Mental Health of Adolescent Relatives of Intensive Care Patients: Benefits of an Open Visitation Policy

Am J Crit Care. 2021 Jan 1;30(1):72-76. doi: 10.4037/ajcc2021799.

Abstract

Background: Symptoms of anxiety and depression are common in adolescents with a loved one in an intensive care unit (ICU) and are known precursors of posttraumatic stress disorder (PTSD).

Objectives: To assess the prevalence of PTSD and associated factors in adolescent (age 12-17 years) relatives of patients in an ICU with an open visitation policy.

Methods: One year after the patient was discharged from the ICU, eligible adolescent relatives completed a satisfaction survey, anxiety history questionnaire, and psychometric evaluations (Hospital Anxiety and Depression Scale and 8-item Children's Revised Impact of Event Scale).

Results: Thirty-two patients intubated for >2 days and with a Simplified Acute Physiology Score II >30 were included. Forty-six adolescents with first- to third-degree relationships to the patient, and in regular contact (≥monthly) with the patient before hospitalization, were enrolled. The prevalence of PTSD among the adolescents was 33%. Adolescents who visited the ICU were less likely to report feelings of regret than those who did not visit the ICU (2% vs 9%, P = .01). A past sense of threat (odds ratio [95% CI], 19.4 [1.9-201.2]; P = .01) and anxiety and depression symptoms (odds ratio [95% CI], 9.6 [1.4-63.7]; P = .02) were independent factors associated with probable PTSD.

Conclusions: A cautiously prepared open visiting policy should be maintained for adolescents with a relative in the ICU, because it could prevent feelings of regret and subsequent PTSD. Adolescents with risk factors should be screened and followed up.

MeSH terms

  • Adolescent
  • Anxiety / epidemiology
  • Child
  • Critical Care
  • Depression / epidemiology
  • Family
  • Humans
  • Intensive Care Units
  • Mental Health*
  • Policy
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Visitors to Patients