Coping Strategies and Posttraumatic Stress Symptoms
in Post-ICU Family Decision Makers
Critical Care
Medicine: June 2015 - Volume 43 - Issue 6 - p 1205–1212
Petrinec, Amy B. et al
Objective: To assess
the coping strategies used by family decision makers of adult critical care
patients during and after the critical care experience and the relationship of
coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization.
Design: A single-group descriptive longitudinal correlational study. Setting:
Medical, surgical, and neurological ICUs in a large tertiary care university
hospital. Patients: Consecutive family decision makers of adult critical care
patients from August 2012 to November 2013. Study inclusion occurred after the
patient’s fifth day in the ICU. Interventions: None.
Measurements and Main
Results: Family decision makers of incapacitated adult ICU patients completed
the Brief COPE instrument assessing coping strategy use 5 days after ICU
admission and 30 days after hospital discharge or death of the patient and
completed the Impact of Event Scale-Revised assessing posttraumatic stress
symptoms 60 days after hospital discharge. Seventy-seven family decision makers
of the eligible 176 completed all data collection time points of this study.
The use of problem-focused (p = 0.01) and emotion-focused (p < 0.01) coping
decreased over time while avoidant coping (p = 0.20) use remained stable.
Coping strategies 30 days after hospitalization (R2 = 0.50, p < 0.001) were
better predictors of later posttraumatic stress symptoms than coping strategies
5 days after ICU admission (R2 = 0.30, p = 0.001) controlling for patient and
decision-maker characteristics. The role of decision maker for a parent and
patient death were the only noncoping predictors of posttraumatic stress
symptoms. Avoidant coping use 30 days after hospitalization mediated the
relationship between patient death and later posttraumatic stress symptom
severity. Conclusions: Coping strategy use is a significant predictor of
posttraumatic stress symptom severity 60 days after hospitalization in family
decision makers of ICU patients.
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