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Original article
Available online 3 August 2026

Interdependent post-traumatic stress symptoms and health-related quality of life in ICU survivor–caregiver dyads: A prospective exploratory pilot study

Síntomas interdependientes de estrés postraumático y calidad de vida relacionada con la salud en las díadas superviviente-cuidador de la UCI: un estudio piloto exploratorio prospectivo
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Andrea Sannaa,
Corresponding author
andrea.sanna@asuit.tn.it

Corresponding author.
, Sara Mioria, Luigi Longoa, Francesca Zanona, Rocco Pacea, Francesco Cipullia, Silvia De Rosaa,b, Giacomo Bellania,b
a Department of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Integrata Di Trento (ASUIT), Trento, Italy
b CISMed — Center for Medical Sciences, University of Trento, Trento, Italy
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Abstract
Objective

To evaluate post-traumatic stress symptoms, anxiety, depression, and health-related quality of life six months after intensive care unit (ICU) discharge, and to explore potential dyadic associations of psychological outcomes within ICU survivor–caregiver dyads.

Design

Prospective single-center pilot observational study.

Setting

Adult intensive care unit of a tertiary-care hospital.

Patients or participants

Adult ICU survivors with length of stay ≥72 h and their identified primary caregivers enrolled as dyads.

Interventions

No therapeutic interventions were performed. ICU-related stressors (ICUESS) and caregiver satisfaction (FS-ICU) were assessed at ICU discharge. At 6 months, post-traumatic stress symptoms (IES-R), anxiety and depression (HADS), and patient-reported quality of life (EQ-5D-5L and EQ-VAS) were evaluated.

Main variables of interest

Prevalence of probable PTSD (IES-R ≥33), dyadic concordance of PTSD symptoms, and associations between PTSD and health-related quality of life deterioration.

Results

Thirty-nine dyads were enrolled; 31 patients and 36 caregivers completed follow-up. Probable PTSD occurred in 15.4% of patients and 23.1% of caregivers. Within-dyad concordance was high (82% overall agreement: φ = 0.44), suggesting non-random clustering of PTSD symptoms within dyads.

Nearly half of survivors (≈48%) experienced clinically meaningful deterioration in EQ-VAS, which was associated with probable PTSD in both dyad members. Perceived ICU-related stressors showed high concordance across dyads.

Conclusions

Post-ICU psychological distress may show relational patterns within ICU survivor–caregiver dyads. Functional decline and shared psychological vulnerability may contribute to post-traumatic stress symptom burden after ICU discharge. These preliminary findings should be considered exploratory and hypothesis-generating and require confirmation in larger, adequately powered dyadic studies.

Keywords:
Intensive care unit
Post-traumatic stress symptoms
Caregivers
Dyadic analysis
Health-related quality of life
PICS-F
IES-R
EQ-5D
Resumen
Objetivo

Evaluar los síntomas de estrés postraumático, ansiedad, depresión y calidad de vida relacionada con la salud seis meses después de la alta de la UCI, y explorar posibles asociaciones diádicas de resultados psicológicos dentro de las díadas superviviente-cuidador de la UCI.

Diseño

Estudio observacional piloto prospectivo de un solo centro.

Ámbito

Unidad de cuidados intensivos de adultos en un hospital de tercer nivel.

Pacientes o participantes

Sobrevivientes adultos de UCI con estancia ≥72 horas y sus cuidadores principales identificados, incluidos como díadas.

Intervenciones

No se realizaron intervenciones terapéuticas. Los factores estresantes relacionados con la UCI (ICUESS) y la satisfacción del cuidador (FS-ICU) se evaluaron al alta. A los 6 meses se evaluaron síntomas de estrés postraumático (IES-R), ansiedad y depresión (HADS), y calidad de vida reportada por el paciente (EQ-5D-5 L y EQ-VAS).

Variables de interés principales

Prevalencia de TEPT probable (IES-R ≥33), concordancia diádica de síntomas de TEPT y asociación entre TEPT y deterioro de la calidad de vida.

Resultados

Se incluyeron 39 díadas; 31 pacientes y 36 cuidadores completaron el seguimiento. El TEPT probable ocurrió en el 15,4% de los pacientes y en el 23,1% de los cuidadores. La concordancia dentro de las díadas fue alta (82% de acuerdo global; φ = 0,44), sugiriendo una posible asociación significativa entre los miembros. Casi la mitad de los sobrevivientes (≈48%) presentó deterioro clínicamente relevante en el EQ-VAS, fuertemente asociado con TEPT en ambos miembros. Los factores estresantes percibidos mostraron alta concordancia entre las díadas.

Conclusiones

El malestar psicológico posterior a la UCI puede mostrar patrones relacionales dentro de las diadas. El deterioro funcional y la vulnerabilidad recíproca dentro de las díadas pueden contribuir a la carga de síntomas de estrés postraumático, apoyando modelos de seguimiento orientados a la díada tras el alta. Estos hallazgos preliminares deben considerarse como generadores de hipótesis y requieren confirmación en estudios diádicos más amplios y con la potencia estadística adecuada.

Palabras clave:
Unidad de cuidados intensivos
Estrés postraumático
Cuidadores
Análisis diádico
Calidad de vida
PICS-F
IES-R
EQ-5D

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