To investigate status of symptom burden in immediate accompanying family members of patients in Neurological Intensive Care Unit (NICU) and to explore effects of physiological, psychological and environmental factors and their interactions on symptom burden in immediate accompanying family members of NICU patients based on The Theory of Unpleasant Symptoms (TOUS) .

This paper was a cross-sectional survey study. The convenient sampling method was used to select immediate accompanying family members of 240 patients who were admitted to NICU of 2 ClassⅢ Grade A hospitals in Jinan City from March to August 2020 as the research objects. The symptom burden and related factors of immediate accompanying family members of NICU patients were assessed by using the Chinese Version of Memorial Symptom Assessment Scale (MSAS) , Fatigue Scale, Mishel Uncertainty in Illness Scale for Family Member (MUIS-FM) and Family APGAR Index (APGAR) . Amos software was used to construct the structural equation model and draw the action path.

A total of 240 questionnaires were distributed in this study and 218 valid questionnaires were recovered, with an effective recovery rate of 90.83%. The total score of symptom burden and the three subscale scores of physical symptoms, psychological symptoms and total distress index of immediate accompanying family members of NICU patients were respectively 0.59 (0.31, 0.94) , 0.53 (0.19, 0.92) , 1.69 (1.11, 2.39) and 1.20 (0.73, 1.90) . The psychological symptoms of immediate accompanying family members of NICU patients were more common, and the incidence of worry was the highest (96.33%, 210/218) , followed by feeling sad (93.58%, 204/218) and feeling nervous (89.91%, 196/218) . Structural equation model analysis results showed that, the interaction between fatigue and illness uncertainty increases the symptom burden of family members (β_standardized=0.14, P=0.044) , and the interaction between family functioning and illness uncertainty reduced the symptom burden (β_standardized=-0.16, P=0.042) .

This study finds that the immediate accompanying family members of NICU patients have a relatively heavy symptom burden and psychological symptoms were more common than physical symptoms. Illness uncertainty, fatigue and family function interact with each other on the symptom burden of accompanying family members. Illness uncertainty and fatigue can increase the symptom burden of accompanying family members and good family support can reduce the symptom burden of them.

Intensive Care Unit; Cross-sectional study; Accompanying family members; Symptom burden; Influencing factor