Psychological effects of remote-only communication among reference persons of ICU patients during COVID-19 pandemic
Jessy Cattelan, Sara Castellano, Hamid Merdji, Jean Audusseau, Baptiste Claude, Léa Feuillassier, Sibylle Cunat, Marc Astrié, Camille Aquin, Guillaume Buis, Edgar Gehant, Amandine Granier, Hassiba Kercha, Camille Le Guillou, Guillaume Martin, Kévin Roulot, Ferhat Meziani, Olivier Putois, Julie Helms
Abstract
BACKGROUND: During COVID-19 pandemic, visits have been prohibited in most French ICUs. Psychological effects, for reference persons (RPs), of remote-only communication have been assessed. METHODS: All RPs of patients referred to ICU for COVID-19 were included. HADS, IES-R, and satisfaction were evaluated at admission, discharge/death, and 3 months. At 3 months, a psychologist provided a qualitative description of RPs' psychological distress. RESULTS: Eighty-eight RPs were included. Prevalence of anxiety and depression was 83% and 73% respectively. At 3 months, lower HADS decrease was associated with patient death/continued hospitalization, and/or sleeping disorders in RPs (p < 0.01). Ninety-nine percent RPs felt the patient was safe (9 [7; 10]/10 points, Likert-type scale), confident with caregivers (10 [9; 10]/10 points), and satisfied with information provided (10 [9; 10]/10 points). All RPs stressed the specific-type of "responsibility" associated with being an RP in a remote-only context, leading RPs to develop narrow diffusion strategies (67%) and restrict the array of contacted relatives to a very few and/or only contacting them rarely. 10 RPs (30%) related the situation to a prior traumatic experience. CONCLUSION: RPs experienced psychological distress and reported that being an RP in a remote-only communication context was a specific responsibility and qualified it as an overall negative experience. TRIAL REGISTRATION: NCT04385121 . Registered 12 May 2020. https://clinicaltrials.gov/ .