AT ATS 2017

WASHINGTON (FRONTLINE MEDICAL NEWS) – Making health care–related decisions for relatives in the ICU heightens an individual’s risk for psychological stress, a new study showed.

While 90% of patients admitted to the ICU lack decision capacity, only 20%-29% of the U.S. population has written advanced directives. Therefore, most often, family members are called upon to make decisions for ICU patients’ care.

In this study, the surrogate decision-makers for patients were 4.43 times, 1.80 times, and 1.11 times more likely to experience symptoms of PTSD, depression, and anxiety (P less than .05).

Sean Cohen, MD, of the University of Washington presented the study’s results in a mini symposium at an international conference of the American Thoracic Society in May.

In this cohort study, 265 patients with acute respiratory distress syndrome and 162 of these patients’ family members were surveyed 3 months after each patient’s discharge. Associations between the family members’ roles and psychological symptoms were examined with regression models. These models were adjusted for family characteristics, which included sex, age, education, and legal next-of-kin status. Results showed that the patients’ family members were on average 52 years of age and that 94% were white, 73% were female, and 64% were legal next-of-kin, mostly spouses or children of the patients.

“I think looking more at identification of the decision-making role and attempting to go toward the surrogates’ preferred role actually mitigates some of these psychological symptoms,” concluded Dr. Cohen.

This study was sponsored by the Cambia Palliative Care Center of Excellence at the University of Washington in Seattle. Funding was provided by the National Institutes of Health and the American Lung Association. The authors reported no other disclosures.