One-Year Outcomes in Caregivers of Critically Ill Patients

被引：267

作者：

Cameron, Jill I. ^{[1
,2
,3
]}

Chu, Leslie M. ^{[4
]}

Matte, Andrea ^{[4
]}

Tomlinson, George ^{[4
]}

Chan, Linda ^{[1
]}

Thomas, Claire ^{[4
]}

Friedrich, Jan O. ^{[5
,6
,7
]}

Mehta, Sangeeta ^{[5
,9
]}

Lamontagne, Francois ^{[18
]}

Levasseur, Melanie ^{[19
,20
]}

Ferguson, Niall D. ^{[4
,5
]}

Adhikari, Neill K. J. ^{[5
,10
]}

Rudkowski, Jill C. ^{[14
,15
]}

Meggison, Hilary ^{[21
]}

Skrobik, Yoanna ^{[22
]}

Flannery, John ^{[3
,4
,11
]}

Bayley, Mark ^{[3
,4
,11
]}

Batt, Jane ^{[5
,6
,7
]}

dos Santos, Claudia ^{[5
,6
,7
]}

Abbey, Susan E. ^{[12
]}

Tan, Adrienne ^{[12
]}

Lo, Vincent ^{[4
]}

Mathur, Sunita ^{[2
,13
]}

Parotto, Matteo ^{[4
,5
]}

Morris, Denise ^{[4
]}

Flockhart, Linda ^{[4
]}

Fan, Eddy ^{[4
]}

Lee, Christie M. ^{[5
,9
]}

Wilcox, M. Elizabeth ^{[4
]}

Ayas, Najib ^{[23
]}

Choong, Karen ^{[16
]}

Fowler, Robert ^{[5
,10
]}

Scales, Damon C. ^{[5
,10
]}

Sinuff, Tasnim ^{[5
,10
]}

Cuthbertson, Brian H. ^{[5
,10
]}

Rose, Louise ^{[6
,7
,9
,10
]}

Robles, Priscila ^{[2
,4
]}

Burns, Stacey ^{[4
]}

Cypel, Marcelo ^{[4
]}

Singer, Lianne ^{[4
,9
]}

Chaparro, Cecilia ^{[4
,5
]}

Chow, Chung-Wai ^{[4
,5
]}

Keshavjee, Shaf ^{[4
]}

Brochard, Laurent ^{[5
,6
,7
,8
]}

Hebert, Paul ^{[18
]}

Slutsky, Arthur S. ^{[5
,8
]}

Marshall, John C. ^{[6
,7
,8
]}

Cook, Deborah ^{[17
]}

Herridge, Margaret S. ^{[4
,5
]}

机构：

[1] Univ Toronto, Dept Occupat Sci & Occupat Therapy, Toronto, ON, Canada

[2] Univ Toronto, Rehabil Sci Inst, Toronto, ON, Canada

[3] Univ Toronto, Toronto Rehabil Inst, Univ Hlth Network, Toronto, ON, Canada

[4] Univ Toronto, Inst Med Sci, Dept Med, Toronto Gen Res Inst,Univ Hlth Network, Toronto, ON, Canada

[5] Univ Toronto, Interdept Div Crit Care, Toronto, ON, Canada

[6] Univ Toronto, Dept Med, Toronto, ON, Canada

[7] Univ Toronto, Dept Crit Care, Toronto, ON, Canada

[8] Univ Toronto, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Toronto, ON, Canada

[9] Univ Toronto, Mt Sinai Hosp, Dept Med & Anesthesia, St Michaels Hosp, Toronto, ON M5G 1X5, Canada

[10] Univ Toronto, Dept Crit Care Med, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada

[11] Univ Toronto, Interdept Div Physiatry, Toronto, ON, Canada

[12] Univ Toronto, Univ Hlth Network, Dept Psychiat, Toronto, ON, Canada

[13] Univ Toronto, Dept Phys Therapy, Toronto, ON, Canada

[14] St Josephs Healthcare, Dept Gen Internal Med, Hamilton, New Zealand

[15] St Josephs Healthcare, Dept Crit Care, Hamilton, New Zealand

[16] McMaster Univ, Div Crit Care & Clin Epidemiol & Biostat, Dept Pediat, Hamilton, ON, Canada

[17] McMaster Univ, Div Crit Care & Clin Epidemiol & Biostat, Dept Med, Hamilton, ON, Canada

[18] Ctr Hosp Univ Sherbrooke, Ctr Rech, Sherbrooke, PQ, Canada

[19] Univ Sherbrooke, Sch Rehabil, Sherbrooke, PQ J1K 2R1, Canada

[20] Univ Sherbrooke, Res Ctr Aging, Hlth & Social Serv Ctr, Sherbrooke, PQ J1K 2R1, Canada

[21] Univ Ottawa, Dept Crit Care, Ottawa, ON, Canada

[22] Univ Montreal, Dept Med, Div Crit Care, Maisonneuve Rosemont Hosp, Montreal, PQ H3C 3J7, Canada

[23] Univ British Columbia, St Pauls Hosp, Dept Med, Vancouver, BC V5Z 1M9, Canada

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2016年 / 374卷 / 19期

基金：

加拿大健康研究院;

关键词：

INFORMAL CAREGIVERS; FAMILY CAREGIVERS; STROKE SURVIVORS; NEGATIVE AFFECT; CARE; DEPRESSION; DISTRESS; SYMPTOMS; BURDEN; PREDICTORS;

D O I：

10.1056/NEJMoa1511160

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Few resources are available to support caregivers of patients who have survived critical illness; consequently, the caregivers' own health may suffer. We studied caregiver and patient characteristics to determine which characteristics were associated with caregivers' health outcomes during the first year after patient discharge from an intensive care unit (ICU). METHODS We prospectively enrolled 280 caregivers of patients who had received 7 or more days of mechanical ventilation in an ICU. Using hospital data and self-administered questionnaires, we collected information on caregiver and patient characteristics, including caregiver depressive symptoms, psychological well-being, health-related quality of life, sense of control over life, and effect of providing care on other activities. Assessments occurred 7 days and 3, 6, and 12 months after ICU discharge. RESULTS The caregivers' mean age was 53 years, 70% were women, and 61% were caring for a spouse. A large percentage of caregivers (67% initially and 43% at 1 year) reported high levels of depressive symptoms. Depressive symptoms decreased at least partially with time in 84% of the caregivers but did not in 16%. Variables that were significantly associated with worse mental health outcomes in caregivers were younger age, greater effect of patient care on other activities, less social support, less sense of control over life, and less personal growth. No patient variables were consistently associated with caregiver outcomes over time. CONCLUSIONS In this study, most caregivers of critically ill patients reported high levels of depressive symptoms, which commonly persisted up to 1 year and did not decrease in some caregivers.

引用

页码：1831 / 1841

页数：11