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Multicomponent Communication Intervention to Support Family Members of the Critically Ill: A Controlled Pre-Post
Eyleen Reifarth1,2, Boris Böll1, Sascha Köpke2
1Department I of Internal Medicine, Center of Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO), University Hospital Cologne, Cologne, Germany.
Objectives:
To investigate the effect of a communication intervention for family members of ICU patients, assessing comprehension of patient information within the first week of ICU admission, symptoms of anxiety and depression at 90 days post-ICU discharge, and corresponding risk factors.
Design:
Controlled pre-post study.
Setting:
Single academic tertiary care center in Germany, between January 2023 and July 2024.
Subjects:
ICU patients' family members.
Interventions:
The intervention comprised a communication manual and skills training for ICU physicians and nurses as well as a supplementary information brochure for ICU patients' families.
Measurement And Main Results:
Within the first week of ICU admission, data of 140 family members (70 control/70 intervention group) were collected via in-person interview on site using the Hospital Anxiety and Depression Scale and a validated questionnaire assessing information comprehension. Overall, in the control and intervention group, 46 (65.7%) and 31 (44.3%) family members, respectively, could not state the patients' diagnosis, therapy, or prognosis following a family-physician conversation in the ICU ( p = 0.011; r = 0.215). On day 90, 67 (95.7%) and 64 (91.4%) family members in the control and intervention group, respectively, participated in the follow-up telephone interview. There was no statistically significant difference between groups regarding symptoms of anxiety or depression ( p > 0.268). The family members' baseline anxiety and depression scores, their age, and their comprehension of the patients' main reason for ICU admission were identified as predictors of increased anxiety and depression scores at 90-day follow-up. In addition, higher education was associated with increased anxiety symptoms at 90-day follow-up.
Conclusions:
The intervention improved the family members' level of comprehension but did not decrease their symptoms of anxiety or depression at 90 days post-ICU discharge.
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