The development and feasibility of a psychologist-led screening and modular-based psychological intervention in an Australian intensive care unit: A pilot study.

Background: Psychological distress is common among intensive care unit (ICU) patients and can lead to long-term adverse psychological sequelae. While early psychological interventions may help mitigate these effects, their feasibility within critical care settings remains largely unexplored. Additionally, the role of psychologists in delivering such interventions in Australia remains unclear, particularly given inconsistencies in workforce availability and integration into standard care.

Aims/objectives: The aim of this study was to (i) outline the development of a psychologist-led screening and intervention protocol in an Australian ICU and (ii) evaluate its preliminary feasibility. It also examined the suitability of a potential outcome measure to inform future trial design.

Methods: The Medical Research Council's framework for developing complex interventions in health was applied. The intervention was designed for an Australian metropolitan ICU. It consisted of a modular-based psychological intervention tailored to the patient's level of psychological distress. A single-arm prospective pilot study was conducted, and 30 patients were recruited. Feasibility was assessed based on recruitment rates, patient engagement, and outcome measure completion.

Results: Recruitment challenges were observed, with a low eligibility screening rate. Staffing constraints and consent-related barriers further limited recruitment. Intervention engagement was high, with 96% of consenting participants completing at least one intervention component. Outcome measure completion rates supported the feasibility of a larger trial, with preliminary findings suggesting a significant reduction in negative emotional affect over time. Consistent with the Medical Research Council's framework, refinements to the intervention are recommended.

Conclusions: The findings support the feasibility of a psychologist-led intervention in the ICU, though refinements are necessary to improve recruitment, streamline delivery, and enhance engagement. This study highlights the potential of early psychological interventions to improve patients' emotional well-being. Addressing staffing limitations and consent barriers could enhance accessibility and effectiveness in future trials.

Registration: This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000619640), with the first participant recruited on 4/07/2023.