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Clinical Investigations in Critical Care |

Prevalence and Outcomes of Caregiving After Prolonged (≥ 48 Hours) Mechanical Ventilation in the ICU*

KyungAh Im; Steven H. Belle; Richard Schulz; Aaron B. Mendelsohn; Lakshmipathi Chelluri; for the QOL-MV Investigators
Author and Funding Information

*From the Epidemiology Data Center, Department of Epidemiology, Graduate School of Public Health (Ms. Im, and Drs. Belle and Mendelsohn), University Center for Social and Urban Research (Dr. Schulz), Department of Critical Care Medicine (Dr. Chelluri), University of Pittsburgh, Pittsburgh, PA.

Correspondance to: KyungAh Im, MS, Epidemiology Data Center, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 Desoto St, 127 Parran Hall, Pittsburgh, PA 15261; e-mail: im@edc.pitt.edu



Chest. 2004;125(2):597-606. doi:10.1378/chest.125.2.597
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Objectives: (1) To estimate caregiver support required by patients 2 months after prolonged (at least 48 h) mechanical ventilation (MV) in an ICU; (2) to describe caregiver burden, caregiver depressive symptomatology, and caregiver limitations in activities; and (3) to investigate factors related to depressive symptoms at 2 months in caregivers.

Design: Prospective cohort study.

Study participants: Caregivers of 115 patients who received prolonged MV in an ICU.

Measurements: Sociodemographics, employment status, hours spent providing care, help from paid caregiving sources, caregiver burden, and caregiver depressive symptoms.

Results: The proportion of patients who survived at least 2 months and required caregiver support was 74.8%. The average age of caregivers was 52.9 years (SD, 14.2), 76.5% were women, and more than half were spouses (52.2%). Only 33 of the caregivers (28.7%) were working, and 30.3% had to reduce their time spent at work to provide care to the patient. The prevalence of risk of clinical depression (defined as Center for Epidemiological Studies depression scale [CES-D] score ≥ 16) among caregivers was 33.9%. The mean caregiver CES-D score was 13.2 (SD, 11; median, 10). Multiple linear regression analysis showed that higher CES-D score was associated with more hours per day helping with patients’ activities of daily living and instrumental activities of daily living (p = 0.003).

Conclusions: Two months after being placed on MV for at least 48 h, a high proportion of patients need caregiver support. Approximately 34% of caregivers are at risk of clinical depression. Many caregivers report lifestyle changes and burden when providing care for the patients.

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