Patient perspectives on stress after ICU and a short primary care based psychological intervention – results from a qualitative sub‑study of the PICTURE trial

Beutel, Antina; Sanftenberg, Linda; Friemel, Chris M.; Kosilek, Robert Philipp; Schauer, Maggie; Elbert, Thomas; Reips, Ulf-Dietrich; Schubert, Tomke; Gehrke-Beck, Sabine; Schmidt, Konrad; Gensichen, Jochen (2025): Patient perspectives on stress after ICU and a short primary care based psychological intervention – results from a qualitative sub‑study of the PICTURE trial. BMC Primary Care, 26: 12. ISSN 2731-4553

Abstract

Background

Approximately 20–25% of patients who survive medical treatment at an intensive care unit (ICU) develop post-traumatic stress symptoms. There is currently a gap in follow-up care for them. As part of the PICTURE study, general practitioners (GPs) carried out a brief interview-based intervention. The aim of this sub-study is to record the most distressing memories of ICU treatment from the patient’s perspective and their evaluation of a GP-based brief psychological intervention.

Methods

Participants were recruited from the intervention group of the main PICTURE study using selective sampling. All of them had experienced an ICU stay with mechanical ventilation and severe organ failure in the previous two years. They were interviewed about their experience of psychological stress during their ICU stay and their retrospective evaluation of the intervention. Semi-structured, guideline-based telephone interviews were conducted for this purpose, processed, and analyzed using the structuring qualitative content analysis based on Mayring.

Findings

When asked N = 8 patients about the most stressful memory of their stay at ICU, the main themes were helplessness, pain, fixation, inability to communicate and sleep disturbances. The question of amnesia regarding the stay in the ICU was answered affirmatively by half of the interviewees but was not experienced as stressful. The brief trauma-focused intervention carried out by their GPs was well received by all respondents.

Conclusions

The interviewees confirm that aversive traumatizing experiences are often associated with intensive care treatment and reinforce each other. These are due to the treatment setting but should be reduced wherever possible. In view of chronification and the lack of specific follow-up treatment options for these patients and the long waiting times for psychotherapy, the implementation of low-threshold treatment options by GPs appears to be ideally suited to closing this gap in care, particularly for patients with mild to moderate symptoms of a post-traumatic stress disorder.

for the PICTURE study group: Christine Adrion Matthias Angstwurm Antje Bergmann Gerhard Bielmeier Andrea Bischhoff Ralph Bogdanski Franz Brettner Christian Brettschneider Josef Briegel Martin Bürkle Johanna Dohmann Peter Falkai Thomas Felbinger Richard Fisch Hans Förstl Benjamin Fohr Martin Franz Patrick Friederich Jürgen Gallinat Herwig Gerlach Andreas Güldner Hanna Hardt Christoph Heintze Andreas Heinz Axel Heller Christian von Heymann Petra Hoppmann Volker Huge Michael Irlbeck Ulrich Jaschinski Dominik Jarczak Stefanie Joos Elisabeth Kaiser Melanie Kerinn Frank-Rainer Klefisch Stefan Kluge Roland Koch Thea Koch Michelle Kowalski Hans-Helmut König Robert Philipp Kosilek Peter Lackermeier Karl-Ludwig Laugwitz Tri Le Yvonne Lemke Achim Lies Klaus Linde Daniela Lindemann Dagmar Lühmann Stephanie May Ludwig Ney Jan Oltrogge Wulf Pankow Sergi Papiol Maximilian Ragaller Nikolaus Rank Lorenz Reill Hans-Peter Richter Reimer Riessen Grit Ringeis Ann Rüchhardt Gustav Schelling Jörg Schelling André Scherag Martin Scherer Antonius Schneider Gerhard Schneider Jürgen Schneider Julia Schnurr Susanne Schultz Thomas G Schulze Karin Schumacher John Singhammer Peter Spieth Kerstin Theisen Franka Thurm Thomas Vogl Karen Voigt Andreas Walther Dietmar Wassilowsky Cornelia Wäscher Regina Wehrstedt Björn Weiss Roland Weierstall-Pust Marion Weis Georg Weiss Harald Well Zöllner Christian Bernhard Zwissler

• Dokumententyp: Artikel (Klinikum der LMU)
• Organisationseinheit (Fakultäten): 07 Medizin > Institut für Allgemeinmedizin
• DFG-Fachsystematik der Wissenschaftsbereiche: Lebenswissenschaften
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 491502892