• David Y Hwang, Mira Reichman, Sarah M Bannon, Kate Meurer, Rina Kubota, Jisoo Kim, Nithyashri Baskaran, Qiang Zhang, Nathan S Fishbein, Kaitlyn Lichstein, Alexander M Presciutti, Emily C Woodworth, Melissa Motta, Susanne Muehlschlegel, Michael E Reznik, Matthew N Jaffa, Claire J Creutzfeldt, Corey R Fehnel, Amanda D Tomlinson, Craig A Williamson, Ana-Maria Vranceanu, and Coma Family Investigators.
• Division of Neurocritical Care, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. david_hwang@med.unc.edu.
• Neurocrit Care. 2025 Jan 16.

BackgroundFamily caregivers of patients with severe acute brain injury (SABI) are at risk for clinically significant chronic emotional distress, including depression, anxiety, and posttraumatic stress. Existing psychosocial interventions for caregivers of intensive care unit (ICU) patients are not tailored to the unique needs of caregivers of patients with SABI, do not demonstrate long-term efficacy, and may increase caregiver burden. In this study, we explored the needs and preferences for psychosocial services among SABI caregivers to inform the development and adaptation of interventions to reduce their emotional distress during and after their relative's ICU admission.MethodsIn this multicenter longitudinal qualitative study, we conducted semistructed interviews with SABI caregivers at two time points: during their relative's ICU admission (n = 30) and 2 months later (n = 20). We analyzed qualitative data using a hybrid of inductive and deductive analytic techniques. We recruited family caregivers of patients with SABI from 14 US neuroscience ICUs. We conducted interviews over live video. Our convenience sample of SABI caregivers (n = 30) was recruited through referral by medical teams and nursing staffs across participating neuroscience ICUs. Caregivers included spouses, children, parents, and siblings to patients with SABI.ResultsWe identified themes and subthemes related to participants' preferences for (1) the content of psychosocial support services and (2) the delivery and implementation of psychosocial support services. Findings revealed an unmet need for psychosocial support around the time of ICU discharge and 2 months later, including information to understand their loved one's condition and guide difficult decision-making, education regarding how best to communicate with the patient's care team and other family members, and emotional and behavioral coping skills.ConclusionsOur findings provide specific recommendations to justify and inform the development and adaptation of psychosocial support services for SABI caregivers for delivery in the ICU and after discharge.© 2025. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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