The Caregiver Pathway Intervention Can Contribute to Reduced Post-Intensive Care Syndrome Among Family Caregivers of ICU Survivors: A Randomized Controlled Trial
Watland, Solbjørg; Solberg Nes, Lise; Ekeberg, Øivind; Rostrup, Morten; Hanson, Elizabeth; Ekstedt, Mirjam; Stenberg, Una; Hagen, Milada; Børøsund, Elin
Peer reviewed, Journal article
Published version
Date
2024Metadata
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Abstract
OBJECTIVES: Explore short-term effects of “The Caregiver Pathway,” an inter- vention for family caregiver follow-up, on Post-Intensive Care Syndrome symp- toms among families (PICS-F). DESIGN: A randomized controlled trial. SETTING: A medical ICU at a Norwegian University Hospital. PARTICIPANTS: One hundred ninety-six family caregivers of critically ill patients randomized to an intervention (n = 101) or control group (n = 95). INTERVENTIONS: “The Caregiver Pathway” four-step model offers individual and structured follow-up, including: 1) mapping family caregivers’ needs and con- cerns with an assessment tool followed by a conversation with an ICU nurse within the first days at the ICU, 2) a supportive card when leaving the ICU, 3) offer for the family caregivers to receive a phone call after ICU patient discharge, and 4) a follow-up conversation within 3 months. MEASUREMENTS AND MAIN RESULTS: Data were collected at baseline and after 3 months and analyzed using linear regression. No significant effects were detected when comparing all participants completing 3-month outcome measurements (n = 144). A subgroups analysis stratified on patient survival, how- ever, showed statistically significant effect for family caregivers of patients surviv- ing the ICU stay receiving the intervention compared with controls. Caregivers of surviving patients reported improved symptoms related to post-traumatic stress disorder, measured by Impact of Event Scale-Revised (B = –8.2 [95% CI, –14.2 to –2.2]; p = 0.008), anxiety (B = –2.2 [95% CI, –4.0 to –0.5]; p = 0.014), and depression (B = –1.5 [95% CI, –2.9 to –0.1]; p = 0.035); measured by the Hospital Anxiety and Depression Scale, subscore physical functioning in health- related quality of life (B = 9.7 [95% CI, 0.3–19.0]; p = 0.043); measured by Short Form 12-Item Health Survey; and hope (B = 2.4 [95% CI, 0.4–4.3]; p = 0.017) and measured by the Herth Hope Index. At 3-month, the model did not appear to improve the outcomes for family caregivers of nonsurviving patients. CONCLUSIONS: “The Caregiver Pathway” intervention was associated with reduced symptoms of PICS-F in family caregivers of surviving ICU patients com- pared with controls.