Citation Information :
Kanmani TR, Thimmappur RM, Birudu R, N KR, Raj P. Burden and Psychological Distress of Intensive Care Unit Caregivers of Traumatic Brain Injury Patients. Indian J Crit Care Med 2019; 23 (5):220-223.
Aim: Admission to Intensive Care Unit (ICU) is a stressful event and unforeseen crisis for the caregivers. Burden and psychosocial distress among caregivers in the ICU were unexplored. Therefore, the current study was aimed to assess the caregivers’ burden and psychological distress among caregivers of traumatic brain injury (TBI) patients at emergency ICU during hospitalization.
Materials and Methods: A total of 60 caregivers recruited by using purposive sampling method with descriptive research design. Consent was obtained. Interview schedule of family for depression, anxiety, stress scale (DAS-21) were administered. The data were analyzed by using SPSS. Descriptive statistics and independent burden t-test were used.
Results: Results revealed that male caregivers (75%) and female caregivers (25%) took part in the study. Caregivers\' mean age was found to be 35.22±11.29 years. Most of the TBI survivors admitted in ICU had severe injury (8.30±3.63). Mean scores showed that caregivers had experienced financial burden (6.28±2.36), severe depression (12.15±4.84), and a moderate level of anxiety (12.85±5.20). Independent t-test showed significant difference in caregiving burden between male and female caregivers at ICU (Male = 18.43±4.83; Female = 14.29±4.83; t = 2.16; p <0.035). Overall, caregivers experienced higher family burden and severe psychological distress at ICU.
Conclusion: There is an immediate need to assess psychological distress and family burden of caregivers at ICU and provide timely psychosocial intervention.
Rodríguez AM, San Gregorio MÁ, Rodríguez AG. Psychological repercussions in family members of hospitalized critical condition patients. J Psychosom Res. 2005;58(5):447–451. doi: 10.1016/j. jpsychores.2004.11.011
Cook D, Rocker G, Heyland D. Dying in the ICU: strategies that may improve end-of-life care. Can J Anaesth. 2004;51(3):266–272. doi: 10.1007/BF03019109
McGarry LJ, Thompson D, Millham FH, Cowell L, Snyder PJ, Lenderking WR, et al. Outcomes and costs of acute treatment of traumatic brain injury. J Trauma Acute Care Surg. 2002;53(6):1152–1159. doi: 10.1097/01. TA.0000025801.33552.71
McAdam JL, Fontaine DK, White DB, Dracup KA, Puntillo KA. Psychological symptoms of family members of high-risk intensive care unit patients. Am J Crit Care. 2012;21(6):386–394. doi: 10.4037/ ajcc2012582
Dams-O'Connor K, Spielman L, Singh A, Gordon WA, Lingsma HF, Maas AIR, et al. The impact of previous traumatic brain injury on health and functioning: A TRACK-TBI study. J Neurotrauma. 2013;30(24):2014–2020. doi: 10.1089/neu.2013.3049 6. D r i v e r S, Ede A. Impact of physical activity on mood after TBI. Brain Inj. 2009;23(3):203–212. doi: 10.1080/02699050802695574
Kumar S, Christina J, Jagadish AR, Peter JV, Thomas K, Sudarsanam TD. Caregiver perceptions on intensive care: a qualitative study from southern India. Natl Med J India. 2017;30(3):131–135. doi: 10.1016/j. jinf.2011.06.008
Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, et al. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med.. 2007;35(2):605–622. doi: 10.1097/01.CCM.0000254067.14607.EB
Truog RD, Campbell ML, Curtis JR, Haas CE, Luce JM, Rubenfeld GD, et al. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College of Critical Care Medicine. Crit Care Med. 2008;36(3):953–963. doi: 10.1097/ CCM.0B013E3181659096
McAdam JL, Dracup KA, White DB, Fontaine DK, Puntillo KA. Symptom experiences of family members of intensive care unit patients at high risk for dying. Crit Care Med. 2010;38(4):1078–1085. doi: 10.1097/ CCM.0b013e3181cf6d94
Lee LYK, Lau YL. Immediate needs of adult family members of adult intensive care patients in Hong Kong. J Clin Nurs. 2003;12(4):490–500.
Raju B, Lukose S, Raj P, Reddy K. Clinically providing psycho-social care for caregivers in emergency and trauma care setting: scope for medical and psychiatric social workers. Int J Crit Illn Inj Sci. 2016;6(4):206–210. doi: 10.4103/2229-5151.195452
Price AM. Intensive care nurses’ experiences in assessing and dealing with patients’ psychological needs. Nurs Crit Care. 2004;9(3):134–142.
Arango-Lasprilla JC, Plaza SLO, Drew A, Romero JLP, Pizarro JAA, Francis K, et al. Family needs and psychosocial functioning of caregivers of individuals with spinal cord injury from Colombia, South America. Neuro Rehabilitation. 2010;27(1):83–93. doi: 10.3233/ NRE-2010-0583
Carlozzi NE, Kratz AL, Sander A, Chiaravalloti ND, Brickell T, Lange R, et al. Health-related quality of life in caregivers of individuals with traumatic brain injury: development of a conceptual model. Arch Phys Med Rehabil. 2015;96(1):105–113. doi: 10.1016/j.apmr.2014.08.021
Venkataraman R, Ranganathan L, Rajnibala V, Abraham BK, Rajagopalan S, Ramakrishnan N, et al. Critical care: are we customer friendly? Indian J Crit Care Med. 2015;19(9):507. doi: 10.4103/0972- 5229.164796
Agrawal A, Munivenkatappa A, Shukla DP, Menon GR, Alogolu R, Galwankar S, et al. Traumatic brain injury related research in India: an overview of published literature. Int J Crit Illn Inj Sci. 2016;6(2):65–69. doi: 10.4103/2229-5151.183025
Pai S, Kaipur RL. The burden on the family of a psychiatric patient: development of an interview schedule. Br J Psychiatry. 1981, 138: 332–335. 10.1192/bjp.138.4.332.
Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the 24.Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–343.
Gururaj G, Kolluri SV, Chandramouli BA, Subbakrishna DK, Kraus JF. Traumatic brain injury. Bangalore: National Institute of Mental Health and Neurosciences; 2005.
Pruthi N, Ashok M, Shiva KV, Jhavar K, Sampath S, Devi BI. Magnitude of pedestrian head injuries & fatalities in Bangalore, south India: a retrospective study from an apex neurotrauma center. Indian J Med Res. 2012;136(6):1039.
Deepika A, Devi BI, Shukla D, others. Predictive validity of disability rating scale in determining functional outcome in patients with severe traumatic brain injury. Neurol India. 2017;65(1):83–.
Agrawal A, Munivenkatappa A, Subrahmanyam BV, Satish KS, Ramamohan P. Admission characteristics and outcome in traumatic brain injury patients: a preliminary report from a tertiary care hospital. Romanian Neurosurg. 2016;30(2):252–257.
Tramonti F, Bonfiglio L, Bernardo CD, Ulivi C, Virgillito A, Rossi B, et al. Family functioning in severe brain injuries: correlations with caregivers’ burden, perceived social support and quality of life. Psychol Health Med. 2015;20(8):933–939. doi: 10.1080/13548506.2015.1009380