Observational studyCritical care (London, England)2021
Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement.
Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed.
- Symptoms of Anxiety, Depression, and Stress among Families of Critically Ill Patients with COVID-19: A Longitudinal Clinical Trial.Annals of the American Thoracic Society · 2023Trial
- Meaning-Making Among Family Members of Hospitalized Traffic Accident Victims: A Grounded Theory Study.Cureus · 2026Article
- Effect of high-dose baclofen on post-traumatic stress disorder symptoms five years after hospitalization among critically ill patients with unhealthy alcohol use.Scientific reports · 2026Observational
- Money and mental health: a scoping review of financial variables, data sources, and analytical methods.Frontiers in public health · 2026Article
- Factors of prolonged-grief-disorder symptom trajectories for ICU bereaved family surrogates.Critical care (London, England) · 2024Article
- Communication, Shared Decision-making and Goals of Care in the ICU through Electronic Health Records: A Scoping Review.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Factors Associated With Quality-of-Dying-and-Death Classes Among Critically Ill Patients.JAMA network open · 2024Observational
- Association between hair cortisol concentration and acute stress symptoms in family members of critically ill patients: a cross-sectional study.Critical care science · 2024Article
- Comorbid Prolonged Grief, PTSD, and Depression Trajectories for Bereaved Family Surrogates.JAMA network open · 2023Article
- Temporal reciprocal relationships among anxiety, depression, and posttraumatic stress disorder for family surrogates from intensive care units over their first two bereavement years.BMC psychiatry · 2023Observational
- One Year Later: Family Members of Patients with COVID-19 Experience Persistent Symptoms of Posttraumatic Stress Disorder.Annals of the American Thoracic Society · 2023Observational
- How symptoms of prolonged grief disorder, posttraumatic stress disorder, and depression relate to each other for grieving ICU families during the first two years of bereavement.Critical care (London, England) · 2022Review
- ICU bereaved surrogates' comorbid psychological-distress states and their associations with prolonged grief disorder.Critical care (London, England) · 2022Observational
- Ethical Lessons from an Intensivist's Perspective.Journal of clinical medicine · 2022Review
- Letter to the Editor in response to "Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement".Critical care (London, England) · 2021Article
- Postintensive care syndrome family: A comprehensive review.Acute medicine & surgeryReview
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND/
objectiveDeath in intensive care units (ICUs) may increase bereaved family members' risk for posttraumatic stress disorder (PTSD). However, posttraumatic stress-related symptoms (hereafter as PTSD symptoms) and their precipitating factors were seldom examined among bereaved family members and primarily focused on associations between PTSD symptoms and patient/family characteristics. We aimed to investigate the course and predictors of clinically significant PTSD symptoms among family members of deceased ICU patients by focusing on modifiable quality indicators for end-of-life ICU care.
methodIn this longitudinal observational study, 319 family members of deceased ICU patients were consecutively recruited from medical ICUs from two Taiwanese medical centers. PTSD symptoms were assessed at 1, 3, 6, and 13 months post-loss using the Impact of Event Scale-Revised (IES-R). Family satisfaction with end-of-life care in ICUs was assessed at 1 month post-loss. End-of-life care received in ICUs was documented over the patient's ICU stay. Predictors for developing clinically significant PTSD symptoms (IES-R score ≥ 33) were identified by multivariate logistic regression with generalized estimating equation modeling.
resultsThe prevalence of clinically significant PTSD symptoms decreased significantly over time (from 11.0% at 1 month to 1.6% at 13 months post-loss). Longer ICU stays (adjusted odds ratio [95% confidence interval] = 1.036 [1.006, 1.066]), financial insufficiency (3.166 [1.159, 8.647]), and reported use of pain medications (3.408 [1.230, 9.441]) by family members were associated with a higher likelihood of clinically significant PTSD symptoms among family members during bereavement. Stronger perceived social support (0.937 [0.911, 0.965]) and having a Do-Not-Resuscitate (DNR) order issued before the patient's death (0.073 [0.011, 0.490]) were associated with a lower likelihood of clinically significant PTSD symptoms. No significant association was observed for family members' satisfaction with end-of-life care (0.988 [0.944, 1.034]) or decision-making in ICUs (0.980 [0.944, 1.018]).
conclusionsThe likelihood of clinically significant PTSD symptoms among family members decreased significantly over the first bereavement year and was lower when a DNR order was issued before death. Enhancing social support and facilitating a DNR order may reduce the trauma of ICU death of a beloved for family members at risk for developing clinically significant PTSD symptoms.
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