• Emily A Harlan, Jacquelyn Miller, Deena K Costa, Angela Fagerlin, Theodore J Iwashyna, Emily P Chen, Kyra Lipman, and Thomas S Valley.
• Department of Internal Medicine, University of Michigan, Ann Arbor, MI. Electronic address: schwessi@med.umich.edu.
• Chest. 2020 Oct 1; 158 (4): 1464-1472.

BackgroundTwo out of three family members experience symptoms of posttraumatic stress, depression, or anxiety lasting for months after the ICU stay. Interventions aimed at mitigating these symptoms have been unsuccessful.Research QuestionTo understand the emotional experiences of family members of critically ill patients and to identify coping strategies used by family members during the ICU stay.Study Designand Methods: As part of a mixed methods study to understand sources of distress among ICU family members, semistructured interviews were conducted with ICU family members. Family members completed surveys at the time of interview and at 90 days to assess for symptoms of depression, anxiety, and posttraumatic stress.ResultsSemistructured interviews and baseline surveys were conducted with 40 ICU family members; 78% of participants (n = 31) completed follow-up surveys at 90 days. At the time of interview, 65% of family members had symptoms of depression, anxiety, or posttraumatic stress. At 90 days, 48% of surveyed family members had symptoms of psychological distress. Three primary emotions were identified among ICU family members: sadness, anger, and fear. A diverse array of coping strategies was used by family members, including problem-solving, information seeking, avoidance/escape, self-reliance, support seeking, and accommodation.InterpretationThis study emphasizes similarities in emotions but diversity in coping strategies used by family members in the ICU. Understanding the relationship between ICU experiences, emotional responses, and long-term psychological outcomes may guide targeted interventions to improve mental health outcomes of ICU family members.Copyright © 2020 American College of Chest Physicians. All rights reserved.

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