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Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients
INTRODUCTION: Family presence during emergency resuscitations is increasingly common, but the question remains whether the practice results in psychological harm to the witness. We examine whether family members who witness resuscitations have increased post-traumatic stress disorder (PTSD) symptoms...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Department of Emergency Medicine, University of California, Irvine School of Medicine
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514396/ https://www.ncbi.nlm.nih.gov/pubmed/32970573 http://dx.doi.org/10.5811/westjem.2020.6.46300 |
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author | Erogul, Mert Likourezos, Antonios Meddy, Jodee Terentiev, Victoria Davydkina, D’anna Monfort, Ralph Pushkar, Illya Vu, Thomas Achalla, Madhu Fromm, Christian Marshall, John |
author_facet | Erogul, Mert Likourezos, Antonios Meddy, Jodee Terentiev, Victoria Davydkina, D’anna Monfort, Ralph Pushkar, Illya Vu, Thomas Achalla, Madhu Fromm, Christian Marshall, John |
author_sort | Erogul, Mert |
collection | PubMed |
description | INTRODUCTION: Family presence during emergency resuscitations is increasingly common, but the question remains whether the practice results in psychological harm to the witness. We examine whether family members who witness resuscitations have increased post-traumatic stress disorder (PTSD) symptoms at one month following the event. METHODS: We identified family members of critically ill patients via our emergency department (ED) electronic health record. Patients were selected based on their geographic triage to an ED critical care room. Family members were called a median of one month post-event and administered the Impact of Event Scale-Revised (IES-R), a 22-item validated scale that measures post-traumatic distress symptoms and correlates closely with Diagnostic and Statistical Manual of Mental Disorders-IV criteria for post-traumatic stress disorder (PTSD). Family members were placed into two groups based on whether they stated they had witnessed the resuscitation (FWR group) or not witnessed the resuscitation (FNWR group). Data analyses included chi-square test, independent sample t-test, and linear regression controlling for gender and age. RESULTS: A convenience sample of 423 family members responded to the phone interview: 250 FWR and 173 FNWR. The FWR group had significantly higher mean total IES-R scores: 30.4 vs 25.6 (95% confidence interval [CI], −8.73 to −0.75; P<.05). Additionally, the FWR group had significantly higher mean score for the subscales of avoidance (10.6 vs 8.1; 95% CI, −4.25 to −0.94; P<.005) and a trend toward higher score for the subscale of intrusion (13.0 vs 11.4; 95% CI, −3.38 to .028; P = .054). No statistical significant difference was noted between the groups in the subscale of hyperarousal (6.95 vs 6.02; 95% CI, −2.08 to 0.22; P=.121). All findings were consistent after controlling for age, gender, and immediate family member (spouse, parent, children, and grandchildren). CONCLUSION: Our results suggest that family members who witness ED resuscitations may be at increased risk of PTSD symptoms at one month. This is the first study that examines the effects of family visitation for an unsorted population of very sick patients who would typically be seen in the critical care section of a busy ED. |
format | Online Article Text |
id | pubmed-7514396 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Department of Emergency Medicine, University of California, Irvine School of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-75143962020-09-29 Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients Erogul, Mert Likourezos, Antonios Meddy, Jodee Terentiev, Victoria Davydkina, D’anna Monfort, Ralph Pushkar, Illya Vu, Thomas Achalla, Madhu Fromm, Christian Marshall, John West J Emerg Med Behavioral Health INTRODUCTION: Family presence during emergency resuscitations is increasingly common, but the question remains whether the practice results in psychological harm to the witness. We examine whether family members who witness resuscitations have increased post-traumatic stress disorder (PTSD) symptoms at one month following the event. METHODS: We identified family members of critically ill patients via our emergency department (ED) electronic health record. Patients were selected based on their geographic triage to an ED critical care room. Family members were called a median of one month post-event and administered the Impact of Event Scale-Revised (IES-R), a 22-item validated scale that measures post-traumatic distress symptoms and correlates closely with Diagnostic and Statistical Manual of Mental Disorders-IV criteria for post-traumatic stress disorder (PTSD). Family members were placed into two groups based on whether they stated they had witnessed the resuscitation (FWR group) or not witnessed the resuscitation (FNWR group). Data analyses included chi-square test, independent sample t-test, and linear regression controlling for gender and age. RESULTS: A convenience sample of 423 family members responded to the phone interview: 250 FWR and 173 FNWR. The FWR group had significantly higher mean total IES-R scores: 30.4 vs 25.6 (95% confidence interval [CI], −8.73 to −0.75; P<.05). Additionally, the FWR group had significantly higher mean score for the subscales of avoidance (10.6 vs 8.1; 95% CI, −4.25 to −0.94; P<.005) and a trend toward higher score for the subscale of intrusion (13.0 vs 11.4; 95% CI, −3.38 to .028; P = .054). No statistical significant difference was noted between the groups in the subscale of hyperarousal (6.95 vs 6.02; 95% CI, −2.08 to 0.22; P=.121). All findings were consistent after controlling for age, gender, and immediate family member (spouse, parent, children, and grandchildren). CONCLUSION: Our results suggest that family members who witness ED resuscitations may be at increased risk of PTSD symptoms at one month. This is the first study that examines the effects of family visitation for an unsorted population of very sick patients who would typically be seen in the critical care section of a busy ED. Department of Emergency Medicine, University of California, Irvine School of Medicine 2020-09 2020-08-24 /pmc/articles/PMC7514396/ /pubmed/32970573 http://dx.doi.org/10.5811/westjem.2020.6.46300 Text en Copyright: © 2020 Erogul et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Behavioral Health Erogul, Mert Likourezos, Antonios Meddy, Jodee Terentiev, Victoria Davydkina, D’anna Monfort, Ralph Pushkar, Illya Vu, Thomas Achalla, Madhu Fromm, Christian Marshall, John Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients |
title | Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients |
title_full | Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients |
title_fullStr | Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients |
title_full_unstemmed | Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients |
title_short | Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients |
title_sort | post-traumatic stress disorder in family-witnessed resuscitation of emergency department patients |
topic | Behavioral Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514396/ https://www.ncbi.nlm.nih.gov/pubmed/32970573 http://dx.doi.org/10.5811/westjem.2020.6.46300 |
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