{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:51:04Z","timestamp":1792194664140,"version":"4.4.0"},"reference-count":58,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Understanding the reciprocal association between post\u2013intensive care syndrome (PICS) and caregiver burden is crucial for optimal care of patients and caregivers following critical illness.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the associations between patient post\u2013intensive care impairments and caregiver burden.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This secondary analysis of the MIND-USA study, a multicenter randomized clinical trial, which enrolled patients admitted to intensive care units (ICU) from 16 academic medical centers across the US (December 2011 to August 2017), included 148 patient-caregiver dyads. Patients were adults aged 18 years or older with ICU delirium randomized to receive haloperidol, ziprasidone, or placebo. A caregiver who provided unpaid assistance to the patient was identified at enrollment. PICS and caregiver burden were assessed at 3 months and 12 months after randomization. Statistical analysis was performed from March 2023 to April 2024.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>ICU survivors were assessed for PICS domains, including physical and cognitive function, and posttraumatic stress disorder using the Katz Activities of Daily Living, the Functional Activities Questionnaire, the Telephone Interview for Cognitive Status, and the Posttraumatic Stress Disorder Checklist-Civilian version, respectively. Caregiver burden was assessed using the Zarit Burden Interview. The associations between patient PICS and caregiver burden at 3 and 12 months were examined using structural equation modeling.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 148 patients included in this study with a median (IQR) age of 58 (48-65) years, the majority identified as male (79 patients [53.4%]), and there were 16 (10.8%) Black, 139 (93.9%) non-Hispanic, and 127 (85.8%) White patients. PICS and caregiver burden at 3-month follow-up was positively associated with these outcomes at 12-month follow-up (PICS: \u03b2\u2009=\u20090.69; 95% CI, 0.50 to 0.88; P<\/jats:italic>\u2009&amp;lt;\u2009.001; caregiver burden: \u03b2\u2009=\u20090.68; 95% CI, 0.53 to 0.82; P<\/jats:italic>\u2009&amp;lt;\u2009.001). However, contrary to the study hypotheses, significant associations between 3-month PICS and 12-month caregiver burden and between 3-month caregiver burden and 12-month PICS were not observed (PICS\u2192caregiver burden: \u03b2\u2009=\u20090.82; 95% CI, \u22120.02 to 1.66; P<\/jats:italic>\u2009=\u2009.09; caregiver burden\u2192PICS: \u03b2\u2009=\u20090.00; 95% CI, \u22120.03 to 0.03; P<\/jats:italic>\u2009=\u2009.95). There was significant covariance between PICS and caregiver burden at each time point.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this secondary analysis of a randomized clinical trial of ICU survivors and their caregivers, patient PICS and caregiver burden were associated at concurrent time points but were not associated with each other longitudinally.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT01211522<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.3443","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T15:41:09Z","timestamp":1744126869000},"page":"e253443","source":"Crossref","is-referenced-by-count":27,"title":["Post\u2013Intensive Care Syndrome and Caregiver Burden"],"prefix":"10.1001","volume":"8","author":[{"given":"Soojung","family":"Ahn","sequence":"first","affiliation":[{"name":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"LaNoue","sequence":"additional","affiliation":[{"name":"School of Nursing, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Su","sequence":"additional","affiliation":[{"name":"School of Nursing, Vanderbilt University, Nashville, Tennessee"},{"name":"Critical Illness, Brain dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda C.","family":"Moale","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie P.","family":"Scheunemann","sequence":"additional","affiliation":[{"name":"Department of Medicine, Divisions of Geriatrics and Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Kiehl","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee"},{"name":"Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivor S.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Denver Health Department of Medicine, Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz MC, Denver"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Exline","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Ohio State University, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle N.","family":"Gong","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Division of Pulmonary Medicine, Department of Medicine, Montefiore Healthcare System\/Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babar A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Owens","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret A.","family":"Pisani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rock","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Maryland School of Medicine, Baltimore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee"},{"name":"Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Geriatric Research Education and Clinical Center, Tennessee Valley Veterans Affairs, Nashville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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