A Correlation Study Of Post-intensive Care Syndrome With Decision-making Role And Social Support In Family Members Of Elderly Patients

Objective: To investigate the specific situation of family members of elderly patients in intensive care unit(ICU)in three aspects: post-intensive care syndrome-family(PICS-F),decision-making roles and social support.Differences in sociodemographic characteristics of PICS-F,decision-making roles,and social support were analyzed.To explore the relationship among PICS-F,decision-making roles and social support.To provide theoretical support for the medical staff to formulate relevant clinical intervention measures for the family members of elderly patients in ICU in the future.Methods: This study investigated the family members of 238 elderly patients who were admitted to the general ICU ward of a third-grade class-A hospital in Wuxi from August 2020 to October 2021 and were transferred out.The researchers conducted an on-site questionnaire survey of family members of patients who met the inclusion criteria and gave informed consent,including nine parts: general data questionnaire,7-time Generalized Anxiety Disorder Scale(GAD-7),Patient Health Questionnaire-9(PHQ-9),Pittsburgh Sleep Quality Index(PSQI),Fatigue Assessment Instrument(FAI),Control Preference Scale(CPS)and Perceived Social Support Scale(PSSS).SPSS 22.0 statistical software was used for statistical analysis of the data,including descriptive analysis,independent sample t-test,one-way ANOVA analysis,Chi-Square test,Fisher’s exact test,Pearson correlation analysis,point biserial correlation analysis,and multiple linear regression.Results:(1)The total score of anxiety of family members of elderly patients in ICU was(7.13 ±4.50)points,and the incidence of anxiety was 29.4%.The anxiety scores of family members of elderly patients in the ICU were statistically different in family age,education,residence,per capita monthly income,relationship with patients,patient age,and medical payment method(P < 0.05).(2)The total score of depression in family members of elderly patients in ICU was(7.31± 4.28)points,and the incidence of depression was 35.7%.The depression scores of family members of elderly patients in the ICU were statistically different in family age,education,residence,per capita monthly income,relationship with patients,and mode of medical payment(P < 0.05).(3)The total score of sleep disorder in family members of elderly patients in ICU was(8.65 ± 3.52)points,and the incidence of sleep disorders was 62.6%.The sleep disorder scores of family members of elderly patients in the ICU were statistically different in family age,education,residence,per capita monthly income,relationship with patients,and mode of medical payment(P < 0.05).(4)The total score of fatigue of family members of elderly patients in ICU was(116.41± 23.79)points,and the incidence of fatigue was 66.0%.The fatigue scores of family members of elderly patients in the ICU were statistically different in family age,education,residence,per capita monthly income,relationship with patients,and medical payment methods(P < 0.05).(5)In the medical decision participation of family members of elderly patients in ICU,the incidence of mismatch between expected role and actual role was 41.6%,and the agreement between expected decision role and actual decision role was poor(kappa = 0.321,P < 0.001).The mismatch in decision-making roles of family members of elderly patients in the ICU was statistically significant in family age and relationship with patients(P < 0.05).(6)The total score of social support for family members of elderly patients in ICU was(58.16 ± 9.18)points,of which the moderate level of social support was the highest in 71.0%,followed by the high level in 26.9%,and finally the low level in 2.1%.The social support scores of family members of elderly patients in the ICU were statistically different in family age,education,work status,residence,per capita monthly income,patient age,and medical payment method(P < 0.05).(7)The decision-making roles of family members of elderly patients in ICU were positively correlated with anxiety,depression,sleep disturbance and fatigue(P < 0.01).Social support was negatively correlated with anxiety,depression,sleep disorders and fatigue(P <0.01).There was a negative correlation between social support and decision-making roles(P< 0.01).(8)Multiple linear regression showed that: patients’ age,decision-making role and family support had predictive effects on family members’ anxiety(P < 0.05);family members’ age,decision-making role and family support had predictive effects on family members’ depression(P < 0.05);family members’ education level,decision-making role and family support had predictive effects on family members’ sleep disturbance(P < 0.05);family members’ education level,decision-making role and family support had predictive effects on family members’ fatigue(P < 0.05).Conclusions: This study found that the incidence of pics-f in family members of elderly patients in ICU was high,indicating that pics-f in family members of elderly patients in ICU is a problem that can not be ignored.The study found that PICS-F,decision-making roles and social support were significantly correlated,and decision-making roles and social support were the main influencing factors of PICS-F variables.It suggests that we can implement personalized interventions according to the relationship between PICS-F,decision role and social support,and different situations of family members to improve the PICS-F status of family members of elderly patients in ICU.