Emotional distress, coping and adjustment in family members of neuroscience intensive care unit patients
Received 22 July 2008; received in revised form 9 December 2008; accepted 11 December 2008. published online 06 March 2009.
Abstract
Objective
We evaluated emotional distress, coping strategy use, caregiver adjustment, and the relationship among these variables in family members (FMs) of patients hospitalized in a neuroscience intensive care unit (NSICU).
Methods
Fifty-one primary relatives of NSICU patients were administered the Brief Symptom Inventory (BSI) and an abbreviated version of the COPE within 2 days of admission to the NSICU, just prior to patient discharge from the unit, and approximately 30 days after patient discharge (follow-up). FMs' adjustment to the role of caregiver was also evaluated at follow-up with the Caregiver Appraisal Scale (CAS).
Results
BSI emotional distress levels were higher than those of the nonpatient normative sample at patient admission, but, except for anxiety, were within a standard deviation of the mean of the said group; with the exception of anxiety they declined to below nonpatient normative levels at follow-up. Females' distress levels were higher than those of males'. FMs' use of both problem-focused and emotion-focused coping strategies increased from admission through follow-up. Emotional distress was unrelated to problem-focused coping but was associated with emotion-focused coping at admission and discharge, with use of denial as a coping strategy primarily accounting for this relationship. Extent of use of both problem-focused and emotion-focused coping at admission was associated with better caregiver adjustment at follow-up, but over time only increases in problem-focused coping were associated with better subsequent caregiver adjustment.
Conclusions
Findings suggest that interventions fostering increased use of problem-focused coping and sense of control will be effective in lowering FM distress level and enhancing subsequent adjustment in the role of caregiver.
aDepartment of Psychology, Virginia Commonwealth University, Richmond, VA, USA
bDepartment of Psychology and Reanimation Engineering Shock Center, Virginia Commonwealth University, Richmond, VA, USA
cReanimation Engineering Shock Center and Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA
Corresponding author. Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Box 842018, Richmond, VA 23284-2018, USA. Tel.: +1 804 828 1172; fax: +1 804 828 2237.
ABSTRACT