Intensive Care Medicine

, Volume 31, Issue 1, pp 86–91

Returning home after intensive care: A comparison of symptoms of anxiety and depression in ICU and elective cardiac surgery patients and their relatives

  • Ellen Young
  • Jane Eddleston
  • Sarah Ingleby
  • Janice Streets
  • Lucy McJanet
  • Michael Wang
  • Lesley Glover
Original

Abstract

Objective

This study gathered data on symptoms of anxiety and depression in patients and relatives after discharge from intensive care and examined whether the intensive care population differ from an elective cardiac surgery group with regards to their anxiety and depression symptom reporting.

Design and setting

A single measurement point matched group comparison study in an ICU follow-up programme.

Patients and participants

Twenty ICU patients and their relatives and a matched comparison group of 15 elective cardiac surgery patients and their relatives.

Measurements and results

Patients and relatives completed the Hospital Anxiety and Depression Scale. Relatives answered an open question to explore the perceived impact of Intensive care/cardiac surgery on their lives. ICU patients’ relatives reported significantly higher number of symptoms of anxiety than did ICU patients, higher number of symptoms of depression than cardiac surgery patients’ relatives, and more troubling and life-altering experiences than the relatives of cardiac surgery patients.

Conclusions

Relatives of ICU patients also suffer anxiety and depression, and services should address this need. Group differences suggest that ICU patients’ relatives have ‘unique’ characteristics of depression symptom reporting.

Keywords

Intensive care unit Patients Relatives Anxiety Depression 

References

  1. 1.
    Royal College of Physicians and Royal College of Psychiatrists (1995) The Psychological care of medical patients: recognition and need of service provision. Royal College of Physicians/Royal College of Psychiatrists, LondonGoogle Scholar
  2. 2.
    Royal College of Physicians and Royal College of Psychiatrists (2003) The psychological care of medical patients: a practical guide, 2nd edn. Royal College of Physicians/ Royal College of Psychiatrists, LondonGoogle Scholar
  3. 3.
    Granberg A, Bergbom-Engberg I, Lunderg D (1996) Intensive care syndrome: a literature review. Intensive Crit Care Nurs 12:173–182PubMedGoogle Scholar
  4. 4.
    Bennun I (1998) Intensive care units: a psychologists contribution. Br J Intensive Care 8:206–212Google Scholar
  5. 5.
    Bennun I (1999) Intensive care units: a systemic perspective. J Fam Ther 21:96–112CrossRefGoogle Scholar
  6. 6.
    McKinney A, Deeny P (2002) Leaving the intensive care unit: a phenomenological study of the patients’ experience. Intensive Crit Care Nurs 18:320–331CrossRefPubMedGoogle Scholar
  7. 7.
    Johnson S, Craft M, Titler M, Halm M (1995) Perceived changes in adult family members roles and responsibilities during critical illness. J Nurs Scholarsh 27:238–243Google Scholar
  8. 8.
    Gavaghan S, Carroll D (2002) Families of critically ill patients and the effect of nursing interventions. Dimens Crit Care Nurs 21:64–71CrossRefPubMedGoogle Scholar
  9. 9.
    Choate K, Stewart M (2002) Reducing anxiety in patients and families discharged from ICU. Aust Nurs J 10:29–31PubMedGoogle Scholar
  10. 10.
    Department of Health (2000) Comprehensive critical care: review of adult critical care services. Department of Health, LondonGoogle Scholar
  11. 11.
    Modernistaion Agency (2003) Critical care outreach 2003: progress in developing services. Department of Health, LondonGoogle Scholar
  12. 12.
    Griffiths RD, Jones C, MacMillan RR (1996) Where is the harm in not knowing? Care after intensive care. Clin Intensive Care 7:144–145Google Scholar
  13. 13.
    Skirrow P, Jones C, Griffiths RD, Kaney S (2001) Intensive care—easing the trauma. Psychologist 14:640–642Google Scholar
  14. 14.
    Griffiths RD, Jones C (1999) ABC of intensive care: recovery from intensive care. BMJ 319:427–429PubMedGoogle Scholar
  15. 15.
    Jones C, O’Donnel C (1994) After Intensive care—what then? Intensive Crit Care Nurse 10:89–92CrossRefGoogle Scholar
  16. 16.
    Jones C, Griffiths RD, MacMillan RR, Palmer TEA (1994) Psychological problems occurring after intensive care. Br J Intensive Care 4:46–53Google Scholar
  17. 17.
    Eddleston JM, White P, Guthrie E (2000) Survival, morbidity and quality of life after discharge from intensive care. Crit Care Med 28:2293–2299CrossRefPubMedGoogle Scholar
  18. 18.
    Jones C, Humphris GM, Griffiths RD (1998) Psychological morbidity following critical illness—the rationale for care after intensive care. Clin Intensive Care 9:199–205Google Scholar
  19. 19.
    Jones C, Macmillan RR, Griffiths RD (1994) Providing psychological support for patients after critical illness. Clin Intensive Care 5:176–179PubMedGoogle Scholar
  20. 20.
    Jones C, Griffiths RD, Humphris G (2000) Disturbed memory and amnesia related to intensive care. Memory 8:79–94CrossRefPubMedGoogle Scholar
  21. 21.
    Chaboyer W, Elliott D (2000) Health related quality of life of ICU survivors: review of the literature. Intensive Crit Care Nurs 16:88–97CrossRefPubMedGoogle Scholar
  22. 22.
    Abraham E, Andrews P, Antonelli M, Brochard L, Brun-Buisson C, Dobb G, Fagon JY, Groeneveld J, Mancebo J, Metnitz P, Nava S, Pinsky M, Radermacher P, Ranieri M, Richard C, Tasker R, Vallet B (2004) Year in review in intensive care medicine—2003. III. Intensive care unit organisation, scoring, quality of life, ethics, neonatal and paediatrics, and experimental. Intensive Care Med 30:1514–1525PubMedGoogle Scholar
  23. 23.
    Jackson J, Hart R, Gordon S, Shintani A, Truman B, May L, Ely W (2003) Six-month neuropsychological outcome of medical intensive care unit patients. Crit Care Med 31:1226–1234CrossRefPubMedGoogle Scholar
  24. 24.
    Jones C, Skirrow P, Griffiths RD, Humphris G, Dawson S, White P, Eddleston J, Waldmann C, Gager M (2003) Rehabilitation after critical illness: a randomised controlled trial. Crit Care Med 31:2456–2461CrossRefPubMedGoogle Scholar
  25. 25.
    Scragg P, Jones A, Fauvel N (2001) Psychological problems following ICU treatment. Anaesthesia 56:9–14CrossRefPubMedGoogle Scholar
  26. 26.
    Schelling G, Stoll C, Meier M, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuβ U, Bullinger M, Schuffel W, Peter (1998) Health related quality of life and post-traumatic stress disorder in survivors of adult respiratory distress syndrome. Crit Care Med 26:651–659CrossRefPubMedGoogle Scholar
  27. 27.
    Cuthbertson BH, Hull A, Strachan M, Scott J (2004) Post-traumatic stress disorder after critical illness requiring general intensive care. Intensive Care Med 30:450–455CrossRefPubMedGoogle Scholar
  28. 28.
    Koshy G, Wilkinson A, Harmsworth A, Waldman CS (1997) ICU follow-up programme at a district general hospital. Intensive Care Med 23, S160Google Scholar
  29. 29.
    Daffurn K, Bishop G, Hillman K, Bauman A (1994) Problems following discharge after intensive care. Intensive Crit Care Nurs 10:244–251CrossRefPubMedGoogle Scholar
  30. 30.
    Compten P (1991) Critical illness and intensive care: What it means to the client. Crit Care Nurse 11:50–56Google Scholar
  31. 31.
    Jones C, Skirrow P, Griffiths RD, Humphris G, Dawson S, Eddleston J (2000) Predicting intensive care relatives at risk of post-traumatic stress disorder. Br J Anaesth 84:666a-667aGoogle Scholar
  32. 32.
    Jones C, Skirrow P, Griffiths RD, Humphris G, Ingleby S, Eddleston J, Waldmann C, Gager M (2004) Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med 30:456–460CrossRefPubMedGoogle Scholar
  33. 33.
    Johnson P, Chaboyer W, Foster M, van der Vooren R (2001) Caregivers of ICU patients discharged home: What burden do they face? Intensive Crit Care Nurs 17:219–227CrossRefPubMedGoogle Scholar
  34. 34.
    Swoboda S, Lipsett P (2002) Impact of a prolonged surgical illness on patients families. Am J Crit Care 11:459–467PubMedGoogle Scholar
  35. 35.
    Carter GA, McGoldrick M (1980) The family life cycle: a framework for family therapy. Gardner, New YorkGoogle Scholar
  36. 36.
    Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370PubMedGoogle Scholar
  37. 37.
    Crawford JR, Henry JD, Crombie HC, Taylor EP (2001) Normative data for the HADS from a large non-clinical sample. Br J Clin Psychol 40:429–434CrossRefPubMedGoogle Scholar
  38. 38.
    Moorey S, Greer S, Watson M, Gorman C, Rowden L, Turnmore R, Robertson B, Bliss, J (1991) The factor structure and factor stability of the Hospital Anxiety and Depression Scale in patients with cancer. Br J Psychiatry 158:255–259PubMedGoogle Scholar
  39. 39.
    Smith JA, Jarman M, Osborn M (1999) Doing interpretative phenomenological analysis. In: Murray M, Chamberlain K (eds) Qualitative health psychology—theories and methods. Sage, LondonGoogle Scholar
  40. 40.
    Blanchard CG, Albrecht TL, Ruckdeschel JC (1997) The crisis of cancer: Psychological impact on family caregivers. Oncology (Huntingt) 11:189–194Google Scholar
  41. 41.
    Groom KN, Shaw TG, O’Connor ME, Howard NI, Pickens A (1998) Neurobehavioural symptoms and family functioning in traumatically brain-injured adults. Arch Clin Neuropsychol 13:695–711CrossRefPubMedGoogle Scholar
  42. 42.
    Pakenham KI (2001) Application of a stress and coping model to caregiving in multiple sclerosis. Psychol Health Med 6:13–27CrossRefGoogle Scholar
  43. 43.
    Northouse LL, Mood D, Templin T, Mellon S, George T (2000) Couples’ patterns of adjustment to colon cancer. Soc Sci Med 50:271–284CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Ellen Young
    • 1
  • Jane Eddleston
    • 2
  • Sarah Ingleby
    • 2
  • Janice Streets
    • 2
  • Lucy McJanet
    • 2
  • Michael Wang
    • 3
  • Lesley Glover
    • 3
  1. 1.Department of Behavioural MedicineHope HospitalManchesterUK
  2. 2.Intensive Care UnitManchester Royal InfirmaryManchesterUK
  3. 3.Clinical Psychology DepartmentUniversity of HullHullUK

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