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Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness.

Publication ,  Journal Article
Khandelwal, N; Hough, CL; Downey, L; Engelberg, RA; Carson, SS; White, DB; Kahn, JM; Jones, DM; Key, MD; Reagan, W; Porter, LS; Curtis, JR; Cox, CE
Published in: Crit Care Med
June 2018

OBJECTIVES: Little is known about the experience of financial stress for patients who survive critical illness or their families. Our objective was to describe the prevalence of financial stress among critically ill patients and their families, identify clinical and demographic characteristics associated with this stress, and explore associations between financial stress and psychologic distress. DESIGN: Secondary analysis of a randomized trial comparing a coping skills training program and an education program for patients surviving acute respiratory failure and their families. SETTING: Five geographically diverse hospitals. PARTICIPANTS: Patients (n = 175) and their family members (n = 85) completed surveys within 2 weeks of arrival home and 3 and 6 months after randomization. MEASUREMENTS AND MAIN RESULTS: We used regression analyses to assess associations between patient and family characteristics at baseline and financial stress at 3 and 6 months. We used path models and mediation analyses to explore relationships between financial stress, symptoms of anxiety and depression, and global mental health. Serious financial stress was high at both time points and was highest at 6 months (42.5%) among patients and at 3 months (48.5%) among family members. Factors associated with financial stress included female sex, young children at home, and baseline financial discomfort. Experiencing financial stress had direct effects on symptoms of anxiety (β = 0.260; p < 0.001) and depression (β = 0.048; p = 0.048). CONCLUSIONS: Financial stress after critical illness is common and associated with symptoms of anxiety and depression. Our findings provide direction for potential interventions to reduce this stress and improve psychologic outcomes for patients and their families.

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Published In

Crit Care Med

DOI

EISSN

1530-0293

Publication Date

June 2018

Volume

46

Issue

6

Start / End Page

e530 / e539

Location

United States

Related Subject Headings

  • Time Factors
  • Survivors
  • Surveys and Questionnaires
  • Stress, Psychological
  • Risk Factors
  • Respiratory Insufficiency
  • Prevalence
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Khandelwal, N., Hough, C. L., Downey, L., Engelberg, R. A., Carson, S. S., White, D. B., … Cox, C. E. (2018). Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness. Crit Care Med, 46(6), e530–e539. https://doi.org/10.1097/CCM.0000000000003076
Khandelwal, Nita, Catherine L. Hough, Lois Downey, Ruth A. Engelberg, Shannon S. Carson, Douglas B. White, Jeremy M. Kahn, et al. “Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness.Crit Care Med 46, no. 6 (June 2018): e530–39. https://doi.org/10.1097/CCM.0000000000003076.
Khandelwal N, Hough CL, Downey L, Engelberg RA, Carson SS, White DB, et al. Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness. Crit Care Med. 2018 Jun;46(6):e530–9.
Khandelwal, Nita, et al. “Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness.Crit Care Med, vol. 46, no. 6, June 2018, pp. e530–39. Pubmed, doi:10.1097/CCM.0000000000003076.
Khandelwal N, Hough CL, Downey L, Engelberg RA, Carson SS, White DB, Kahn JM, Jones DM, Key MD, Reagan W, Porter LS, Curtis JR, Cox CE. Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness. Crit Care Med. 2018 Jun;46(6):e530–e539.

Published In

Crit Care Med

DOI

EISSN

1530-0293

Publication Date

June 2018

Volume

46

Issue

6

Start / End Page

e530 / e539

Location

United States

Related Subject Headings

  • Time Factors
  • Survivors
  • Surveys and Questionnaires
  • Stress, Psychological
  • Risk Factors
  • Respiratory Insufficiency
  • Prevalence
  • Middle Aged
  • Male
  • Humans