Scholars@Duke publication: Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial.

Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial.

Publication , Journal Article

Cox, CE; Hough, CL; Carson, SS; White, DB; Kahn, JM; Olsen, MK; Jones, DM; Somers, TJ; Kelleher, SA; Porter, LS

Published in: Am J Respir Crit Care Med

January 1, 2018

RATIONALE: Many survivors of critical illness and their family members experience significant psychological distress after patient discharge. OBJECTIVES: To compare the effects of a coping skills training (CST) program with an education program on patient and family psychological distress. METHODS: In this five-center clinical trial, adult patients who received mechanical ventilation for more than 48 hours and one family member of each patient were randomized to six weekly CST telephone sessions plus access to a study website or a critical illness education program. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the patient Hospital Anxiety and Depression Scale (HADS) score at 3 months. Secondary outcomes included 3- and 6-month HADS subscales and the Impact of Events Scale-Revised. Among the 175 patients randomized to CST (n = 86) or education (n = 89), there was no significant difference between CST and education in either 3-month HADS scores (difference, 1.3; 95% confidence interval [CI], -0.9 to 3.4; P = 0.24) or secondary patient and family outcomes. In prespecified analyses, among patients with high baseline distress (n = 60), CST recipients had greater improvement in 6-month HADS score (difference, -4.6; 95% CI, -8.6 to -0.6; P = 0.02) than the education group. Among patients ventilated longer than 7 days (n = 47), education recipients had greater improvement in 3-month HADS score (difference, -4.0; 95% CI, -8.1 to -0.05; P = 0.047) than the CST group. CONCLUSIONS: CST did not improve psychological distress symptoms compared with an education program. However, CST improved symptoms of distress at 6 months among patients with high baseline distress, whereas the education program improved distress at 3 months among those ventilated for more than 7 days. Future efforts to address psychological distress among critical illness survivors should target high-risk populations. Clinical trial registered with www.clinicaltrials.gov (NCT01983254).

Duke Scholars

Author Christopher Ethan Cox Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Maren Karine Olsen Biostatistics & Bioinformatics, Division of Biostatistics

Author Derek Jones

Author Tamara J. Somers Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...

Author Sarah Anne Kelleher Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...

Author Laura S Porter Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...

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Published In

Am J Respir Crit Care Med

DOI

10.1164/rccm.201704-0720OC

EISSN

1535-4970

Publication Date

January 1, 2018

Volume

197

Issue

Start / End Page

66 / 78

Location

United States

Related Subject Headings

Telephone
Survivors
Stress Disorders, Post-Traumatic
Sex Factors
Risk Assessment
Respiratory System
Quality of Life
Prospective Studies
Program Evaluation
Program Development

Citation

APA

Chicago

ICMJE

MLA

NLM

Cox, C. E., Hough, C. L., Carson, S. S., White, D. B., Kahn, J. M., Olsen, M. K., … Porter, L. S. (2018). Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial. Am J Respir Crit Care Med, 197(1), 66–78. https://doi.org/10.1164/rccm.201704-0720OC

Cox, Christopher E., Catherine L. Hough, Shannon S. Carson, Douglas B. White, Jeremy M. Kahn, Maren K. Olsen, Derek M. Jones, Tamara J. Somers, Sarah A. Kelleher, and Laura S. Porter. “Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial.” Am J Respir Crit Care Med 197, no. 1 (January 1, 2018): 66–78. https://doi.org/10.1164/rccm.201704-0720OC.

Cox CE, Hough CL, Carson SS, White DB, Kahn JM, Olsen MK, et al. Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial. Am J Respir Crit Care Med. 2018 Jan 1;197(1):66–78.

Cox, Christopher E., et al. “Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial.” Am J Respir Crit Care Med, vol. 197, no. 1, Jan. 2018, pp. 66–78. Pubmed, doi:10.1164/rccm.201704-0720OC.

Cox CE, Hough CL, Carson SS, White DB, Kahn JM, Olsen MK, Jones DM, Somers TJ, Kelleher SA, Porter LS. Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial. Am J Respir Crit Care Med. 2018 Jan 1;197(1):66–78.