The experience of being admitted to an Intensive Care Unit (ICU) is extremely stressful and disruptive for all family members, but in particular, to the patients themselves. A study, which aims to develop prevention and intervention to improve the wellbeing and lives of those involved, has discovered that 20% of patients admitted to ICU showed signs of anxiety, whilst 23-27% of patients displayed signs of depression. The anxiety rate amongst family members increased to 76% and the family’s depression rate to 42-60%.

The study also showed significant discrepancies between deciding who makes decisions regarding the person admitted into hospital. Patients believe that they should be first in line to decide, followed by psychologists and doctors, with family in last place. However, family members believe that their role in deciding should become before that of doctors, leaving the patient in last place.

At the Intensive Care Units, different factors have come into play, which, when combined with the seriousness of the patient’s condition, can be stressful and disruptive for the patient. The study focused on the subjective reality that is linked to being admitted into an ICU, rating the grade of psychological affectation of patients and their families regarding their potential role as a modulator of different factors of who should be making decisions.

The team noted that medical attention ranked as being the most important factor for those admitted to an ICU, whilst the worst factor was reported to be lack of tranquility and opportunities for distraction and entertainment. The most stressful factor reported was to be in pain, lie in bed all day and being unable to be surrounded by close family.

Gil-Julià believes that this is an interesting result, given that it “is the decision-making process, where the patients consider themselves to be most important in this process, followed by the psychologist and the doctor, leaving family opinion in last place. Almost three-quarters feel perfectly capable to participate in the decision-making, although one in five view this more as a burden than a privilege”.

Most doctors therefore act prudently in providing patients with information, and choose to not divulge any information that is not yet certain, meaning for which they are unsure of potential risks.

The stress of family members is predominantly caused by fear that their family member may either die or experience a serious medical setback, followed by the fear that their loved one may be in pain, but also the unexpected admittance into the ICU itself, as well as not being able to be close to their loved one.

Work-hours and time off are other factors that also affect the lives of the patient’s family; with the one being most affected being the patient’s partner. The families report that they are overall very satisfied with the medical care the patient receives, although they report they feel there is insufficient support for family members. Interestingly, in the decision-making process, family members feel they should have a more relevant part than the doctor and consider the patient’s decision as being last. The researchers point out that, “only a fifth feel capable of intervening in the decision-making process and for a little more than half, taking part in this is more of a burden than a privilege”.

This is the first study to investigate the necessary steps that are required to implement preventive and intervention programs for ICU patients and their families to improve their wellbeing and quality of life, considering the admission can have major repercussions in the quality of care provided to both the patient and family members.

Written by Grace Rattue