Psychological Distress Among Black Surrogates of Intensive Care Unit Patients: A Cross-Sectional Survey Study

Anticipatory grief and Post-Intensive Care Syndrome-Family (PICS-F) are increasingly recognised as important sources of psychological distress among family members of critically ill patients. However, these experiences remain understudied among Black surrogate decision-makers. The aim of this study was to evaluate the association between anticipatory grief and PICS-F and to examine whether emotional closeness and positive religious coping were associated with anticipatory grief among Black family surrogates of intensive care unit (ICU) patients. In this cross-sectional survey study, 70 Black surrogate decision-makers of adult ICU patients were recruited from ICUs at a large metropolitan hospital in the Midwestern United States. Participants completed measures of emotional closeness, positive religious coping, anticipatory grief, anxiety, depression and post-traumatic stress symptoms. Multivariable linear regression analyses examined associations among study variables. Emotional closeness and positive religious coping were not statistically significantly associated with anticipatory grief. Anticipatory grief was statistically significantly associated with higher PICS-F symptoms. Among Black ICU surrogate decision-makers, anticipatory grief was associated with greater psychological distress, suggesting it may represent an important target for future supportive interventions and research.