What about the caregivers?

Dr Kimberley Haines1, Associate Professor  Sue  Berney2, Dr  Stephen  Warrillow2, Professor  Linda Denehy3

1Western Health, Melbourne, Australia, 2Austin Health, Melbourne, Australia, 3The University of Melbourne, Melbourne, Australia

Aim: To investigate the prevalence and short-term trajectory of psychological morbidity in informal caregivers of the critically ill.

Methods: Multi-site, prospective observational study of caregivers of patients mechanically ventilated >48 hours. Outcomes measures collected at intensive care unit (ICU) admission, hospital discharge, two-month follow-up: Depression (Center for Epidemiological Studies – Depression), Anxiety (Hospital Anxiety and Depression Scale), Mastery (Pearlin’s Mastery Scale); HRQoL (Short-Form 36 v2 – SF36v2), PTSD (Impact of Events Scale – two-months only). Preliminary results are presented descriptively for n = 40.

Results: Caregivers were mainly female, spouses, mean age of 54 ± 15, and no pre-existing psychology. Caregiver psychological morbidity was highest during ICU and decreased over time. During ICU, 63% experienced clinically significant symptoms of depression, reducing to 30% at hospital discharge and 15% at two-months. Forty-eight percent experienced clinically significant symptoms of anxiety during ICU, reducing to 15% by follow-up. The highest proportion (38%) of caregivers experienced low self-mastery scores at hospital discharge.

HRQoL mental health was most affected with mean SF-36v2 mental component summary scores of 44 ± 13, 40 ± 16, 48 ± 10 over time. At two-months, 33% of caregivers experienced clinically significant PTSD symptoms.

Conclusions: We provide for the first time comprehensive psychosocial trajectory data among non-bereaved caregivers. Psychosocial morbidity was greatest during ICU and decreased over time, although more than a third of informal caregivers experience PTSD at two-month follow-up.

Significance of findings to Allied Health: These data are important as caregiver well-being may impact patient recovery. These results indicate when caregivers are most at risk, informing clinical care and future interventional studies.