Emotional experiences and coping strategies of family members of critically ill patients.

Abstract Background Two out of three of family members experience symptoms of post-traumatic stress, depression, or anxiety lasting for months after the intensive care unit (ICU) stay. Interventions aimed at mitigating these symptoms have been unsuccessful. Research Question To understand the emotional experiences of family members of critically ill patients and to identify coping strategies used by family members during the ICU stay. Study Design and Methods As part of a mixed methods study to understand sources of distress among ICU family members, semi-structured interviews were conducted with ICU family members. Family members completed surveys at the time of interview and at 90 days to assess for symptoms of depression, anxiety, and post-traumatic stress. Results Semi-structured interviews and baseline surveys were conducted with 40 ICU family members; 78% of participants (n = 31) completed follow-up surveys at 90 days. At the time of interview, 65% of family members had symptoms of depression, anxiety, or post-traumatic stress. At 90 days, 48% of surveyed family members had symptoms of psychological distress. Three primary emotions were identified among ICU family members: sadness, anger, and fear. A diverse array of coping strategies was used by family members, including problem-solving, information seeking, avoidance/escape, self-reliance, support seeking, and accommodation. Interpretation This study emphasizes similarities in emotions but diversity in coping strategies used by family members in the ICU. Understanding the relationship between ICU experiences, emotional responses, and long-term psychological outcomes may guide targeted interventions to improve mental health outcomes of ICU family members.