Prevalence and outcomes of caregiving after prolonged (> or =48 hours) mechanical ventilation in the ICU

Chest. 2004 Feb;125(2):597-606. doi: 10.1378/chest.125.2.597.

Abstract

Objectives: (1) To estimate caregiver support required by patients 2 months after prolonged (at least 48 h) mechanical ventilation (MV) in an ICU; (2) to describe caregiver burden, caregiver depressive symptomatology, and caregiver limitations in activities; and (3) to investigate factors related to depressive symptoms at 2 months in caregivers.

Design: Prospective cohort study.

Study participants: Caregivers of 115 patients who received prolonged MV in an ICU.

Measurements: Sociodemographics, employment status, hours spent providing care, help from paid caregiving sources, caregiver burden, and caregiver depressive symptoms.

Results: The proportion of patients who survived at least 2 months and required caregiver support was 74.8%. The average age of caregivers was 52.9 years (SD, 14.2), 76.5% were women, and more than half were spouses (52.2%). Only 33 of the caregivers (28.7%) were working, and 30.3% had to reduce their time spent at work to provide care to the patient. The prevalence of risk of clinical depression (defined as Center for Epidemiological Studies depression scale [CES-D] score > or =16) among caregivers was 33.9%. The mean caregiver CES-D score was 13.2 (SD, 11; median, 10). Multiple linear regression analysis showed that higher CES-D score was associated with more hours per day helping with patients' activities of daily living and instrumental activities of daily living (p = 0.003).

Conclusions: Two months after being placed on MV for at least 48 h, a high proportion of patients need caregiver support. Approximately 34% of caregivers are at risk of clinical depression. Many caregivers report lifestyle changes and burden when providing care for the patients.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Caregivers / psychology*
  • Cohort Studies
  • Continuity of Patient Care
  • Critical Care / methods*
  • Critical Illness / therapy
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Probability
  • Prospective Studies
  • Quality of Life
  • Respiration, Artificial / adverse effects
  • Respiration, Artificial / methods*
  • Respiratory Insufficiency / therapy
  • Risk Assessment
  • Stress, Psychological
  • Time Factors