Objective:

The article examines families’ experiential pathway to PTSD after a relative’s critical illness, focusing on experiences they described as buffers or stressors before and during ICU care.

Approach:

• Study design: Kentish-Barnes et al. conducted a qualitative study using inductive thematic analysis, with PTSD as the conceptual focus.
• Participants and data collection: Researchers interviewed 17 relatives of mechanically ventilated patients who had PTSD symptoms at 3 months post-ICU. Telephone interviews took place about 6 months after ICU discharge and lasted 49–155 minutes.

Key Findings:

• Families described critical illness as abrupt and disruptive, often bringing existing illness burdens, prior traumatic experiences, and guilt to the forefront.
• Familiarity with the ICU and staff, clinician empathy, compassionate actions, and clear, high-quality communication were described as helpful.
• Unfamiliar technical surroundings, changes in patients’ appearance or behavior, disrupted family togetherness, exclusion, worry, sleep deprivation, and everyday demands were described as distressing.
• Waiting, uncertainty about illness progression and ICU access, hope, and fatalism contributed to stress.
• Bereaved relatives valued time to anticipate and prepare for death and to participate in decisions about treatment withdrawal or withholding. The technical setting, difficulty recognizing impending death, and viewing the deceased’s body were difficult.

Interpretation:

The authors frame families’ experiences as a trajectory in which buffers and stressors accumulate and interact over time, rather than as the effect of a single risk factor. They suggest that examining ICU care experiences may clarify how workflows, clinician behaviors, and structural features can mitigate or intensify risks, and note the importance of following families beyond the ICU, including through post-ICU clinics.

Limitations:

• The study included 17 relatives, all of whom had PTSD symptoms at 3 months post-ICU; the findings describe their experiences and do not establish how common each experience is among all ICU families.
• Nearly half of the interviewed relatives were bereaved, and participants were relatives of mechanically ventilated patients, limiting the scope of the experiences represented.

Conclusion:

The article highlights the value of examining modifiable factors associated with ICU care and following families’ experiences beyond the ICU, including through post-ICU clinics.

Sources:

• Article context provided by the user