Emma E Meyers1,2,3,4, Alex Presciutti5, Kelly M Shaffer6, Melissa Gates4,7, Ann Lin4,7, Jonathan Rosand1,2,3, Ana-Maria Vranceanu8,9,10,11. 1. Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, 55 Fruit St., Wang Ambulatory Care Center 8th Floor, Suite 815 and 85, Boston, MA, 021140, USA. 2. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA. 3. Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. 4. Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA. 5. Department of Psychology, University of Colorado Denver, Denver, CO, 80217, USA. 6. Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22902, USA. 7. Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. 8. Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, 55 Fruit St., Wang Ambulatory Care Center 8th Floor, Suite 815 and 85, Boston, MA, 021140, USA. avranceanu@mgh.harvard.edu. 9. Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. avranceanu@mgh.harvard.edu. 10. Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA. avranceanu@mgh.harvard.edu. 11. Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. avranceanu@mgh.harvard.edu.
Abstract
BACKGROUND/ OBJECTIVE: Anxiety is common in patients experiencing neurocritical illness and their family caregivers. 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 neurocritical 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 < 0.001)-this was also true for caregivers. For both patients and caregivers, one's own baseline mindfulness predicted their partner's anxiety symptoms 3 months later (p = 0.008), but not at 6-month follow-up. CONCLUSIONS: Anxiety symptoms in Neuro-ICU patient-caregiver dyads are high through 6 months following admission. Mindfulness is interdependent and protective against anxiety in dyads at 3-month but not 6-month follow-up. Early, dyad-based interventions may prevent the development of chronic anxiety in patients without major cognitive impairment and caregivers.
BACKGROUND/ OBJECTIVE: Anxiety is common in patients experiencing neurocritical illness and their family caregivers. 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 neurocritical 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 < 0.001)-this was also true for caregivers. For both patients and caregivers, one's own baseline mindfulness predicted their partner's anxiety symptoms 3 months later (p = 0.008), but not at 6-month follow-up. CONCLUSIONS: Anxiety symptoms in Neuro-ICU patient-caregiver dyads are high through 6 months following admission. Mindfulness is interdependent and protective against anxiety in dyads at 3-month but not 6-month follow-up. Early, dyad-based interventions may prevent the development of chronic anxiety in patients without major cognitive impairment and caregivers.
Authors: Sarah M Bannon; Talea Cornelius; Melissa V Gates; Ethan Lester; Ryan A Mace; Paula Popok; Eric A Macklin; Jonathan Rosand; Ana-Maria Vranceanu Journal: Health Psychol Date: 2021-09-09 Impact factor: 4.267
Authors: Sarah Bannon; Ethan G Lester; Melissa V Gates; Jessica McCurley; Ann Lin; Jonathan Rosand; Ana-Maria Vranceanu Journal: Pilot Feasibility Stud Date: 2020-05-25
Authors: Alfonso Martínez-Moreno; Ricardo José Ibáñez-Pérez; Francisco Cavas-García F; Francisco Cano-Noguera Journal: Int J Environ Res Public Health Date: 2020-11-09 Impact factor: 3.390
Authors: Ana-Maria Vranceanu; Sarah Bannon; Ryan Mace; Ethan Lester; Emma Meyers; Melissa Gates; Paula Popok; Ann Lin; Danielle Salgueiro; Tara Tehan; Eric Macklin; Jonathan Rosand Journal: JAMA Netw Open Date: 2020-10-01