Family facing the stress of ICU care, with a transparent view of their hidden emotional struggles.

ICU Aftercare: Why Recovery Programs Might Not Always Ease Family Stress

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Exploring the surprising results of the RAPIT study and what it means for supporting families of ICU survivors."

The intensive care unit (ICU) is a place of medical miracles, but it's also a pressure cooker for families. The stress of seeing a loved one in critical condition can lead to anxiety, depression, and even post-traumatic stress disorder (PTSD). It’s a phenomenon known as post-intensive care syndrome-family (PICS-F), and it can significantly impact a family's quality of life.

Recovery programs are often implemented to help ICU survivors regain their health and well-being. These programs typically focus on the patient's physical and psychological recovery. But what about the families? Do these programs also benefit the loved ones who have been through the emotional wringer?

A recent study called RAPIT (Recovery and Aftercare in Post-Intensive Care Therapy patients), sought to answer that question. The results, however, were not what researchers expected. The study found that recovery programs for ICU survivors didn't necessarily translate into improved quality of life for their relatives. Let's dive into the findings and explore what this means for future support strategies.

RAPIT Study Results: No Significant Boost for Relatives

Family facing the stress of ICU care, with a transparent view of their hidden emotional struggles.

The RAPIT study, a randomized controlled trial conducted across ten ICUs in Denmark, involved 181 adult relatives of ICU patients. The relatives were divided into two groups: an intervention group (n = 87) and a control group (n = 94). The intervention group's relatives were associated with patients who received a recovery program consisting of three consultations with specially trained nurses. These consultations aimed to help patients construct an illness narrative and address issues of importance.

The primary outcome measured was the mental component score (MCS) from the Medical Health Survey Short-Form 36 (SF-36) at 12 months after ICU discharge. Secondary outcomes included the level of sense of coherence (SOC), and symptoms of anxiety, depression, and PTSD at both three and 12 months post-ICU.

No significant difference in HRQOL: The study found no significant difference in health-related quality of life (HRQOL) between the intervention and control groups at 12 months.
Secondary outcomes unaffected: Similarly, there were no significant differences in secondary outcomes such as sense of coherence (SOC), anxiety, depression, or PTSD symptoms.
Higher baseline well-being: Interestingly, the study also revealed that relatives in the study generally reported better health-related quality of life, a stronger sense of coherence, and fewer psychological symptoms compared to previous research.

While the recovery program aimed to support ICU survivors, it didn't appear to extend those benefits to their families, at least not in a measurable way. This raises important questions about how best to support the families of ICU patients.

Moving Forward: Targeted Support for ICU Families

The RAPIT study's findings underscore the need for a more nuanced approach to supporting families of ICU patients. While recovery programs are valuable for patients, families may require different or more targeted interventions. Future research should focus on identifying the specific needs of ICU families and developing tailored programs to address those needs. These interventions might include counseling services, support groups, or educational resources designed to help families cope with the emotional challenges of having a loved one in the ICU. By providing targeted support, we can better help families navigate the difficult journey through critical illness and beyond.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.iccn.2018.11.009, Alternate LINK

Title: Reprint Of Recovery Programme For Icu Survivors Has No Effect On Relatives’ Quality Of Life: Secondary Analysis Of The Rapit-Study

Subject: Critical Care Nursing

Journal: Intensive and Critical Care Nursing

Publisher: Elsevier BV

Authors: Søs Bohart, Ingrid Egerod, Morten H. Bestle, Dorthe Overgaard, Doris F. Christensen, Janet F. Jensen

Published: 2019-02-01

Everything You Need To Know

What is post-intensive care syndrome-family (PICS-F), and why is it important to address?

Post-intensive care syndrome-family, or PICS-F, refers to the anxiety, depression, and even post-traumatic stress disorder (PTSD) that can affect family members of patients who have been in the intensive care unit (ICU). It's crucial to address PICS-F because it can significantly impact a family's quality of life, potentially hindering their ability to support the patient's recovery and maintain their own well-being. Addressing PICS-F ensures a more holistic approach to care, recognizing that the family's health is intertwined with the patient's.

What was the purpose of the RAPIT study, and what were its main findings regarding family members of ICU patients?

The RAPIT study (Recovery and Aftercare in Post-Intensive Care Therapy patients) aimed to determine if recovery programs designed for ICU survivors also benefit their families by reducing stress and improving their quality of life. Surprisingly, the RAPIT study found that these recovery programs didn't necessarily translate into improved quality of life for family members. Specifically, there was no significant difference in health-related quality of life, sense of coherence, or symptoms of anxiety, depression, or PTSD between the families of patients who received the recovery program and those who didn't.

What specific interventions were included in the recovery program evaluated in the RAPIT study?

In the RAPIT study, the recovery program consisted of three consultations with specially trained nurses. These consultations were designed to help patients construct an illness narrative and address issues of importance to them. The focus was primarily on the patient's experience and recovery process, rather than directly addressing the specific needs and concerns of their family members. This might explain why the program didn't significantly impact the relatives' mental well-being, as measured by the mental component score (MCS) from the Medical Health Survey Short-Form 36 (SF-36).

What does the RAPIT study suggest about the current methods of supporting families of ICU patients, and what alternative approaches are recommended?

The RAPIT study suggests that current recovery programs, while beneficial for ICU patients, may not be sufficient to adequately support their families. It highlights the need for a more nuanced and targeted approach. Alternative approaches recommended include counseling services, support groups, and educational resources specifically designed to help families cope with the emotional challenges of having a loved one in the ICU. These interventions should focus on addressing the specific needs of ICU families, such as managing stress, dealing with uncertainty, and processing the trauma of the ICU experience. This approach acknowledges the unique challenges families face and aims to provide tailored support.

The RAPIT study mentioned that relatives in the study reported better health-related quality of life, a stronger sense of coherence, and fewer psychological symptoms compared to previous research. How does this impact the interpretation of the study's primary findings?

The fact that relatives in the RAPIT study reported higher baseline well-being compared to previous research suggests that the study population may have been more resilient or had better coping mechanisms from the outset. This could have made it more difficult to detect any significant impact of the intervention, as they were already functioning at a relatively high level. However, even with this higher baseline, the RAPIT study still underscores the importance of specifically designed interventions, because despite their resilience there was no measurable change in key mental health metrics. It emphasizes that while general well-being is important, targeted support is still needed to address the unique stressors associated with having a loved one in the ICU.