Should we screen patients' relatives for psychological status, signs and symptoms in the emergency department? A cross-sectional survey using the Symptom Check List (SCL-90)

Objectives: The objectives were to investigate psychological symptoms in patients’ relatives (PR), coming into the ED with their patient and to evaluate the relationship between sociodemographic characteristics and psychological symptom scores.

Methods: PR in the ED of Cerrahpasa Faculty of Medicine aged 18 years and older were included into the study. Symptom Check List- Revised (SCL-90-R) was administered to 120 PR and sociodemographic characteristics of all were recorded.

Results: The majority of the PR were female (n = 66, 55%), graduate of high school (n = 46, 38.3%) and self-employed (n = 22, 18.3%). The highest mean score on SCL-90-R was found on obsessive-compulsive disorder and the lowest scores were found on phobic anxiety. The mean score was higher than 1.0 on obsessive-compulsive disorder, somatization, interpersonal sensitivity, depression and paranoid ideation. There was no correlation between education level, duration of hospitalization and SCL-90 scores. Mean general, somatization, obsessive-compulsive and depression scores of females were found to be significantly higher than of males.

Conclusion: High scores in psychological symptoms were observed in PR in the ED. Therefore, besides assessment of the psychological status of patients; it is recommended that PR should be evaluated carefully in this regard and given necessary psychosocial support in the emergency setting.

Patients’ relatives; Psychological symptoms; Symptom Check List; SCL-90; Emergency department

[1] Yardan THG, Eden AO, Baydın A, Genç S, Gönüllü H. Acil serviste hasta yakınları ile iletişim. Akademik Acil Tıp Dergisi. 2008; 7: 9-13. (In Turkish)

[2] Horn EV, Tesh A. The effect of critical care hospitalization on family members. Dimensions of Critical Care Nursing. 2000; 19: 40-49.

[3] Van Horn E, Tesh A. The effect of critical care hospitalization on family members: stress and responses. Dimensions of Critical Care Nursing. 2000; 19: 40-49.

[4] Redley B, LeVasseur SA, Peters G, Bethune E. Families’ needs in emergency departments: instrument development. Journal of Advanced Nursing. 2003; 43: 606-615.

[5] Redley B, Beanland C. Revising the critical care family needs ınventory for the emergency department. Journal of Advanced Nursing. 2004; 45: 95-104.

[6] Jones C, Skirrow P, Griffiths RD, Humphris G, Ingleby S, Eddleston J, et al. Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Medicine. 2004; 30: 456-460.

[7] Davidson JE. Family-centered care: meeting the needs of patients’ families and helping families adapt to critical ıllness. Critical Care Nurse. 2009; 29: 28-34.

[8] Olgun N, Kuğuoğlu S. Acil Bakımda İletişim. İçinde: Şelimen D (editör). Acil Bakım, 3. Baskı. İstanbul: Yüce Yayım. 2004: 49. (In Turkish)

[9] Kılıç M. Belirti Tarama Listesi (SCL-90-R) nin Geçerlilik ve Güvenirliği. Psikolojik Danışma ve Rehberlik Dergisi. 1991; 1: 45-52. (In Turkish)

[10] Aşkın R, Ilısu B, Çilli AS, Altuğ B, Kaya N, Kucur R. Lise öğrencilerinde SCL-90-R ile semptom taraması. Düşünen Adam. 1995; 8: 43-47. (In Turkish)

[11] Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptoms Checklist (HSCL): a self-report symptom inventory. Behavioral Science.1974; 19: 1-15.

[12] Derogatis LR, Cleary PA. Confirmation of the dimensional structure of the scl-90: a study in construct validation. Journal of Clinical Psychology. 1977; 33: 981-989.

[13] Dağ İ. Belirti Tarama Listesi (SCL-90-R)’nin üniversite öğrencileri için güvenirliği ve geçerliliği. Türk Psikiyatr Derg. 1991; 2: 5-11. (In Turkish)

[14] Götze H, Brähler E, Gansera L, Polze N, Köhler N. Psychological distress and quality of life of palliative cancer patients and their caring relatives during home care. Supportive Care in Cancer. 2014; 22: 2775-2782.

[15] Çivi S, Kutlu R, Çelik HH. Kanserli hasta yakınlarında depresyon ve yaşam kalitesini etkileyen faktörler. Gülhane Tıp Derg. 2011; 53: 248-253.

[16] Karabulutlu EY, Bilici M, Çayır K, Tekin SB, Kantarcı R. Coping, anxiety and depression in Turkish patients with cancer. Electronic Journal of General Medicine. 2010; 7: 296-302.

[17] Jadoon NA, Munir W, Shahzad MA, Choudhry ZS. Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study. BMC Cancer. 2010; 10: 594.

[18] Northouse LL, Mood D, Templin T, Mellon S, George T. Couples’ patterns of adjustment to colon cancer. Social Science & Medicine. 2000; 50: 271-284.

[19] Parker Oliver D, Albright DL, Washington K, Wittenberg-Lyles E, Gage A, Mooney M, et al. Hospice caregiver depression: the evidence surrounding the greatest pain of all. Journal of Social Work in End-of-Life & Palliative Care. 2013; 9: 256-271.

[20] Hancı V, İkiz B, Günenç E, Sangare M, Özbilgin S, Erkin Y, et al. Ağrı polikliniğine başvuran hastaların ve yakınlarının psikososyal özelliklerinin değerlendirilmesi. Ağrı. 2015; 27: 143-148. (In Turkish)

[21] Nabors N, Seacat J, Rosenthal M. Predictors of caregiver burden following traumatic brain injury. Brain Injury. 2002; 16: 1039-1050.

[22] Kim Y, Given BA. Quality of life of family caregivers of cancer survivors. Cancer. 2008; 112: 2556-2568.

[23] Emanuel EJ, Fairclough DL, Slutsman J, Alpert H, Baldwin D, Emanuel LL. Assistance from family members, friends, pain care givers and volunteers in the care of terminally ill patients. The New England Journal of Medicine. 1999; 341: 956-963.

[24] Tuncay T, Isikhan V. Psychological symptoms, illness-related concerns and characteristics of relatives of Turkish patients with cancer. Asian Pacific Journal of Cancer Prevention. 2011; 11: 1659-1667.

[25] Çıtlık Sarıtaş S ve Büyükbayram Z. Kemoterapi alan hastaların ve bakım veren yakınlarının anksiyete düzeyleri ve etkileyen faktörler. TAF Preventive Medicine Bulletin. 2016; 15: 141-50. (In Turkish)

[26] Friðriksdóttir N, Saevarsdóttir T, Halfdánardóttir SÍ, Jónsdóttir A, Magnúsdóttir H, Ólafsdóttir KL, et al. Family members of cancer patients: needs, quality of life and symptoms of anxiety and depression. Acta Oncologica. 2011; 50: 252-258.

[27] Kim Y, Baker F, Spillers RL. Cancer Caregivers’ quality of life: effects of gender, relationship, and appraisal. Journal of Pain and Symptom Management. 2007; 34: 294-304.

[28] Rose-Rego SK, Strauss ME, Smyth KA. Differences in the perceived well-being of wives and husbands caring for persons with Alzheimer’s disease. The Gerontologist. 1998; 38: 224-230.

[29] Allen SM, Goldscheider F, Ciambrone DA. Gender Roles, Marital ınti-macy, and nomination of spouse as primary caregiver. The Gerontologist. 1999; 39: 150-158.

[30] Chan CW, Chang AM. Experience of palliative home care according to caregivers’ and patients’ ages in Hong Kong Chinese people. Oncology Nursing Forum. 2001; 27: 1601-1605.

[31] Goldstein NE, Concato J, Fried TR, Kasl SV, Johnson-Hurzeler R, Bradley EH. Factors associated with caregiver burden among caregivers of terminally ıll patients with cancer. Journal of Palliative Care. 2004; 20: 38-43.

[32] Yıldırım T. Acil servise gelen kritik hasta yakınlarının gereksinimleri ve karşılanma durumları. [Yüksek Lisans Tezi]. Erzurum. 2015. (In Turkish)

[33] Mendonca D, Warren NA. Perceived and unmet needs of critical care family members. Critical Care Nursing Quarterly. 1998; 21: 58-67.

[34] Sucu G, Cebeci F, Karazeybek E. Acil servisteki kritik hasta yakınlarının gereksinimleri ve karşılanma durumu. Ulus Travma Acil Cerrahi Derg. 2009; 15: 473-481. (In Turkish)

[35] Özgürsoy BN ve Akyol AD. Yoğun bakım ünitesinde yatan hastaların ailelerinin gereksinimleri. Yoğun Bakım Hemşireliği Dergisi. 2008; 12: 33-38. (In Turkish)

[36] Kosco M, Warren NA. Critical care nursesʼ perceptions of family needs as met. Critical Care Nursing Quarterly. 2000; 23: 60-72.

[37] Wilkinson P. A qualitative study to establish the self-perceived needs of family members of patients in general intensive care unit. Intensive and Critical Care Nursing. 1995; 11: 77-86.