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One-Year Outcomes in Caregivers of Critically Ill Patients
Jill I Cameron1, Leslie M Chu1, Andrea Matte1
1From the Department of Occupational Science and Occupational Therapy (J.I.C., L.C.), Rehabilitation Sciences Institute (J.I.C., S.Mathur, P.R.), Toronto Rehabilitation Institute, University Health Network (J.I.C., J.F., M.B.), Department of Medicine, Toronto General Research Institute, Institute of Medical Science, University Health Network (L.M.C., A.M., G.T., C.T., N.D.F., J.F., M.B., V.L., M.P., D.M., L.F., E.F., M.E.W., P.R., S.B., M.C., L.S., C.C., C.-W.C., S.K., M.S.H.), Interdepartmental Division of Critical Care (J.O.F., S. Mehta, N.D.F., N.K.J.A., J.B., C.S., M.P., C.M.L., R.F., D.C.S., T.S., B.H.C., C.C., C.-W.C., L.B., A.S.S., M.S.H.), Departments of Medicine and Critical Care (J.O.F., J.B., C.S., L.R., L.B., J.C.M.) and Keenan Research Center at the Li Ka Shing Knowledge Institute (L.B., A.S.S., J.C.M.), St. Michael's Hospital, Department of Medicine and Anesthesia, Mount Sinai Hospital (S. Mehta, C.M.L., L.R., L.S.), Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (N.K.J.A., R.F., D.C.S., T.S., B.H.C., L.R.), Interdepartmental Division of Physiatry (J.F., M.B.), Department of Psychiatry, University Health Network (S.E.A., A.T.), and Department of Physical Therapy (S. Mathur), University of Toronto, Toronto, the Departments of General Internal Medicine and Critical Care, St. Joseph's Healthcare (J.C.R.), and the Departments of Pediatrics (K.C.) and Medicine (D.C.), Division of Critical Care and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (F.L., P.H.) and the School of Rehabilitation and Research Centre on Aging, Health and Social Services Centre (M.L.), University of Sherbrooke, Sherbrooke, QC, the Department of Critical Care, University of Ottawa, Ottawa (H.M.), the Department of Medicine Division of Critical Care, Maisonneuve Rosemont Hospital, University of Montreal, Montreal (Y.S.), and the Department of Medicine, St. Paul's H
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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