Postintensive care syndrome family: A comprehensive review

Postintensive care syndrome family: A comprehensive review

2024 | Kasumi Shirasaki, Toru Hifumi, Nobuto Nakanishi, Nobuyuki Nosaka, Kyohei Miyamoto, Miyuki H. Komachi, Junpei Haruna, Shigeaki Inoue, Norio Otani
This review article discusses the concept, risk factors, assessment tools, prevalence, and management of Postintensive Care Syndrome Family (PICS-F), a condition affecting families of critically ill patients. PICS-F encompasses psychological, physical, and socioeconomic burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. It is not limited to psychological impairments but also includes physical and socioeconomic impairments. The prevalence of psychological problems such as depression, anxiety, and post-traumatic stress disorder is 20–40%, while non-physical problems like fatigue are 15% at 6 months after ICU stay. Assessment of PICS-F is typically conducted at 3- or 6-month points, although the beginning of the evaluation varies among studies. Families need accurate information about the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions, including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F. Risk factors for PICS-F include patient-related factors, family-related factors, and protective factors. Resilience and religious beliefs are important factors in preventing PICS-F. Assessment tools for PICS-F include the Hospital Anxiety and Depression Scale, Impact of Event Scale, and others. The timing of PICS-F assessment is important for understanding and addressing the challenges faced by families of ICU patients. Longitudinal outcomes show that psychological symptoms improve in the short term but may persist or worsen in the long term. Non-psychological problems such as socioeconomic issues and physical symptoms are also important. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions for the patient and families from during the ICU stay to after discharge from the ICU. The review highlights the importance of family support in the recovery of ICU patients and the need for further research to improve the understanding and management of PICS-F.This review article discusses the concept, risk factors, assessment tools, prevalence, and management of Postintensive Care Syndrome Family (PICS-F), a condition affecting families of critically ill patients. PICS-F encompasses psychological, physical, and socioeconomic burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. It is not limited to psychological impairments but also includes physical and socioeconomic impairments. The prevalence of psychological problems such as depression, anxiety, and post-traumatic stress disorder is 20–40%, while non-physical problems like fatigue are 15% at 6 months after ICU stay. Assessment of PICS-F is typically conducted at 3- or 6-month points, although the beginning of the evaluation varies among studies. Families need accurate information about the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions, including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F. Risk factors for PICS-F include patient-related factors, family-related factors, and protective factors. Resilience and religious beliefs are important factors in preventing PICS-F. Assessment tools for PICS-F include the Hospital Anxiety and Depression Scale, Impact of Event Scale, and others. The timing of PICS-F assessment is important for understanding and addressing the challenges faced by families of ICU patients. Longitudinal outcomes show that psychological symptoms improve in the short term but may persist or worsen in the long term. Non-psychological problems such as socioeconomic issues and physical symptoms are also important. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions for the patient and families from during the ICU stay to after discharge from the ICU. The review highlights the importance of family support in the recovery of ICU patients and the need for further research to improve the understanding and management of PICS-F.
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