Improving Psychological Distress Among Critical Illness Survivors and Their Informal Caregivers
|Project Period: 2012 - 2017||PI: Douglas White, MD, MAS|
|Funding Source: PCORI|
|Researchers: Christopher Cox, MD, Duke University (Co-PI)|
Following release from the ICU, many patients and their caregivers report psychological distress including depression, anxiety, and PTSD, for over one year post-discharge. This distress poses a negative impact on their quality of life. Patients expressed that assistance with developing coping skills to deal with the physical and emotional changes of critical illness would be beneficial to them. In addition to these coping skills, patients reported that receiving more information about critical illness, recovery, and what to expect, would help alleviate some of their stress.
Over 200 survivor-caregiver dyads were enrolled and randomized to receive one of two 6-week, telephone-based interventions - A) an ICU survivor-specific coping skills training (CST) program or B) a critical illness educational program. Researchers used surveys to compare the level of participant psychological distress and quality of life over the 6-month intervention period.
The study took place over three years at five different medical centers across the US. Researchers found that the CST program did not improve psychological distress symptoms when compared tot he education program. They did observe, however, that the CST program did improve symptoms of distress at 6 months among patients with high baseline distress, where the education program improved distress at 3 months among those ventilated for more than seven days. Researchers agreed that future efforts to address psychological distress among survivors should target high-risk populations.
- Cox CE, Porter LS, Hough CL, White DB, Kahn JM, Carson SS, Tulsky JA, Keefe FJ. Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers. Intensive Care Med. 2012;38(8):1289-97.
- Cox CE, Hough CL, Carson SS, White DB, Kahn JM, Olsen MK, Jones DM, Somers TJ, Kelleher SA, Porter LS. Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial. Am J Respir Crit Care Med. 2018;197(1):66-78.
- Khandelwal N, Hough CL, Downey L, Engelberg RA, Carson SS, White DB, Kahn JM, Jones DM, Key MD, Reagan W, Porter LS, Curtis JR, Cox CE. Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness. Crit Care Med. 2018;46(6):e530-e539.
- Cox CE, Wysham NG, Kamal AH, Jones DM, Cass B, Tobin M, White DB, Kahn JM, Hough CL, Carson SS. Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness. Am J Crit Care. 2016;25(4):340-9.