Long-term effects of flexible visitation in the intensive care unit on family members’ mental health: 12-month results from a randomized clinical trial,Intensive Care Medicine

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Long-term effects of flexible visitation in the intensive care unit on family members’ mental health: 12-month results from a randomized clinical trial
Intensive Care Medicine ( IF 27.1 ) Pub Date : 2024-08-22 , DOI: 10.1007/s00134-024-07577-3
Jennifer Menna Barreto de Souza _{1,

2} , Aline Paula Miozzo ₁ , Rosa da Rosa Minho Dos Santos ₁ , Duane Mocellin ₁ , Gabriela Soares Rech ₁ , Geraldine Trott ₁ , Gabriel Pozza Müller Estivalete ₁ , Daniel Sganzerla ₃ , Denise de Souza ₁ , Regis Goulart Rosa ₁ , Cassiano Teixeira _{1,

2}

Affiliation

Purpose

The aim of this study was to assess the effects of flexible intensive care unit (ICU) visitation on the 1-year prevalence of post-traumatic stress, anxiety and depression symptoms among family members of critically ill patients.

Methods

This is a long-term outcome analysis of a cluster-crossover randomized clinical trial that evaluated a flexible visitation model in the ICU (12 h/day) compared to a restrictive visitation model (median 1.5 h/day) in 36 Brazilian ICUs. In this analysis, family members were assessed 12 months after patient discharge from the ICU for the following outcomes: post-traumatic stress symptoms measured by the Impact Event Scale-6 and anxiety and depression symptoms measured by the Hospital Anxiety and Depression Scale.

Results

A total of 519 family members were analyzed (288 in the flexible visitation group and 231 in the restrictive visitation group). Three-hundred sixty-nine (71.1%) were women, and the mean age was 46.6 years. Compared to family members in the restrictive visitation group, family members in the flexible visitation group had a significantly lower prevalence of post-traumatic stress symptoms (21% vs. 30.5%; adjusted prevalence ratio [aPR], 0.91; 95% confidence interval [CI] 0.85–0.98; p = 0.01). The prevalence of anxiety (28.9% vs. 33.2%; aPR 0.93; 95% CI 0.72–1.21; p = 0.59) and depression symptoms (19.2% vs. 25%; aPR, 0.78; 95% CI 0.60–1.02; p = 0.07) did not differ significantly between the groups.

Conclusion

Flexible ICU visitation, compared to the restrictive visitation, was associated with a significant reduction in the 1-year prevalence of post-traumatic stress symptoms in family members.

中文翻译：

重症监护病房灵活探视对家庭成员心理健康的长期影响：一项随机临床试验的 12 个月结果

目的

本研究的目的是评估灵活的重症监护病房（ICU）探视对危重患者家庭成员 1 年创伤后应激、焦虑和抑郁症状患病率的影响。

方法

这是一项整叉随机临床试验的长期结果分析，该试验评估了 ICU 中的灵活探视模型（12 小时/天）与 36 个巴西 ICU 中的限制性探视模型（中位数 1.5 小时/天）的比较。在该分析中，在患者从 ICU 出院 12 个月后评估家庭成员的以下结局：通过影响事件量表 6 测量的创伤后应激症状，以及通过医院焦虑和抑郁量表测量的焦虑和抑郁症状。

结果

共分析 519 名家庭成员（灵活探视组 288 名，限制性探视组 231 名）。369 例（71.1%）为女性，平均年龄为 46.6 岁。与限制性探视组的家庭成员相比，灵活探视组的家庭成员创伤后应激症状的患病率显著降低（21% vs. 30.5%;调整患病率 [aPR]，0.91;95% 置信区间 [CI] 0.85-0.98;p = 0.01）。焦虑的患病率（28.9% vs. 33.2%;aPR 0.93;95% CI 0.72-1.21;p = 0.59）和抑郁症状（19.2% vs. 25%;aPR，0.78;95% CI 0.60-1.02;p = 0.07）在两组之间没有显著差异。