -3.4; 95% CI, -5.6 to -1.3; P = .002; among caregivers: -3.8 vs 0.6; difference, -4.5; 95% CI, -6.7 to -2.3; P < .001), anxiety (among survivors: -6.0 vs 0.3; difference, -6.3; 95% CI, -8.8 to -3.8; P < .001; among caregivers: -5.0 vs -0.9; difference, -4.1; 95% CI, -6.7 to -1.5, P = .002), and PTS (among survivors: -11.3 vs 1.0; difference, -12.3; 95% CI, -18.1 to -6.5, P < .001; among caregivers, -11.4 vs 5.0; difference, -16.4, 95% CI, -21.8 to -10.9; P < .001). Improvements sustained through the 12-week follow-up visit. We also observed RT-dependent improvement in dyadic interpersonal interactions for survivors (0.2 vs -0.2; difference, 0.4; 95% CI, 0.0 to 0.8; P = .04). Conclusions and Relevance: In this pilot randomized clinical trial, RT was feasible and potentially efficacious in preventing chronic emotional distress in dyads of survivors of the neuroscience intensive care unit and their informal caregivers. Trial Registration: ClinicalTrials.gov Identifier: NCT03694678.

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  • EMPOWER's focus on grief (including pre-loss grief) and the intrapsychic plight of the surrogate distinguishes it from another promising dyadic intervention that focuses on how patients with acute neurological injuries, who are likely to survive, can cope effectively with distress together with their caregivers post-ICU discharge.

    “Its focus on grief (including pre-loss grief) and the intrapsychic plight of the surrogate distinguishes EMPOWER from another promising dyadic intervention that focuses on how patients with acute neurological injuries, who are likely to survive, can cope effectively with distress together with their caregivers post-ICU discharge (62).”

    From EMPOWER: A Multi-Site Pilot Trial to Reduce Distress in Surrogate Decision-Makers in the ICU (2024) · cites this paper as [62]

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1 of the 46 references couldn’t be matched to a known paper.

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  1. Puhan, 2008, The minimal important difference of the Hospital Anxiety and Depression Scale in patients with chronic obstructive pulmonary disease., Health Qual Life Outcomes, 6, 46, 10.1186/1477-7525-6-46 · DOI · Paper page
  2. Liang, 2000, Longitudinal data analysis of continuous and discrete responses for pre-post designs., Sankhya: Indian J Stat, Ser B, 62, 134
  3. Dimeff, 2007, Dialectical Behavior Therapy in Clinical Practice: Applications Across Disorders and Settings
  4. Attkisson, 1995, The Client Satisfaction Questionnaire (CSQ) Scales: Outcome Assessment in Clinical Practice, 2
  5. Jain? S, Iverson? LM. Glasgow Coma Scale. In: StatPearls. StatPearls Publishing; 2020. Accessed April 6, 2020. https://www.ncbi.nlm.nih.gov/books/NBK513298/

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Metadata

Authors
Vranceanu, A.-M., Bannon, S., Mace, R., Lester, E., Meyers, E., Gates, M., Popok, P., Lin, A., Salgueiro, D., Tehan, T., Macklin, E., & Rosand, J.
Affiliations
  • Harvard University (US)
  • Massachusetts General Hospital (US)
Corresponding author
Vranceanu, Ana-Maria
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2020-10-14
Volume
3
Issue
10
Pages
e2020807
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2020.20807
PMC
PMC7557506
OpenAlex
W3092194839
Cited by
114
References
46
Citations by year
2026: 15 · 2025: 17 · 2024: 21 · 2023: 26 · 2022: 17 · 2021: 14 · 2020: 3
FWCI
5.42
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Defense
  • American Heart Association
  • Pfizer
  • GlaxoSmithKline
  • Massachusetts General Hospital
  • Biogen
  • National Institutes of Health
  • National Institute of Nursing Research (R21NR017979, NR017979)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Family and Patient Care in Intensive Care Units
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Keywords
depression, anxiety, post-traumatic stress, critical illness survivors, informal caregivers, caregiver burden, dyadic intervention, neuroscience intensive care unit, mindfulness, coping, interpersonal relationships, feasibility, telemedicine, neurocritical care, brain injury survivors, stroke survivors
MeSH terms
Brain Injuries, Traumatic, Psychological Distress, Adaptation, Psychological, Adult, Aged, Anxiety, Brain Neoplasms, Depression, Feasibility Studies, Female, Humans, Male, Middle Aged, Pilot Projects, Stress Disorders, Post-Traumatic, Stress, Psychological, Single-Blind Method, Critical Illness, Caregivers, Resilience, Psychological, Mindfulness

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