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Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Research article

Psychological response of family members of patients hospitalised for influenza A/H1N1 in Oaxaca, Mexico

Authors: Jesús Elizarrarás-Rivas, Jaime E Vargas-Mendoza, Maurilio Mayoral-García, Cuauhtémoc Matadamas-Zarate, Anaid Elizarrarás-Cruz, Melanie Taylor, Kingsley Agho

Published in: BMC Psychiatry | Issue 1/2010

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Abstract

Background

The A/H1N1 pandemic originated in Mexico in April 2009, amid high uncertainty, social and economic disruption, and media reports of panic. The aim of this research project was to evaluate the psychological response of family primary caregivers of patients hospitalised in the Intensive Care Unit (ICU) with suspected influenza A/H1N1 to establish whether there was empirical evidence of high adverse psychological response, and to identify risk factors for such a response. If such evidence was found, a secondary aim was to develop a specific early intervention of psychological support for these individuals, to reduce distress and possibly lessen the likelihood of post-traumatic stress disorder (PTSD) in the longer term.

Methods

Psychological assessment questionnaires were administered to the family primary caregivers of patients hospitalised in the ICU in the General Hospital of Zone 1 of the Mexican Institute for Social Security (IMSS), Oaxaca, Mexico with suspected influenza A/H1N1, during the month of November 2009. The main outcome measures were ratings of reported perceived stress (PSS-10), depression (CES-D), and death anxiety (DAQ). Data were subjected to simple and multiple linear regression analysis to identify risk factors for adverse psychological response.

Results

Elevated levels of perceived stress and depression, compared to population normative data, and moderate levels of death anxiety were noted. Levels of depression were similar to those found in comparable studies of family members of ICU patients admitted for other conditions. Multiple regression analysis indicated that increasing age and non-spousal family relationship were significantly associated with depression and perceived stress. Female gender, increasing age, and higher levels of education were significantly associated with high death anxiety. Comparisons with data collected in previous studies in the same hospital ICU with groups affected by a range of other medical conditions indicated that the psychological response reported in this study was generally lower.

Conclusions

Data indicated that, contrary to widely publicised reports of 'panic' surrounding A/H1N1, that some of those most directly affected did not report excessive psychological responses; however, we concluded that there was sufficient evidence to support provision of limited psychological support to family caregivers.
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Literature
1.
go back to reference Lopez-Cervantes M, Venado A, Moreno A, Pacheco-Dominguez RL, Ortega-Pierres G: On the spread of novel influenza A (H1N1) virus in Mexico. J Infect Dev Ctries. 2009, 3 (5): 327-330. 10.3855/jidc.238.CrossRefPubMed Lopez-Cervantes M, Venado A, Moreno A, Pacheco-Dominguez RL, Ortega-Pierres G: On the spread of novel influenza A (H1N1) virus in Mexico. J Infect Dev Ctries. 2009, 3 (5): 327-330. 10.3855/jidc.238.CrossRefPubMed
2.
go back to reference Echevarria-Zuno S, Mejia-Arangure JM, Mar-Obeso AJ, Grajales-Muniz C, Robles-Perez E, Gonzales-Leon M, Ortega-Alvarez MC, Gonzalez-Bonilla C, Rascon-Pacheco RA, Borja-Aburto VH: Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis. The Lancet. 2009 Echevarria-Zuno S, Mejia-Arangure JM, Mar-Obeso AJ, Grajales-Muniz C, Robles-Perez E, Gonzales-Leon M, Ortega-Alvarez MC, Gonzalez-Bonilla C, Rascon-Pacheco RA, Borja-Aburto VH: Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis. The Lancet. 2009
3.
go back to reference CDC: Outbreak of swine origin influenza A (H1N1) virus infection - Mexico. MMWR Morb Mortal Wkly Rep. 2009, 58: 463-6. CDC: Outbreak of swine origin influenza A (H1N1) virus infection - Mexico. MMWR Morb Mortal Wkly Rep. 2009, 58: 463-6.
10.
go back to reference McAdam JL, Puntillo K: Symptoms experienced by family members of patients in intensive care units. American Journal of Critical Care. 2009, 18 (3): 200-209. 10.4037/ajcc2009252.CrossRefPubMed McAdam JL, Puntillo K: Symptoms experienced by family members of patients in intensive care units. American Journal of Critical Care. 2009, 18 (3): 200-209. 10.4037/ajcc2009252.CrossRefPubMed
11.
go back to reference Azoulay E, Pochard F, Kentish-Barnes N, Cevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B: Risk of post-traumatic stress symptoms in family members of intensive care unit patients. American Journal of Respiratory and Critical Care Medicine. 2005, 171 (9): 987-994. 10.1164/rccm.200409-1295OC.CrossRefPubMed Azoulay E, Pochard F, Kentish-Barnes N, Cevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B: Risk of post-traumatic stress symptoms in family members of intensive care unit patients. American Journal of Respiratory and Critical Care Medicine. 2005, 171 (9): 987-994. 10.1164/rccm.200409-1295OC.CrossRefPubMed
12.
go back to reference Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, Barnoud D, Bleichner G, Bruel C, Choukroun G, Curtis JR, Fieux F, Galliot R, Garrouste-Orgeas M, Georges H, Goldgran-Toledano D, Jourdain M, Loubert G, Reignier J, Saidi F, Souweine B, Vincent F, Kentish Barnes N, Pochard F, Schlemmer B, Azoulay E: A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med. 2007, 356 (5): 469-478. 10.1056/NEJMoa063446.CrossRefPubMed Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, Barnoud D, Bleichner G, Bruel C, Choukroun G, Curtis JR, Fieux F, Galliot R, Garrouste-Orgeas M, Georges H, Goldgran-Toledano D, Jourdain M, Loubert G, Reignier J, Saidi F, Souweine B, Vincent F, Kentish Barnes N, Pochard F, Schlemmer B, Azoulay E: A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med. 2007, 356 (5): 469-478. 10.1056/NEJMoa063446.CrossRefPubMed
13.
go back to reference Van Pelt DC, Schulz R, Chelluri L, Pinsky MR: Patient specific, time-varying predictors of post-ICU informal caregiver burden. Chest. 2010, 137 (1): 88-94. 10.1378/chest.09-0795.CrossRefPubMed Van Pelt DC, Schulz R, Chelluri L, Pinsky MR: Patient specific, time-varying predictors of post-ICU informal caregiver burden. Chest. 2010, 137 (1): 88-94. 10.1378/chest.09-0795.CrossRefPubMed
14.
go back to reference Douglas SL, Daly BJ, O'Toole E, Hickman RL: Depression among white and non-white caregivers of the chronically critically ill. Journal of Critical Care. 2009, Douglas SL, Daly BJ, O'Toole E, Hickman RL: Depression among white and non-white caregivers of the chronically critically ill. Journal of Critical Care. 2009,
15.
go back to reference Flaskerud JH, Carter PA, Lee P: Distressing emotions in female caregivers of people with AIDS, age-related dementias, and advanced-stage cancers. Perspectives in psychiatric care. 2009, 36 (4): 121-130. 10.1111/j.1744-6163.2000.tb00600.x.CrossRef Flaskerud JH, Carter PA, Lee P: Distressing emotions in female caregivers of people with AIDS, age-related dementias, and advanced-stage cancers. Perspectives in psychiatric care. 2009, 36 (4): 121-130. 10.1111/j.1744-6163.2000.tb00600.x.CrossRef
16.
go back to reference Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. Journal of Health and Social Behavior. 1983, 24: 386-396. 10.2307/2136404.CrossRef Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. Journal of Health and Social Behavior. 1983, 24: 386-396. 10.2307/2136404.CrossRef
17.
go back to reference Radloff LS: The CES-D Scale: a self-reported depression scale for research in the general population. Applied Psychological Measurement. 1977, 1 (3): 385-401. 10.1177/014662167700100306.CrossRef Radloff LS: The CES-D Scale: a self-reported depression scale for research in the general population. Applied Psychological Measurement. 1977, 1 (3): 385-401. 10.1177/014662167700100306.CrossRef
18.
go back to reference Pettit JW, Lewinsohn PM, Seeley JR, Roberts RE, Hibbard JH, Hurtado AV: Association between the Center for Epidemiologic Studies Depression Scale (CES-D) and mortality in as community sample: An artefacts of the somatic complaints factor?. International Journal of Clinical and Health Psychology. 2008, 8 (2): 383-397.PubMedPubMedCentral Pettit JW, Lewinsohn PM, Seeley JR, Roberts RE, Hibbard JH, Hurtado AV: Association between the Center for Epidemiologic Studies Depression Scale (CES-D) and mortality in as community sample: An artefacts of the somatic complaints factor?. International Journal of Clinical and Health Psychology. 2008, 8 (2): 383-397.PubMedPubMedCentral
19.
go back to reference Conte HR, Weiner MB, Plutchik R: Measuring death anxiety: conceptual, psychometric, and factor analytic aspects. Journal of Personality and Social Psychology. 1982, 43 (4): 775-785. 10.1037/0022-3514.43.4.775.CrossRefPubMed Conte HR, Weiner MB, Plutchik R: Measuring death anxiety: conceptual, psychometric, and factor analytic aspects. Journal of Personality and Social Psychology. 1982, 43 (4): 775-785. 10.1037/0022-3514.43.4.775.CrossRefPubMed
20.
go back to reference Lester D, Templer DI, Abdel-Khalek A: A cross-cultural comparison of death anxiety: a brief note. OMEGA - Journal of Death and Dying. 2006, 54 (3): 255-260. 10.2190/W644-8645-6685-358V.CrossRefPubMed Lester D, Templer DI, Abdel-Khalek A: A cross-cultural comparison of death anxiety: a brief note. OMEGA - Journal of Death and Dying. 2006, 54 (3): 255-260. 10.2190/W644-8645-6685-358V.CrossRefPubMed
22.
go back to reference Remor E: Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS). The Spanish Journal of Psychology. 2006, 9 (1): 86-93.CrossRefPubMed Remor E: Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS). The Spanish Journal of Psychology. 2006, 9 (1): 86-93.CrossRefPubMed
23.
go back to reference Cohen S, Williamson GM: Perceived stress in a probability sample of the United States. The social psychology of health. Edited by: Spacapan S, Oskamp S. 1988, Newbury Park, CA. Sage, 31-67. Cohen S, Williamson GM: Perceived stress in a probability sample of the United States. The social psychology of health. Edited by: Spacapan S, Oskamp S. 1988, Newbury Park, CA. Sage, 31-67.
24.
go back to reference Fortner BV, Neimeyer RA: Death anxiety in older adults: a quantitative review. Death Studies. 1999, 23 (5): 387-411. 10.1080/074811899200920.CrossRefPubMed Fortner BV, Neimeyer RA: Death anxiety in older adults: a quantitative review. Death Studies. 1999, 23 (5): 387-411. 10.1080/074811899200920.CrossRefPubMed
Metadata
Title
Psychological response of family members of patients hospitalised for influenza A/H1N1 in Oaxaca, Mexico
Authors
Jesús Elizarrarás-Rivas
Jaime E Vargas-Mendoza
Maurilio Mayoral-García
Cuauhtémoc Matadamas-Zarate
Anaid Elizarrarás-Cruz
Melanie Taylor
Kingsley Agho
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-104

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