Authored by Frank Kiwanuka
Aim: In this review, we sought to succinctly review what Postintensive care syndrome is, it’s risk factors, consequences, assessment, diagnosis, prevention and treatment among family members of intensive care patients.
Background: The proportion of family members caring for a patient in intensive care units is expected to proportionally increase with increase in utilization of intensive care units due to various reasons. Subsequently, unfavorable physical, psychosocial responses due to exposure to complications following admission of a family member in intensive care due to critical illness will consequently increase among family members. These unfavorable family responses to critical illness have been termed “Postintensive care syndrome-family (PICS-F).” Postintensive care syndrome-family encompasses: anxiety, acute stress disorder, post-traumatic stress, depression and complicated grief. Healthcare providers as well as family members need to be knowledgeable on the extent, diagnosis, prevention and outcomes of these sequelae. Relationship to the patient, younger patients, prior experience of ICU, low economic status, length of ICU stay, unmet self-care, communication needs and distance from the hospital seem to predispose family members to PICS-F. Longer distance from hospital and higher resilience seem to protect family members from PICS-F. Prevention of PICS-F includes: effective family-ICU staff communication, enhancing resilience and coping, post discharge planning and follow-up interventions.
Conclusion: results highlight the importance of acknowledging experiences of family members having a patient admitted in intensive care unit. Healthcare professionals need to have insights into this phenomenon and optimally intervene to prevent these physiological and psychosocial sequelae.
Health and illness are family events therefore; an individual family member’s health affects the entire family functioning. A family can simply be defined as “who the member says it is,” implying that, it is not limited to people with ancestral linkages. In context, the family holds strong health practices, attitude and beliefs and interrelationships [1]. Why, however should we be concerned about family members of patients once admitted in ICU? Healthcare providers need to be concerned about the family members in the context of Intensive Care owing to advances in intensive care and the increasing graying population, there is increasing utilization of intensive care services. Eventually, the proportion of family caregivers and families having experiences of Intensive Care Units (ICU) is consequently growing [2].
Experience of a family member in ICU has long standing compilations which may present up to more than four year following discharge from ICU [3]. As a result, nurses and other healthcare providers need to be knowledgeable, intervene, promote health, identify, prevent illness risks and rehabilitate those experiencing complications. The Society of Critical Care Medicine has termed this myriad of complications as “Postintensive care syndromefamily” (PICS-F). Consequently, PICS-F has negative implications on the patient and family following discharge from ICU [4-6]. There is a growing body of literature on psychological experiences of relatives of patients admitted in ICU globally. This could partly be attributed to the growing number of patients admitted in ICU and ICU survivors. In addition, studies have reported remarkable risk of depression, anxiety and posttraumatic disorders among family members of patients admitted in ICU. There are previous reviews that have attempted to discuss psychological repercussions in family members of ICU patients.
For Instance: Jezierska [5] and colleagues explored the psychological repercussions and prevention measures to PICS-F. A similar narrative by Schmidt & Azoulay [7] also appraised the significance of PICS-F burden among family members, its prevention measures and consequences for the family. Another review by Davidson et al. [3] also highlighted the epidemiology, assessment and interventions. The above reviews present seminal evidence on PICS-F however; in depth evidence on interventions to prevent PICS-F is unremarkable. In this scoping review, we succinctly describe PICS-F among family members of adult intensive care patients including: what it is, risk factors, consequences, assessment, diagnosis, treatment and prevention measures. Scoping reviews are important in expeditiously mapping out literature on a topic. They are methodologically more exploratory which permits broader evidentiary understanding that can inform the development of research questions that guide interventions, systematic reviews and empirical studies.
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