Associations Between Gender, Resiliency Factors, and Anxiety in Neuro-ICU Caregivers: a Prospective Study
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Associations Between Gender, Resiliency Factors, and Anxiety in Neuro-ICU Caregivers: a Prospective Study Ethan G. Lester 1,2,3 & Ilyssa H. Silverman 1 & Melissa V. Gates 1 & Ann Lin 1 & Ana-Maria Vranceanu 1,2,3
# International Society of Behavioral Medicine 2020
Abstract Background Informal caregivers of patients admitted to the neuroscience intensive care unit (Neuro-ICU) are at risk for developing chronic anxiety. Resiliency factors may reduce risk, yet their differential effects for female and male caregivers have not been studied in this population. We aim to examine interactions between gender and baseline resiliency factors and anxiety at baseline, 3 months, and 6 months. Method Prospectively studied caregivers (N = 96) of patients admitted to the Neuro-ICU completed baseline sociodemographics and resiliency measures (coping, mindfulness, self-efficacy, intimate care, and caregiver preparedness), and anxiety severity at baseline (hospitalization), 3 months, and 6 months. Results Baseline anxiety predicted future anxiety (3 and 6 months). Caregivers who reported high (versus low) baseline coping, mindfulness, self-efficacy, and preparedness for caregiving reported lower baseline anxiety (ps ≤ 0.012). An interaction between caregiver gender and baseline mindfulness was seen at 3 months (p = 0.021), with high mindfulness males reporting lower anxiety than high mindfulness females, and low mindfulness males reporting higher anxiety than low mindfulness females. Conclusion Results emphasize the protective role of resilience in the trajectory of anxiety among informal caregivers. Findings emphasize the need to rapidly deploy skills-based treatment to Neuro-ICU caregivers to prevent future development and maintenance of anxiety, specifically emphasizing mindfulness in male caregivers. Keywords Caregiver . Neuroscience ICU . Gender . Anxiety . Resilience . Mindfulness
Introduction Recent medical advancements have resulted in greater survival rates and shorter hospital stays for critically ill patients. As a result, informal caregivers (patients’ family members, partners, or close friends who provide the majority of unpaid care for a loved one [1]) are asked to play key roles in patient care during admission and after discharge, including those of case manager, bedside nurse, and, in some cases, first responder. These are responsibilities for which caregivers are underprepared, untrained, and unsupported [2]. As a result, rates of * Ana-Maria Vranceanu [email protected] 1
Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA 02114, USA
2
Neuroscience Intensive Care Unit, Massachusetts General Hospital, Boston, MA, USA
3
Harvard Medical School, Boston, MA, USA
anxiety are high among these caregivers [3, 4] and persist long after their loved ones’ discharge [5]. Anxiety impacts caregivers’ daily functioning [6], increases their risk for morbidity and mortality [7-9],
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