For a study, researchers sought to determine if a direct intervention aimed at the surrogate’s spiritual and emotional well-being might enhance the surrogate’s results. In 5 medical, cardiac, and neurological ICUs at one academic medical facility, they performed a single-blind randomized controlled study of a spiritual care intervention for ICU surrogates. The Spiritual Care Examination and Intervention included four or more proactive phone or in-person visits by a chaplain, an assessment of four aspects of spirituality (meaning/purpose, transcendence/peace, relationships, and self-worth), and individually personalized spiritual care treatments. The intervention was carried out by ethnically and religiously diverse chaplains who had been educated to address a wide range of patients, including nonreligious individuals.
The primary outcome (Generalized Anxiety Disorders-7) was examined 6-8 weeks following discharge. Secondary outcomes included depression (PHQ-9), posttraumatic stress (IES-R), spiritual well-being (FACIT-sp), satisfaction (Patient Satisfaction Instrument—Chaplaincy), and positive religious coping (RCOPE).
Investigators enrolled 192 patient/surrogate dyads and followed up with 128 of them (66.7%). Patients were 45.7% female and 20.7% African American, with a mean age of 54.8 years (SD 18.2). Surrogates were frequently the husband (35.1%). At the follow-up, anxiety was considerably reduced in the intervention group (GAD-7 intervention group median score of 1 (range 0-5); control 4 (1-9), P<.0001), as was depression (P=0.0042) and posttraumatic stress symptoms (P=0.0257). Satisfaction with spiritual care increased (P=.0005), but not spiritual well-being (P=0.226) or good religious coping (P=0.0857). The study revealed the significance of spiritual care on ICU surrogates’ well-being.