• Amy B Petrinec, Polly M Mazanec, Christopher J Burant, Alan Hoffer, and Barbara J Daly.
• 1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH. 2Department of Neurosurgery, University Hospitals of Cleveland, Cleveland, OH.
• Crit. Care Med. 2015 Jun 1; 43 (6): 1205-12.

ObjectiveTo assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization.DesignA single-group descriptive longitudinal correlational study.SettingMedical, surgical, and neurological ICUs in a large tertiary care university hospital.PatientsConsecutive family decision makers of adult critical care patients from August 2012 to November 2013. Study inclusion occurred after the patient's fifth day in the ICU.InterventionsNone.Measurements And Main ResultsFamily decision makers of incapacitated adult ICU patients completed the Brief COPE instrument assessing coping strategy use 5 days after ICU admission and 30 days after hospital discharge or death of the patient and completed the Impact of Event Scale-Revised assessing posttraumatic stress symptoms 60 days after hospital discharge. Seventy-seven family decision makers of the eligible 176 completed all data collection time points of this study. The use of problem-focused (p=0.01) and emotion-focused (p<0.01) coping decreased over time while avoidant coping (p=0.20) use remained stable. Coping strategies 30 days after hospitalization (R2=0.50, p<0.001) were better predictors of later posttraumatic stress symptoms than coping strategies 5 days after ICU admission (R2=0.30, p=0.001) controlling for patient and decision-maker characteristics. The role of decision maker for a parent and patient death were the only noncoping predictors of posttraumatic stress symptoms. Avoidant coping use 30 days after hospitalization mediated the relationship between patient death and later posttraumatic stress symptom severity.ConclusionsCoping strategy use is a significant predictor of posttraumatic stress symptom severity 60 days after hospitalization in family decision makers of ICU patients.

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