Structured meetings led by palliative care specialists did not provide appreciable reductions of depression or anxiety in family members of patients with chronic critical illnesses, compared to routine family meetings conducted by ICU teams, researchers say.
Writing in the July issue of JAMA, investigators theorize that typical care may provide enough high-quality communication and emotional support to build family satisfaction. They also acknowledged that the number of visits (two or more) with a palliative care expert might have been “insufficient to overcome the high levels of family stress.” All study participants also received informational brochures.
Palliative care specialists provide information and emotional support to chronically ill patients and their surrogate decision-makers, including family members. An estimated 380,000 patients fit the description in 2009, officials said.
The intervention and control groups each included about 130 patients (all with at least seven days of mechanical ventilation) and 180 family members. After three months, there were no differences among surrogate decision-makers regarding anxiety and depression symptoms. Post-traumatic stress disorder symptoms, however, were less in the control group.
The researchers were led by Shannon S. Carson, M.D., of the University of North Carolina School of Medicine, and Judith E. Nelson, M.D., J.D., of the Memorial Sloan Kettering Cancer Center in New York.
