The effects of written emotional disclosure on anxiety and perceived stress among the family members of patients in intensive care unit: A randomized clinical trial

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Background and aims: The family members of patients in intensive care unit (ICU) experience high levels of anxiety and stress. This study sought to assess the effects of written emotional disclosure (WED) on anxiety and perceived stress among the family members of patients in ICU. Methods: This clinical trial was conducted in 2019 on seventy family members of patients hospitalized in the ICUs of Kashani hospital, Shahrekord, Iran. Family members were conveniently recruited and randomly assigned to a 35-person control and a 35-person intervention group. Participants in the intervention group were trained to write for twenty minutes every other day for two consecutive weeks about their negative emotional feelings, negative thoughts, concerns, and fears associated with their patient hospitalization in ICU. The Spielberger State-Trait Anxiety Inventory and the Cohen Perceived Stress Scale were used for anxiety and stress assessment before, two weeks after, and one month after the study intervention. The data were analyzed using the SPSS software (v. 18.0) at a significance level of less than 0.05. Results: The mean of participants’ age was 38.91±9.01 years in the control group and 33.83±10.22 years in the intervention group. Around 37.1% of participants in the control group and 54.3% of participants in the intervention group were male. There were no significant differences between the groups respecting participants’ age and gender (P>0.05). One month after the intervention, the mean scores of state and trait anxiety were respectively 57.83±11.58 and 51.11±10.49 in the control group and 46.94±11.07 and 43.71±8.76 in the intervention group. Between-group differences were significant (P<0.05). The mean score of perceived stress at one month after the intervention was 29.00±7.21 in the control group and 26.51±6.15 in the intervention group and the between-group difference was not significant (P>0.05). Conclusion: WED is effective in significantly reducing anxiety and slightly reducing perceived stress among the family members of patients in ICU. Therefore, WED can be used as a simple, cost-free, and complication-free strategy to reduce anxiety and stress among the family members of patients in hospital settings, particularly in ICU.