Caring for a seriously ill family member during and after an intensive care unit (ICU) stay is often an emotionally and physically daunting task that may lead to depression, anxiety, and posttraumatic stress, collectively known as post-intensive care syndrome-family (PICS-F). College of Nursing faculty Drs. Amy Petrinec and Cindy Wilk focus their research efforts on improving quality of life for family members who not only struggle with their loved one’s prolonged illness, but also find themselves propelled into a caregiving role.
Dr. Amy Petrinec, Ph.D., RN, ϳԹ College of Nursing Interim Associate Dean, Research, is also an associate professor. She began her career as a clinical ICU nurse and eventually shifted to academia to teach critical care nursing and research psychological distress experienced by family members during and after patient ICU hospitalization. Dr. Cindy Wilk, Ph.D., APRN-CNS, CCRN, CNE, serves as both a professor for ϳԹ College of Nursing and a clinical nurse specialist with over 20 years of acute and critical care experience. Her research interests align with those of Dr. Petrinec and include family engagement and caregiving for patients in the ICU.
According to the Society of Critical Care Medicine, nearly six million patients in the United States are admitted to the ICU each year, and their family members are at risk for developing PICS-F. Drawing from her extensive background as a practitioner in the ICU clinical setting, Dr. Petrinec became interested in developing an intervention designed to improve health outcomes and quality of life for families of ICU patients. Dr. Petrinec notes that during her clinical practice, “I noticed certain characteristics that challenged most family members who had a loved one in the ICU. This includes high stress levels, little time, and uncertainty about the loved one’s prognosis and outcome.”
With an aging population and ongoing nursing shortage, the need to conserve resources while meeting increased demands for nursing care continues to escalate, including care for family members of ICU patients. “Family members are often the only source of family income and called upon to provide informal caregiving for the patient while they are suffering the symptoms of PICS-F,” Dr. Petrinec explains. “Their needs are often not addressed since they are not the patient and are too stressed and busy to seek the help they need.” As Dr. Petrinec began conducting research on this vulnerable population, she found that one common denominator linking most families was the possession of a cell phone, leading to her to consider the provision of needed mental health support through a smartphone app.
With funding awarded through the American Association of Critical-Care Nurses, Dr. Petrinec served as Principal Investigator and Dr. Cindy Wilk contributed as Research Assistant for a feasibility study with family caregivers at risk for PICS-F to examine smartphone app delivery of cognitive behavioral therapy (CBT). Typically delivered during an in-person or virtual appointment, CBT is non-pharmacological treatment that emphasizes changing distorted thoughts and behaviors and promoting more positive coping strategies. Titled Smartphone Delivery of Cognitive Behavioral Therapy for Post-intensive Care Syndrome-Family: A Pilot Study, their research provided a novel approach to the treatment of post-intensive care syndrome symptoms by providing CBT to family caregivers of ICU patients via a self-care mental health smartphone app (MHapp), along with other support provided to patients and family members during and after ICU hospitalization.
Results from their pilot data indicate that cognitive behavioral therapy delivered via smartphone app shows promising results for helping to ease PICS-F symptoms, including anxiety, depression, and posttraumatic stress disorder, to positively affect the health and quality of life for caregivers of critically ill patients. As the team continues to further develop the mental health app, Dr. Wilk has considered additional methods to support and prevent PICS-F for this population such as allowing family caregivers to assist patients in the ICU. “I wanted to first understand the components of caregiver willingness before developing a scale to measure the concept,” she explained. “Subsequently, for my dissertation work, I developed a scale to measure caregiver willingness of family members of ICU mechanically ventilated patients.”
Provision of CBT through a smartphone app allows family members to access needed support whenever and wherever they need it. Family members of ICU patients may see their loved one progress through a variety of health outcomes and transitions of care, including hospitals and other short- and long-term care facilities, and they may also struggle with the possibility of losing their loved one. The MHapp intervention not only addresses symptoms of PICS-F, but the smartphone app also provides nurses with a vital tool to support families without significantly increasing their workload. Dr. Petrinec notes that “ICU illness is experienced by the entire family. The family members need support, and my program of research is looking for ways to do that effectively.”
Dr. Petrinec received her Bachelor of Science in Nursing (BSN) degree from Bowling Green State University, her Master of Science in Nursing (MSN) degree from Ursuline College, and her Doctor of Philosophy (Ph.D.) in Nursing degree from Case Western Reserve University, where she also completed a postdoctoral fellowship in symptom management and palliative care. Findings from her research studies have been published in numerous scholarly journals, including Critical Care Medicine, American Journal of Critical Care, Journal of the American Geriatric Society, Western Journal of Nursing Research, Palliative & Supportive Care, Psycho-Oncology, and the Journal of Clinical Oncology. Dr. Wilk earned her BSN degree from Youngstown State University and her MSN and Ph.D. in Nursing degrees from ϳԹ. Her publications include articles in Nursing Forum, Rehabilitation Nursing, and Nurse Leader, and she currently has an article in press for the American Journal of Critical Care.
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Drs. Amy Petrinec (left) and Cindy Wilk discuss their research.