The presence of a close family member in the intensive care unit (ICU) can result in a number of stressors for the other family members. Recognition of excessive stress in family members with interventions to reduce the stress can result in improved patient care.


Factors which may be associated with stress in close family members:

(1) ill health in other family members

(2) demands for caregiving to others

(3) perception of the ICU as a strange and foreign environment

(4) lack of familiarity with a constantly changing staff

(5) appearance and condition of the patient

(6) pain or distress in the patient

(7) deterioration in the patient's condition or the development of complications

(8) uncertainty about the outcome

(9) needing to try to understand complex medical problems and to make valid decisions

(10) not having all of the necessary information (not being told all of the facts)

(11) physical demands of long hours in the hospital

(12) economic difficulties

(13) conflicts in work schedule

(14) feelings of guilt

(15) pre-existing conflict in the family

(16) physical separation, especially if the patient is an infant

(17) distance of the hospital from home and unfamiliarity with the area

(18) cultural, language, religious or social differences


The presence of one or more of these factors can result in significant distress for close family members.


Health care providers should regularly communicate with family members and watch for signs of distress so that appropriate interventions can be made.


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