Caregivers and Families of Critically Ill Patients

to the editor: The study by Cameron and colleagues (May 12 issue)¹ takes an expanded view of outcomes after critical illness. The authors found that many caregivers have persistent depressive symptoms, which reveal the reverberations of illness beyond the index patient. This article and others² highlight the need to revise the view of the patient from a solitary figure to a person embedded in a social network. A personal network method offers the means to do this. Also called egocentric networks, this approach identifies the various persons around a focal person and elaborates the structure and characteristics of the relationships.³ The personal network method explicates how a patient is situated in a complex “social connectome” that is made of strong and weak relationships, kin and non-kin, and persons with varied health habits. It shows the ripples in the network that occur from health shocks such as sudden critical illness, stroke, and myocardial infarction; conversely, network characteristics probably affect outcomes. We look forward to future studies that take a network approach to better understand outcomes and suggest targets for sustainable network recovery.