Lower perceived social support is significantly associated with elevated levels of psychological distress in racially and ethnically diverse close family members of cardiac arrest survivors

Mina Yuan, Isabella M Tincher, Bhanvi Sachdeva, Sabine Abukhadra, Danielle A Rojas, Christine DeForge, Sachin Agarwal
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Abstract

Background: Poor perceived social support has been associated with worse psychological distress in close family members after their loved one hospitalization with prolonged mechanical ventilation, but never been tested after cardiac arrest. Methods: Close family members of consecutive cardiac arrest patients hospitalized at an academic tertiary care center were recruited before hospital discharge, and perceived social support was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS). Indicators of psychological distress were administered via telephone at 1 month after cardiac arrest. Multivariate linear regressions were used to estimate the associations between MSPSS total score and total Patient Health Questionnaire 8 (PHQ 8) score (primary outcome) and total PTSD (PCL 5) and generalized anxiety (GAD 2) scores, after adjusting for previously known covariates. Results: Of 102 close family members (mean age 52 Standard deviation 15 years, 70% female, 40% Non Hispanic white, 21% Black, 33% Hispanic/Latinx, 22% with preexisting psychiatric illness) with complete data, the mean PHQ 8 total score at a median duration of 28.5 days (interquartile range 10 to 63 days) from cardiac arrest was 7 with standard deviation of 6, and the mean MSPSS score was 69 with standard deviation of 15. Lower perceived social support was significantly associated with elevated levels of depressive symptoms in univariate (beta= negative 0.11; p<0.01) and after adjusting for age, sex, race/ethnicity, and previous psychiatric history (beta= negative 0.11; p<0.01). Similar inverse associations were seen with 1 month PTSD and generalized anxiety symptoms as secondary outcomes. Conclusions: Close family members of cardiac arrest survivors perception of poor social support during hospitalization is associated with increased levels of depressive symptoms at 1 month. Longitudinal studies understanding the temporal associations between social support and psychological distress are warranted.
在不同种族和族裔的心脏骤停幸存者近亲属中,较低的社会支持感知与较高的心理压力水平明显相关
背景:感知到的社会支持较差与近亲属在其亲人住院接受长期机械通气后心理压力加重有关,但从未在心脏骤停后进行过测试。方法在出院前招募在一家学术性三级医疗中心住院的连续心脏骤停患者的近亲属,并使用感知社会支持多维量表(MSPSS)对其感知社会支持进行评估。在心脏骤停后 1 个月,通过电话对心理困扰指标进行评估。在对之前已知的协变量进行调整后,使用多变量线性回归估算 MSPSS 总分与患者健康问卷 8(PHQ 8)总分(主要结果)、创伤后应激障碍(PCL 5)总分和广泛焦虑(GAD 2)总分之间的关系。结果在 102 名数据完整的近亲属(平均年龄 52 岁,标准差 15 岁,70% 为女性,40% 为非西班牙裔白人,21% 为黑人,33% 为西班牙裔/拉丁裔,22% 患有精神病)中,在距离心脏骤停 28.5 天(四分位数间距为 10 到 63 天)的中位数时间内,PHQ 8 总分的平均值为 7 分,标准差为 6 分,MSPSS 的平均值为 69 分,标准差为 15 分。在单变量(β= 负 0.11;p<0.01)和调整年龄、性别、种族/民族和既往精神病史(β= 负 0.11;p<0.01)后,感知到的社会支持较低与抑郁症状水平升高明显相关。作为次要结果,1 个月创伤后应激障碍和广泛焦虑症状也存在类似的负相关。结论心脏骤停幸存者的近亲属认为住院期间社会支持不足与1个月后抑郁症状水平升高有关。有必要开展纵向研究,以了解社会支持与心理困扰之间的时间关联。
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