Informal Caregivers (Family and Friends) Clinical Trial
Official title:
Improving Psychological Distress Among Critical Illness Survivors and Their Caregivers
Patients who receive life support in intensive care units commonly suffer from persistent depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms after discharge. We are trying to learn which is a better way to manage this distress: a telephone-based adaptive coping skills training program or an educational program.
Public Summary of Research Project Why is this important? Nearly 800,000 Americans receive
mechanical ventilation for acute respiratory failure in the ICU each year. Afterward, over
half of both patients and their family caregivers suffer from psychological distress
(depression, anxiety, and post-traumatic stress ["PTSD"]) for over 1 year after discharge.
Patients and families told us that they need help with their distress because it worsens
their quality of life. More specifically, patients said that learning how to adapt (that is,
how to cope) with the physical and emotional changes of critical illness would be helpful. In
fact, most ICU survivors use coping skills infrequently, which worsens psychological
distress. But patients also told us that they wanted more information about critical illness,
recovery, and what to expect. A lack of information increases PTSD symptoms. However, there
are few treatments for this distress that can overcome ICU survivors' physical disability,
great distance from expert medical centers, and concerns about how much treatments would
cost. Therefore, we developed two treatments to address coping and lack of information.
What is the main goal? We aim to compare which of two treatments are more effective in
reducing psychological distress and improving quality of life. One is a coping skills
training (CST) program provided by telephone. The other is an education program about
critical illness that is accessed primarily online. Also, we will determine if unique groups
of people with special characteristics have especially good improvement—and if so, what
personal factors explain this response.
How will we know which treatment is better? We will determine which treatment is most helpful
by comparing participants' levels of psychological distress and quality of life with surveys
taken over 6 months. We'll also record patients' own descriptions of how the treatments
impacted their daily lives. The study will take 3 years and would be performed at 5 medical
centers across the US that treat patients with diverse backgrounds and illnesses. 200 ICU
survivor-family member pairs will be randomly assigned (like a coin flip) to receive either
the CST program or the education program. Treatments consist of 6 weekly telephone calls with
a trained staff member, web-based modules, and handouts.
How will this help others in the future? This research is important because it aims to
improve long-term recovery for entire families by focusing on a devastating, common, yet
inadequately addressed problem. These treatments were developed with the direct input of
patients and families. These treatments represent a new direction in treating critical
illness because they can be delivered inexpensively by phone, easily adapted to future
technologies, overcome barriers to care common to ICU survivors, and shared easily by phone
or computer with others in need across the world.
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