Medicina intensiva · 2026
Interdependent post-traumatic stress symptoms and health-related quality of life in ICU survivor-caregiver dyads: A prospective exploratory pilot study.
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Sanna Andrea, Miori Sara, Longo Luigi, Zanon Francesca, Pace Rocco, Cipulli Francesco, De Rosa Silvia, Bellani Giacomo
Аннотация
OBJECTIVE: To evaluate post-traumatic stress symptoms, anxiety, depression, and health-related quality of life six months after intensive care unit (ICU) discharge, and to explore potential dyadic associations of psychological outcomes within ICU survivor-caregiver dyads.
DESIGN: Prospective single-center pilot observational study.
SETTING: Adult intensive care unit of a tertiary-care hospital.
PATIENTS OR PARTICIPANTS: Adult ICU survivors with length of stay ≥72 h and their identified primary caregivers enrolled as dyads.
INTERVENTIONS: No therapeutic interventions were performed. ICU-related stressors (ICUESS) and caregiver satisfaction (FS-ICU) were assessed at ICU discharge. At 6 months, post-traumatic stress symptoms (IES-R), anxiety and depression (HADS), and patient-reported quality of life (EQ-5D-5L and EQ-VAS) were evaluated.
MAIN VARIABLES OF INTEREST: Prevalence of probable PTSD (IES-R ≥33), dyadic concordance of PTSD symptoms, and associations between PTSD and health-related quality of life deterioration.
RESULTS: Thirty-nine dyads were enrolled; 31 patients and 36 caregivers completed follow-up. Probable PTSD occurred in 15.4% of patients and 23.1% of caregivers. Within-dyad concordance was high (82% overall agreement: φ = 0.44), suggesting non-random clustering of PTSD symptoms within dyads. Nearly half of survivors (≈48%) experienced clinically meaningful deterioration in EQ-VAS, which was associated with probable PTSD in both dyad members. Perceived ICU-related stressors showed high concordance across dyads.
CONCLUSIONS: Post-ICU psychological distress may show relational patterns within ICU survivor-caregiver dyads. Functional decline and shared psychological vulnerability may contribute to post-traumatic stress symptom burden after ICU discharge. These preliminary findings should be considered exploratory and hypothesis-generating and require confirmation in larger, adequately powered dyadic studies.
DESIGN: Prospective single-center pilot observational study.
SETTING: Adult intensive care unit of a tertiary-care hospital.
PATIENTS OR PARTICIPANTS: Adult ICU survivors with length of stay ≥72 h and their identified primary caregivers enrolled as dyads.
INTERVENTIONS: No therapeutic interventions were performed. ICU-related stressors (ICUESS) and caregiver satisfaction (FS-ICU) were assessed at ICU discharge. At 6 months, post-traumatic stress symptoms (IES-R), anxiety and depression (HADS), and patient-reported quality of life (EQ-5D-5L and EQ-VAS) were evaluated.
MAIN VARIABLES OF INTEREST: Prevalence of probable PTSD (IES-R ≥33), dyadic concordance of PTSD symptoms, and associations between PTSD and health-related quality of life deterioration.
RESULTS: Thirty-nine dyads were enrolled; 31 patients and 36 caregivers completed follow-up. Probable PTSD occurred in 15.4% of patients and 23.1% of caregivers. Within-dyad concordance was high (82% overall agreement: φ = 0.44), suggesting non-random clustering of PTSD symptoms within dyads. Nearly half of survivors (≈48%) experienced clinically meaningful deterioration in EQ-VAS, which was associated with probable PTSD in both dyad members. Perceived ICU-related stressors showed high concordance across dyads.
CONCLUSIONS: Post-ICU psychological distress may show relational patterns within ICU survivor-caregiver dyads. Functional decline and shared psychological vulnerability may contribute to post-traumatic stress symptom burden after ICU discharge. These preliminary findings should be considered exploratory and hypothesis-generating and require confirmation in larger, adequately powered dyadic studies.