The Impact of Resilience Factors and Anxiety During Hospital Admission on Longitudinal Anxiety Among Dyads of Neurocriti
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ORIGINAL WORK
The Impact of Resilience Factors and Anxiety During Hospital Admission on Longitudinal Anxiety Among Dyads of Neurocritical Care Patients Without Major Cognitive Impairment and Their Family Caregivers Emma E. Meyers1,2,3,4, Alex Presciutti5, Kelly M. Shaffer6, Melissa Gates4,7, Ann Lin4,7, Jonathan Rosand1,2,3 and Ana‑Maria Vranceanu1,3,4,7* © 2020 Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society
Abstract Background/Objective: Anxiety is common in patients experiencing neurocritical illness and their family caregiv‑ ers. Resilience factors like mindfulness and coping skills may be protective against symptoms of emotional distress, including anxiety. Less is known about the interplay of anxiety symptoms and resilience factors between patients and caregivers. The purpose of this study is to examine the trajectory of anxiety symptoms among dyads of neurocriti‑ cal care patients without major cognitive impairment and their family caregivers and to elucidate the relationship between resiliency (e.g., mindfulness and coping) and anxiety in these dyads. Methods: Prospective, longitudinal study of adults admitted to the neurological intensive care unit (Neuro-ICU) and their caregivers. Dyads of patients (N = 102) and family caregivers (N = 103) completed self-report measures of mindfulness (Cognitive Affective Mindfulness Scale-Revised) and coping (Measure of Current Status-Part A) during Neuro-ICU hospitalization and anxiety symptoms (anxiety subscale of the Hospital Anxiety and Depression Scale) during hospitalization and at 3- and 6-month follow-up. We used actor–partner interdependence modeling to predict the effect of one’s own baseline characteristics on one’s own and one’s partner’s future anxiety symptoms. Results: Rates of clinically significant anxiety symptoms were 40% for patients and 42% for caregivers at baseline. Of these, 20% of patients and 23% of caregivers showed moderate and severe symptoms. Approximately, one-third of patients and caregivers reported clinically significant anxiety symptoms at 3- and 6-month follow-ups, with more than 20% endorsing moderate or severe symptoms. Patients’ own baseline mindfulness, coping, and anxiety symptoms were associated with lower anxiety symptoms at all time points (ps 0.42). Rates of clinically significant moderate or severe anxiety symptoms were high and were similar for patients and caregivers at baseline (χ2 (1) = 0.6, p = 0.49). At 3- and 6-month follow-up, rates of clinically significant symptoms in patients slightly increased, while rates in caregivers slightly decreased. Overall, patients were more likely than caregivers to report moderate to severe anxiety symptoms at 3-month (χ2(1) = 9.01, p 0.09). There was no difference in mean HADS-A scores between patients with vascular, structural, or other types of diagnoses (ps > 0.06), between patients who were intubated and patients who were not intubated (ps > 0.1), and between family caregivers of intubated patients and non-intubated patients (ps
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