Dataset Information

The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours.

ABSTRACT:

Objectives

To identify the psychologic impact of admission to the ICU on the relatives of critically ill patients, the influence of coping, and the factors involved.

Design

We performed a cohort study with repeated measures evaluation using descriptive and comparative bivariate and multivariate analyses.

Settings

An adult ICU of a third-level complexity hospital.

Patients

The family members of patients (maximum of three per patient) staying longer than 3 days.

Interventions

Not applicable.

Measurements and main results

Psychologic impact was assessed using two subgroups of psychologic distress: anxiety (by the State-Trait Anxiety Inventory) and depression (by the Beck Depression Inventory). Satisfaction and coping were assessed by the Critical Care Family Needs Inventory and the Brief Coping Orientations to Problems Experienced Inventory, respectively. We included 104 family members; psychologic distress was high at admission (72% had anxiety, 45% had depression, and 42% had both) but decreased at discharge (34% had anxiety, 23% had depression, and 21% had both). The risk factors related to psychologic impact were severity (anxiety: Acute Physiology and Chronic Health Evaluation score ≥ 18 points: relative risk [RR], 2; 95% CI, 1-4; p = 0.03), invasive mechanical ventilation (anxiety: RR, 1.9; 95% CI, 1-3.6; p = 0.04), recent psychotropic medication use by relatives (depression: RR, 1.6; 95% CI, 1-2.9; p = 0.05), a restrictive visiting policy (anxiety: RR, 5.7; 95% CI, 2-10.4; p = 0.002), no emotion-focused coping strategy (anxiety: strategy < 11 points, RR, 6.1; 95% CI, 1.2-52; p = 0.01), and functional impairment (depression: Barthel index ≤ 60 points, RR, 7.4; 95% CI, 1.7-26.3; p = 0.01).

Conclusions

The psychologic impact from admission to the ICU on family members is high. Visiting hours is the main modifiable factor to reduce the impact.

SUBMITTER: Iglesias J

PROVIDER: S-EPMC8826955 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours.

Iglesias Judit J Martín Juan J Alcañiz Montserrat M Ezquiaga Elena E Vega Gema G

Critical care explorations 20220208 2

<h4>Objectives</h4>To identify the psychologic impact of admission to the ICU on the relatives of critically ill patients, the influence of coping, and the factors involved.<h4>Design</h4>We performed a cohort study with repeated measures evaluation using descriptive and comparative bivariate and multivariate analyses.<h4>Settings</h4>An adult ICU of a third-level complexity hospital.<h4>Patients</h4>The family members of patients (maximum of three per patient) staying longer than 3 days.<h4>Int ...[more]

PMID: 35156047

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Project description:BackgroundThe potential relationship between intravascular catheter infections with their insertion during weekend or night-time (i.e., off-hours or not regular business hours) remains an open issue. Our primary aim was to describe differences between patients and catheters inserted during on- versus off-hours. Our secondary aim was to investigate whether insertions during off-hours influenced the intravascular catheter infectious risks.MethodsWe performed a post hoc analysis using the databases from four large randomized-controlled trials. Adult patients were recruited in French ICUs as soon as they required central venous catheters or peripheral arterial (AC) catheter insertion. Off-hours started at 6 P.M. until 8:30 A.M. during the week; at weekend, we defined off-hours from 1 P.M. on Saturday to 8.30 A.M. on Monday. We performed multivariable marginal Cox models to estimate the effect of off-hours (versus on-hours) on major catheter-related infections (MCRI) and catheter-related bloodstream infections (CRBSIs).ResultsWe included 7241 patients in 25 different ICUs, and 15,208 catheters, including 7226 and 7982 catheters inserted during off- and on-hours, respectively. Catheters inserted during off-hours were removed after 4 days (IQR 2, 9) in median, whereas catheters inserted during on-hours remained in place for 6 days (IQR 3,10; p < 0.01) in median. Femoral insertion was more frequent during off-hours. Among central venous catheters and after adjusting for well-known risk factors for intravascular catheter infection, we found a similar risk between off- and on-hours for MCRI (HR 0.91, 95% CI 0.61-1.37, p = 0.65) and CRBSI (HR 1.05, 95% CI 0.65-1.68, p = 0.85). Among central venous catheters with a dwell-time > 4 or > 6 days, we found a similar risk for MCRI and CRBSI between off- and on-hours. Similar results were observed for ACs.ConclusionsOff-hours did not increase the risk of intravascular catheter infections compared to on-hours. Off-hours insertion is not a sufficient reason for early catheter removal, even if femoral route has been selected.

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Dataset Information

The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours.

Objectives

Design

Settings

Patients

Interventions

Measurements and main results

Conclusions

Publications

The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours.

Similar Datasets

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