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Cited by 429Family and Patient Care in Intensive Care UnitsNursing care and researchFamily Caregiving in Mental Illness

One-Year Outcomes in Caregivers of Critically Ill Patients

Open access
Cameron, Jill I., Chu, Leslie M., Matte, Andrea, Tomlinson, George, Chan, Linda, Thomas, Claire, Friedrich, Jan O., Mehta, Sangeeta +41 more·2016·New England Journal of Medicine
DOI 10.1056/nejmoa1511160
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Abstract

BACKGROUND: Few resources are available to support caregivers of patients who have survived critical illness; consequently, the caregivers' own health may suffer. We studied caregiver and patient characteristics to determine which characteristics were associated with caregivers' health outcomes during the first year after patient discharge from an intensive care unit (ICU). METHODS: We prospectively enrolled 280 caregivers of patients who had received 7 or more days of mechanical ventilation in an ICU. Using hospital data and self-administered questionnaires, we collected information on caregiver and patient characteristics, including caregiver depressive symptoms, psychological well-being, health-related quality of life, sense of control over life, and effect of providing care on other activities. Assessments occurred 7 days and 3, 6, and 12 months after ICU discharge. RESULTS: The caregivers' mean age was 53 years, 70% were women, and 61% were caring for a spouse. A large percentage of caregivers (67% initially and 43% at 1 year) reported high levels of depressive symptoms. Depressive symptoms decreased at least partially with time in 84% of the caregivers but did not in 16%. Variables that were significantly associated with worse mental health outcomes in caregivers were younger age, greater effect of patient care on other activities, less social support, less sense of control over life, and less personal growth. No patient variables were consistently associated with caregiver outcomes over time. CONCLUSIONS: In this study, most caregivers of critically ill patients reported high levels of depressive symptoms, which commonly persisted up to 1 year and did not decrease in some caregivers. (Funded by the Canadian Institutes of Health Research and others; ClinicalTrials.gov number, NCT00896220.).

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  • Ineffective communication can lead to psychological distress among family members.

    “and lead to psychological distress among family members (16).”

    From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [16]

    The Outcomes in Caregivers section (page not provided) reports depressive symptoms and poorer psychological well-being among caregivers. The Predictor Caregiver Outcomes section (page not provided) suggests that communication with the care team may influence caregiver outcomes, but it does not show that ineffective communication causes psychological distress. (LLM, conf=0.84)

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  • The clinical context was likely a challenge to careful decision making because of the sudden onset and rapid pace of critical illness, the proximity of possible death, the many clinicians involved with each patient, and the difficulties of deciding about life-sustaining therapy for a loved one.

    “the clinical context was likely a challenge to careful decision making because of the sudden onset and rapid pace of critical illness, the proximity of possible death, the many clinicians involved with each patient, and the difficulties of deciding about life-sustaining therapy for a loved one (16).”

    From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [16]

    The Discussion and Data Collection sections address caregivers’ mental health after ICU discharge, not their ability to make treatment decisions during critical illness. Searches for sudden onset, multiple clinicians, possible death, and decisions about life-sustaining therapy found no passage in our copy linking those circumstances to difficulties with careful decision making. (LLM, conf=0.75)

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1 of the 50 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. Mul- tiple Organ Dysfunction Score: a reliable descriptor of a complex clinical outcome. Crit Care Med 1995; 23: 1638-52.
  2. Proust C, Jacqmin-Gadda H. Estima- tion of linear mixed models with a mix- ture of distribution for the random ef- fects. Comput Methods Programs Biomed 2005; 78: 165-73.
  3. Harrell FE. Regression modeling strat- egies: with applications to linear models, logistic regression, and survival analysis. New York: Springer, 2001.

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Authors
Cameron, J. I., Chu, L. M., Matte, A., Tomlinson, G., Chan, L., Thomas, C., Friedrich, J. O., Mehta, S., Lamontagne, F., Levasseur, M., Ferguson, N. D., Adhikari, N. K. J., Rudkowski, J. C., Meggison, H., Skrobik, Y., Flannery, J., Bayley, M., Batt, J., dos Santos, C., Abbey, S. E., Tan, A., Lo, V., Mathur, S., Parotto, M., Morris, D., Flockhart, L., Fan, E., Lee, C. M., Wilcox, M. E., Ayas, N., Choong, K., Fowler, R., Scales, D. C., Sinuff, T., Cuthbertson, B. H., Rose, L., Robles, P., Burns, S., Cypel, M., Singer, L., Chaparro, C., Chow, C.-W., Keshavjee, S., Brochard, L., Hébert, P., Slutsky, A. S., Marshall, J. C., Cook, D., & Herridge, M. S.
Affiliations
Mount Sinai Hospital (CA)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2016-05-12
Volume
374
Issue
19
Pages
1831-1841
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1511160
OpenAlex
W2385708538
Cited by
429
References
50
Citations by year
2026: 33 · 2025: 33 · 2024: 48 · 2023: 33 · 2022: 33 · 2021: 52 · 2020: 49 · 2019: 42 · 2018: 36 · 2017: 52 · 2016: 18
FWCI
82.27
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Toronto
  • Canadian Institutes of Health Research (97809_1)
Topics
  • Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords
caregiver burden, family caregivers, critically ill patients, intensive care unit survivors, depressive symptoms, caregiver mental health, health-related quality of life, psychological well-being, social support, perceived control, personal growth, mechanical ventilation, post-discharge outcomes
MeSH terms
Adult, Aged, Depression, Family, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Stress, Psychological, Critical Illness, Caregivers

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