Intensive Care Medicine: Published 18 May 2026
Purpose
To examine the effect of a multicomponent, nurse-led,
interprofessional family support intervention on family functioning and mental
health in adult intensive care units (ICUs).
Methods
A cluster-randomized controlled trial in 16 Swiss ICUs
compared an intervention—a family care pathway with specially trained ICU
family nurses engaging and liaising with families, giving psychoeducational and
relationship-focused care, and providing structured, interprofessional
communication—to usual care. Family members of patients with an expected ICU
stay of ≥ 48 h and a high risk of death, serious impairment, or
prolonged mechanical ventilation participated. Outcomes included family
functioning, resilience, life satisfaction, quality of life, distress, anxiety,
depression, and posttraumatic stress, assessed at patient ICU admission,
discharge, 3-, 6-, and 12 months post-ICU, and analyzed by linear mixed
effects models.
Results
Almost half (43%) of the invited family members participated
(885; May 2022 to January 2024). Follow-ups were completed on time by 736
(83.2%), 665 (75.1%), 643 (71.6%), and 593 (67.0%), respectively. Between 609
and 613 were included in the analysis. Family member characteristics were
comparable at baseline, yet patient mechanical ventilation (60.3 vs. 49.5%) and
ICU death (19.9 vs. 13.2%) were higher in the intervention than the control
arm. There was no significant difference between the study arms for any of
the outcomes. Type of relationship, prior ICU experience, and patient
mechanical ventilation were associated with some of the outcomes. Mental health
systematically improved post-ICU.
Conclusion
No evidence of a significant improvement in family
functioning or mental health was found within the first year
after ICU treatment. Due to limitations, the results of our study have to
be interpreted cautiously and in a hypothesis-generating manner.
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