Table 1 Unfamiliar health care and treatment processes related to caregiver psychological distress during critical care

“I mean that was a worrisome time, wondering and when we were going to get the answer…” (Spouse, Caregiver 01)

“The scariest thing is when they said they might put him on a ventilator and I thought I didn’t even know how, didn’t have any idea how that goes or how it works, maybe if they would’ve explained that a little bit more” (Significant other, Caregiver 15)

“Every time they come in, they’ll ask him, “What medicines do you take?” I mean it’s already in the chart, I mean I don’t understand…they just keep asking him all these questions over and over again” (Spouse, Caregiver 18)

Sole factor quote:^a “I think, you know perioperatively when they’re in the OR, there’s a lot of anxiety that seems to come across because they’re not aware of you know how much longer, are they doing okay, and so they come in a little bit worried, like, “Oh my gosh, I’ve been waiting out there to find out if he’s okay for some time,” and you know I think it’s just the initial phases of getting into the unit” (Provider, Team member 11)

Strategy quote:^b “If I know that they have a super anxious spouse or something at home, if I find you know something that’s changed or something I know that that spouse was concerned about…, then I would definitely update the family on that.” (Nurse, Team member 09)

Strategy quote: “In advance of the actual surgical date, assuming it was not an emergency or an unanticipated surgery…would be the right time is to have the patient you know and family members sort of prepare themselves mentally for what could potentially be kind of a rocky period.” (Provider, Team member 07)