Mirror Emotions: A Cross-Sectional Study of How Patients' Stress, Anxiety and Depression in Critical Care Settings Shape Family Caregivers' Emotional Distress.

Background: Emotional distress-including anxiety, depression and stress-is highly prevalent among critically ill patients and their caregivers. While a substantial body of research focuses on addressing patients' emotional distress, comparatively less attention has been given to the emotional distress experienced by family caregivers.

Aim: This study aimed to identify the associated factors of anxiety, depression and stress among the caregivers of critically ill family members in Oman, focusing on clinical and demographic factors that influence these outcomes.

Study design: A descriptive, cross-sectional survey was conducted in three major referral hospitals in Oman. A total of 440 participants completed the Depression Anxiety Stress Scale (DASS-21), comprising 220 patients and 220 family caregivers. Multiple linear regression analyses were conducted to identify the associated factors of emotional distress among caregivers based on patients' emotional distress.

Results: Self-reported symptoms of emotional distress among caregivers were influenced by multiple psychological and demographic factors. Specifically, caregivers' self-reported anxiety and stress were strong positive predictors of their self-reported depression symptoms. Longer durations of caregiving and lower income were also associated with higher self-reported depression scores, suggesting that prolonged caregiving responsibilities and financial hardship contribute to the emotional burden experienced by caregivers. Furthermore, self-reported caregiver depression, patient anxiety, and caregiver stress were all positively associated with higher self-reported anxiety levels. Conversely, having assistance at home was a significant negative predictor of caregivers' self-reported emotional distress.

Conclusions: Emotional distress among caregivers is driven by psychological and socio-economic factors, making it essential to address these issues to improve the psychological well-being of both caregivers and the patients for whom they care.

Relevance to clinical practice: Family caregivers of ICU patients face considerable emotional distress that can impair caregiving capacity. Recognising caregivers as integral to the care team, particularly in cultures where familial caregiving is expected, supports both patient outcomes and caregiver well-being.