The impact of the eHealth intervention IC-NaastenCoach on anxiety, depression, and posttraumatic stress among relatives of intensive care patients: a quasi-experimental multicentre study

Abstract

Admission to the intensive care unit (ICU) is a stressful event for both patients and their relatives. Relatives frequently develop symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD), recognised as post-intensive care syndrome-family (PICS-F). Despite growing interest in digital mental health interventions, solutions for PICS-F remain scarce. This study evaluates the IC-NaastenCoach, a newly developed eHealth intervention aimed at supporting relatives of ICU patients. The aim of the study is to evaluate the impact of the newly developed eHealth intervention IC-NaastenCoach on symptoms of anxiety, depression, and PTSD among relatives of ICU patients in the first two months after discharge. This study adopts a non-randomised quasi-experimental multicentre design in four ICUs in the Netherlands. Participants were adult relatives of ICU patients admitted for ≥ 48 hours. Symptoms were assessed using the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised. Data were collected through online questionnaires, and between-group differences were analysed using the Mann-Whitney U test (p < 0.05). Of the 94 participating relatives, 82 were involved in pre-measurement (mean age 56.5 years, 67.1% female, 54.9% partner/spouse) and 12 in post-measurement (mean age 51.3 years, 91.7% female, 66.7% partner/spouse). Compared to pre-measurement, relatives using the IC-NaastenCoach did not experience a significant change in symptoms of anxiety (U = 352, p = 0.11), depression (U = 400, p = 0.29), and PTSD (U = 355, p = 0.12). Conclusion: the IC-NaastenCoach did not lead to a significant change in symptoms of anxiety, depression, and PTSD among relatives of ICU patients in the first two months after discharge. The IC-NaastenCoach remains a low-cost, accessible support tool aligned with relatives' needs, but implementation is not recommended before completion of the overall study. Future research should focus on broader outcomes, such as satisfaction with care and implementation outcomes.