Coping and Psychological Distress of Family Members of Adult Cardiac Surgery Patients in the ICU and Prior to Discharge.

Abstract

The purpose of this research was to explore the relationships of family functioning, social support, appraisal of illness/caregiving, uncertainty, and coping on psychological distress among family members of loved ones undergoing adult cardiac surgery. A descriptive correlational design with instruments to measure the six variables of interest and demographics was used to collect data at three points in a planned adult cardiac surgery experience. A convenience sample of 81 family members was recruited and completed all three data collection points. The sample was primarily Caucasian (92.8%), female (70%), spouses (63%) and highly educated (100% had completed high school or more). There were no statistically significant differences in any of the predictor variables by age, gender or race. Psychological distress, as measured on the Distress Thermometer, during the ICU stay was 5.791 (S.D. 2.587) and 5.220 (S.D. 2.615) prior to discharge. While both psychological distress scores indicate significant effect on the family members, the decrease was statistically significant. The results of the regression analysis showed that the model, along with three demographic variables (age, relationship, and gender) accounted for 36.3% of the variance; both overall active coping and avoidant coping predicted psychological distress. Path analysis showed that the only significant predictors of psychological distress were overall active coping and overall avoidant coping at similar levels of influence. The most frequently used coping strategies reported by the sample were active coping strategies of acceptance, use of emotional support, positive reframing, active coping and planning. Avoidant coping strategies, such as venting, self-blame, and substance use, were reported less frequently, although some subjects did report using these strategies. Nurses should be mindful of the psychological distress these family members experience throughout the hospital stay and further research should determine what interventions may assist with decreasing it.