Observational studyCritical care medicine2018
Acute Physiologic Stress and Subsequent Anxiety Among Family Members of ICU Patients.
Observational study in Critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Identification of risk factors for post-intensive care syndrome in family members (PICS-F) among adult patients: a systematic review.Anaesthesiology intensive therapy · 2023Pooled it
- Surrogate resilience and clinical titration of presence in the open intensive care unit: a systematic narrative synthesis.International journal of nursing studies advances · 2026Review
- The Development, Acceptability and Suitability of an Information and Well-Being Booklet for Family Members of Intensive Care Unit Patients.Nursing in critical care · 2026Article
- Developing and Evaluating an Inpatient Caregiver Support Program: Feasibility, Acceptability, and Perceived Impact.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- The effect of coping with stress in predicting the needs, death anxiety, and depression of patients' relatives in intensive care units.BMC public health · 2026Article
- Anxiety, depression and distress in family members of people who have experienced a critical care admission: a systematic review and Bayesian meta-analysis.Journal of intensive care · 2025Article
- Pawsitive Care: Canine-Assisted Intervention for Anxiety in ICU Patients and Family Members: A Single-Center, Single-Arm Study.Critical care explorations · 2025Article
- Psychological symptoms, quality of life and dyadic relations in family members of intensive care survivors: a multicentre, prospective longitudinal cohort study.Annals of intensive care · 2025Article
- Development and Validation of a Nomogram Prediction Model for Key Symptoms of Post-Intensive Care Syndrome-Family in Family Members of Critically-Ill Patients: Focusing on Sleep Disturbance, Fatigue, Anxiety, and Depression.Risk management and healthcare policy · 2025Article
- Post-Intensive Care Syndrome Family.Critical care clinics · 2025Review
- Salivary Diurnal Cortisol Predicts Post-Traumatic Stress Symptoms in Parents of Infants With Congenital Heart Disease.Biological research for nursing · 2024Article
- The Experiences of Family Members of Patients Discharged from Intensive Care Unit: A Systematic Review of Qualitative Studies.Nursing reports (Pavia, Italy) · 2024Review
- The Effect of Video Call with Family Members on Physiological Parameters of Critically Ill Patients in Intensive Care Unit: A Quasi-experimental Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Development and psychometric evaluation of the family intensive care units syndrome inventory.Brain and behavior · 2023Review
- Family experiences and perceptions of intensive care unit care and communication during the COVID-19 pandemic.Australian critical care : official journal of the Confederation of Australian Critical Care Nurses · 2023Article
- Restraint stress induced anxiety and sleep in mice.Frontiers in psychiatry · 2023Article
- Heart rate variability and subsequent psychological distress among family members of intensive care unit patients.The Journal of international medical research · 2021Article
- Using an ICU Diary to Communicate With Family Members of COVID-19 Patients in ICU: A Case Report.Journal of patient experience · 2021Article
- Family care in intensive care units.The Southern African journal of critical care : the official journal of the Critical Care Society · 2019Article
- The Effects of Scheduled Visitation Policy on Depression, Anxiety, and Stress among the Family Members of Patients with Open Heart Surgery: A Randomized Controlled Trial.Iranian journal of nursing and midwifery researchArticle
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe ICU is a complex and stressful environment and is associated with significant psychologic morbidity for patients and their families. We sought to determine whether salivary cortisol, a physiologic measure of acute stress, was associated with subsequent psychologic distress among family members of ICU patients.
designThis is a prospective, observational study of family members of adult ICU patients.
settingAdult medical and surgical ICU in a tertiary care center. SUBJECTS: Family members of ICU patients.
interventionsParticipants provided five salivary cortisol samples over 24 hours at the time of the patient ICU admission. The primary measure of cortisol was the area under the curve from ground; the secondary measure was the cortisol awakening response. Outcomes were obtained during a 3-month follow-up telephone call. The primary outcome was anxiety, measured by the Hospital Anxiety and Depression Scale-Anxiety. Secondary outcomes included depression and posttraumatic stress disorder. MEASUREMENTS AND MAIN
resultsAmong 100 participants, 92 completed follow-up. Twenty-nine participants (32%) reported symptoms of anxiety at 3 months, 15 participants (16%) reported depression symptoms, and 14 participants (15%) reported posttraumatic stress symptoms. In our primary analysis, cortisol level as measured by area under the curve from ground was not significantly associated with anxiety (odds ratio, 0.94; p = 0.70). In our secondary analysis, however, cortisol awakening response was significantly associated with anxiety (odds ratio, 1.08; p = 0.02).
conclusionsRoughly one third of family members experience anxiety after an ICU admission for their loved one, and many family members also experience depression and posttraumatic stress. Cortisol awakening response is associated with anxiety in family members of ICU patients 3 months following the ICU admission. Physiologic measurements of stress among ICU family members may help identify individuals at particular risk of adverse psychologic outcomes.
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