Stress Management Intervention to Prevent Post-Intensive Care Syndrome-Family in Patients' Spouses

Paula L. Cairns, Harleah G. Buck, Kevin E. Kip, Carmen S. Rodriguez, Zhan Liang, Cindy L. Munro

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Post-intensive care syndrome-family (PICS-F) refers to acute and chronic psychological effects of critical care on family members of patients in intensive care units (ICUs). Evidence suggests that increased distress during the ICU stay increases risk of PICS-F. Sensation Awareness Focused Training (SĀF-T) is a new, promising stress management intervention, but the feasibility of such training during the ICU stay for family caregivers who are acting as the surrogate decision-maker for patients who are undergoing mechanical ventilation is unknown. OBJECTIVES: To assess feasibility and acceptability of SĀF-T to inform a future larger randomized controlled trial. METHODS: This randomized controlled trial of SĀF-T (n = 5) versus a control (n = 5) group was conducted at a level 1 trauma center. Participants assigned to SĀF-T completed 1 session daily for 3 days. Measures included enrollment rate, data completion rate, acceptability of SĀF-T, and symptoms of PICS-F. Scales used included Perceived Stress, Hospital Anxiety and Depression, Impact of Event, and National Institutes of Health Toolbox Emotion Battery. RESULTS: Mean age was 58 (SD, 12) years; 70% of participants were female. Predetermined feasibility criteria were met in enrollment rate (67%), outcome measures completion rate (> 90%), and SĀF-T acceptability (100% of doses completed during the ICU stay) without adverse events. Stress scores after SĀF-T were significantly lower than scores before SĀF-T (z = -3.5, P = .01). CONCLUSIONS: SĀF-T intervention during the ICU stay is feasible, acceptable, and may improve family caregivers' post-ICU outcomes. Larger clinical trial to assess the effectiveness of SĀF-T in preventing PICS-F seem warranted.

Original languageEnglish (US)
Pages (from-to)471-476
Number of pages6
JournalAmerican journal of critical care : an official publication, American Association of Critical-Care Nurses
Volume28
Issue number6
DOIs
StatePublished - Nov 1 2019
Externally publishedYes

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Critical Care
Spouses
Intensive Care Units
Caregivers
Randomized Controlled Trials
Trauma Centers
National Institutes of Health (U.S.)
Artificial Respiration
Emotions
Anxiety
Outcome Assessment (Health Care)
Clinical Trials
Depression
Psychology

ASJC Scopus subject areas

  • Critical Care

Cite this

Stress Management Intervention to Prevent Post-Intensive Care Syndrome-Family in Patients' Spouses. / Cairns, Paula L.; Buck, Harleah G.; Kip, Kevin E.; Rodriguez, Carmen S.; Liang, Zhan; Munro, Cindy L.

In: American journal of critical care : an official publication, American Association of Critical-Care Nurses, Vol. 28, No. 6, 01.11.2019, p. 471-476.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Post-intensive care syndrome-family (PICS-F) refers to acute and chronic psychological effects of critical care on family members of patients in intensive care units (ICUs). Evidence suggests that increased distress during the ICU stay increases risk of PICS-F. Sensation Awareness Focused Training (SĀF-T) is a new, promising stress management intervention, but the feasibility of such training during the ICU stay for family caregivers who are acting as the surrogate decision-maker for patients who are undergoing mechanical ventilation is unknown. OBJECTIVES: To assess feasibility and acceptability of SĀF-T to inform a future larger randomized controlled trial. METHODS: This randomized controlled trial of SĀF-T (n = 5) versus a control (n = 5) group was conducted at a level 1 trauma center. Participants assigned to SĀF-T completed 1 session daily for 3 days. Measures included enrollment rate, data completion rate, acceptability of SĀF-T, and symptoms of PICS-F. Scales used included Perceived Stress, Hospital Anxiety and Depression, Impact of Event, and National Institutes of Health Toolbox Emotion Battery. RESULTS: Mean age was 58 (SD, 12) years; 70{\%} of participants were female. Predetermined feasibility criteria were met in enrollment rate (67{\%}), outcome measures completion rate (> 90{\%}), and SĀF-T acceptability (100{\%} of doses completed during the ICU stay) without adverse events. Stress scores after SĀF-T were significantly lower than scores before SĀF-T (z = -3.5, P = .01). CONCLUSIONS: SĀF-T intervention during the ICU stay is feasible, acceptable, and may improve family caregivers' post-ICU outcomes. Larger clinical trial to assess the effectiveness of SĀF-T in preventing PICS-F seem warranted.",
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