Enhancing Family Communication in the Intensive Care Unit Using a Co-Designed Informational Brochure: A Prospective Before–After Study

Background and Objectives: Communication gaps contribute substantially to anxiety, depression, and post-traumatic stress disorder (PTSD) among relatives of critically ill patients. This study evaluated whether supplementing routine bedside meetings with a concise, co-designed informational brochure was associated with reduced psychological distress and improved satisfaction among family members in the intensive care unit (ICU). Materials and Methods: We conducted a single-centre prospective before–after observational study in a mixed medical–surgical ICU in Naples, Italy. Relatives of adult patients with an ICU length of stay >72 h completed the Hospital Anxiety and Depression Scale (HADS) and the Short Screening Scale for PTSD (SSS-PTSD) at ICU discharge. The pre-intervention phase enrolled 12 relatives (May–September 2018); following a co-design and staff training period, the post-intervention phase enrolled 23 relatives (April–October 2019). Primary outcomes were the prevalence of anxiety (HADS-A ≥8), depression (HADS-D ≥8), and probable PTSD (SSS-PTSD ≥4). Groups were compared using Fisher’s exact test and the Mann–Whitney U test. Results: Anxiety remained highly prevalent (100% pre vs. 95.7% post; p = 1.00). Depression severity decreased, with median HADS-D scores declining from 13 (IQR 10–18) to 9 (IQR 7–12) (p = 0.021), while the prevalence of HADS-D ≥8 was lower post-intervention (91.7% vs. 73.9%; p = 0.38). The prevalence of probable PTSD was numerically reduced from 58.3% to 30.4% (p = 0.116). Perceived comprehension improved (7.9 ± 1.1 vs. 8.6 ± 0.9; p = 0.037), whereas objective comprehension remained unchanged. Overall family satisfaction increased (FS-ICU-24: 66 ± 15 vs. 75 ± 12; p = 0.041). Staff depersonalization decreased from 35% to 10% (p = 0.048). Conclusions: In this real-world before–after study, integrating a low-cost, co-designed brochure into clinician–family communication was associated with reduced depressive symptom severity, a numerical reduction in PTSD prevalence, and improved satisfaction, without adverse effects on staff well-being. These findings support the use of structured written information in family-centred ICU care.