Table 3 Patient- and family member-related data

 Age, gender, civil status (T2–T4 change), Education

X

X

X

X

X

 Type of family member (T0), primary carer (yes/no)

X

X

X

X

 Co-habiting with patient (yes/no), frequency of contact

X

 Travel time to hospital

X

 Medical diagnosis (MDSi)

X

X

 Trauma (yes/no); if yes, AIS^a

X

 Mechanical ventilation and circulary support (T0: yes/no, T1: # of days)

X

X

 SAPS-2^b

X

 NEMS^c, SOFA^d

X

X

 Death (yes/no); if yes, date, cause, place^e

X

X

X

X

X

 Organ donation (yes/no); if yes, organ, surrogate dm)

X

 Functional status (Katz ADL/Lawton IADL)^e

X

X

X

 Prior/present psychiatric diagnosis (yes/no)

X

 Self-perceived health (VAS)

 X

X

X

X

X

 Cause of admission

X

 Type of admission (expected, unexpected), admitted from

X

 Surgery (emergency, planned, none)

X

 Previous ICU stays (yes/no)

X

 Prior need for informal/ formal care (yes/no)^f

X

 Length of ICU stay

X

 Discharge/transfer destination, planned vs. unexpected

X

 Need for informal/formal care (yes / no); if yes, change, hours/frequency, more/less than before ICU treatment)^e

X

X

X

 Prior/current/new psychological/psychiatric treatment (yes / no)

X

X

X

X

X

 Use of prescription drugs

X

X

X

X

X

 Current treatment for a chronic condition (yes/no)

X

 Number of family physician visits/hospitalizations (if yes: related to critical illness yes/no/length of stay)

X

X

X

X

 Previous ICU experience (as patient, as family of the patient)

X

 Family satisfaction with prior care experience (VAS)

X

 Family satisfaction with care on hospital wards (VAS)

X

 Level of employment, income

X

 Change in level of employment (yes / no); if yes: related to critical illness yes/no), new income

X

X

X

X

 Sick leave/absence from work (if yes: # of (half-)days)

X

X

X

X

X

 Presenteeism

X

X

X

X