Family members’ perceptions of pain behaviors and pain management of adult patients unable to self-report in the intensive care unit: A qualitative descriptive study

Objective: This study investigated symptoms of anxiety and depression in relatives of patients admitted in the Intensive Care Unit and determined whether these symptoms were associated to the seriousness of the patients’ condition.Metodology: A total of 102 patients’ relatives were surveyed during the study. They were given a self-report questionnaire in order to assess demographic data, anxiety and depression symptoms. The symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (hads). Patient’s condition was evaluated with a.p.a.ch.e ii Score.Results: More than 60% of patients’ relatives presented severe symptoms of anxiety and depression. No relation was found between symptoms of anxiety and depression of the relatives of patients and patients’ condition of health. On the contrary, these feelings used to exist regardless of the seriousness of patient’s condition.Conclusions: The assessment of these patients is recommended in order serious problems of anxiety and depression to be prevented.

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Characteristics of Nonpharmacological Interventions for Pain Management in the ICU: A Scoping Review

AACN Advanced Critical Care ◽

10.4037/aacnacc2019281 ◽

2019 ◽

Vol 30 (4) ◽

pp. 388-397 ◽

Cited By ~ 1

Author(s):

Geraldine Martorella

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Pain Management ◽

Pain Relief ◽

Scoping Review ◽

Elderly Women ◽

The Elderly ◽

Self Report ◽

Pharmacological Interventions

Pain relief in the intensive care unit (ICU) is of particular concern since patients are exposed to multiple painful stimuli associated with care procedures. Considering the adverse effects of pharmacological approaches, particularly in vulnerable populations such as the elderly, the use of non-pharmacological interventions has recently been recommended in the context of critical care. The main goal of this scoping review was to systematically map the research done on non-pharmacological interventions for pain management in ICU adults and describe the characteristics of these interventions. A wide variety of non-pharmacological interventions have been tested, with music and massage therapies being the most frequently used. An interesting new trend is the use of combined or bundle interventions. Lastly, it was observed that these interventions have not been studied in specific subgroups, such as the elderly, women, and patients unable to self-report.

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Role of Family Members in Pain Management in Adult Critical Care

AACN Advanced Critical Care ◽

10.4037/aacnacc2019275 ◽

2019 ◽

Vol 30 (4) ◽

pp. 398-410 ◽

Cited By ~ 1

Author(s):

Émilie Gosselin ◽

Mélissa Richard-Lalonde

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pain Management ◽

Pain Assessment ◽

Family Members ◽

Future Research ◽

Rigorous Research ◽

Family Member Involvement

This review describes family member involvement in intensive care unit pain assessment and management and generates implications for clinical practice, education, and future research. A literature review was performed in MEDLINE, PubMed, EMBASE, Cochrane, and CINAHL databases from their inception until April 30, 2019. Only 11 studies addressing the topic were identified, and the current quality of evidence is low. Family members can be involved in pain assessment by describing patients’ pain behaviors and in pain management by selecting and delivering nonpharmacological interventions tailored to patients’ needs, if the family members feel comfortable with this role. More-rigorous research is required to describe the role of family members in patients’ pain assessment and management. Advancing knowledge in this field could improve patients’ and family members’ experiences with pain assessment and management in the intensive care unit.

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Building organizational compassion among teams delivering end-of-life care in the intensive care unit: The 3 Wishes Project

Palliative Medicine ◽

10.1177/0269216320929538 ◽

2020 ◽

Vol 34 (9) ◽

pp. 1263-1273 ◽

Cited By ~ 2

Author(s):

Meredith Vanstone ◽

Marina Sadik ◽

Orla Smith ◽

Thanh H Neville ◽

Allana LeBlanc ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

End Of Life ◽

End Of Life Care ◽

Qualitative Content Analysis ◽

Family Members ◽

Life Care ◽

Dying Patients ◽

Qualitative Descriptive

Background: The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians. Aim: To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit. Design: Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework. Setting/participants: Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders. Results: The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians. Conclusions: Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.

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The needs and experiences of family members of adult patients in an intensive care unit: a review of the literature

Journal of Clinical Nursing ◽

10.1111/j.1365-2702.2004.01081.x ◽

2005 ◽

Vol 14 (4) ◽

pp. 501-509 ◽

Cited By ~ 181

Author(s):

Sofie Verhaeghe ◽

Tom Defloor ◽

Florence Van Zuuren ◽

Mia Duijnstee ◽

Mieke Grypdonck

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Family Members ◽

Adult Patients ◽

Review Of The Literature

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Qualitative descriptive study to explore nurses’ perceptions and experience on pain, agitation and delirium management in a community intensive care unit

BMJ Open ◽

10.1136/bmjopen-2018-024328 ◽

2019 ◽

Vol 9 (4) ◽

pp. e024328 ◽

Cited By ~ 5

Author(s):

Jennifer L Y Tsang ◽

Katie Ross ◽

Franziska Miller ◽

Ramez Maximous ◽

Priscilla Yung ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Focus Group ◽

Critically Ill ◽

Critically Ill Patients ◽

Descriptive Study ◽

Medium Size ◽

Healthcare Teams ◽

Qualitative Descriptive ◽

Professional Perspectives

ObjectivesThe purpose of this study was to explore the experiences, beliefs and perceptions of intensive care unit (ICU) nurses on the management of pain, agitation and delirium (PAD) in critically ill patients.DesignA qualitative descriptive study.SettingThis study took place in a community hospital ICU located in a medium size Canadian city.ParticipantsPurposeful sampling was conducted. Participants included full-time nurses working in the ICU. Forty-six ICU nurses participated.MethodsA total of five focus group sessions were held to collect data. There were one to three separate groups in each focus group session, with no more than seven participants in each group. There were 10 separate groups in total. A semistructured question guide was used. Thematic analysis method was adopted to analyse the data, and to search for emergent themes and patterns.ResultsThree main themes emerged: (1) the professional perspectives on patient wakefulness state, (2) the professional perspectives on PAD management of critically ill patients and (3) the factors impacting PAD management. Nurses have different opinions on the optimal level of patient sedation and felt that many factors, including environmental, healthcare teams, patients and family members, can influence PAD management. This potentially leads to inconsistent PAD management in critically ill patients. The nurses also believed that PAD management requires a multidisciplinary approach including healthcare teams and patients’ families.ConclusionsMany external and internal factors contribute to the complexity of PAD management including the attitudes of nursing staff towards PAD. The themes emerged from this study suggested the need of a multifaceted and multidisciplinary quality improvement programme to optimise the management of PAD in the ICU.

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Perspective of family members regarding the process of dying in the intensive care unit

Texto & Contexto - Enfermagem ◽

10.1590/0104-07072014002200012 ◽

2014 ◽

Vol 23 (3) ◽

pp. 751-757 ◽

Cited By ~ 1

Author(s):

Thieli Lemos de Souza ◽

Sofia Louise Santin Barilli ◽

Nára Selaimem Gaertner de Azeredo

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Public Hospital ◽

Family Members ◽

Descriptive Study ◽

Rio Grande Do Sul ◽

Porto Alegre ◽

Loved One ◽

Individual Interviews ◽

The Family

This study aimed to investigate the perspective of family members on end-of-life in the Intensive Care Unit. This is an exploratory descriptive study with a qualitative approach. Semi-structured individual interviews were held with eight family members of terminally-ill patients receiving inpatient treatment in an Intensive Care Unit in a public hospital in Porto Alegre, in the State of Rio Grande do Sul . The method of content analysis was used for data analysis. During the process of dying, it was evident that the feelings experienced by the family members were diverse, including distress, insecurity, anger, guilt and missing the loved one. Also demonstrated by the family members were the importance of being with the loved person, and the desire to establish a link between the team-patient-family

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Importância da presença dos pais durante o internamento neonatal

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2019.239790 ◽

2019 ◽

Vol 13 ◽

Author(s):

Rosália Teixeira Luz ◽

Talita Brito Silva Trindade ◽

Diana De Souza Lima ◽

Layres Canuta Cardoso Climaco ◽

Ivana Santos Ferraz ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Health Education ◽

Thematic Analysis ◽

Neonatal Intensive Care ◽

Descriptive Study ◽

Neonatal Intensive Care Units ◽

Structured Interviews ◽

Qualitative Descriptive ◽

Terapia Intensiva

RESUMOObjetivo: averiguar o conhecimento de pais e mães sobre a importância das suas presenças durante o internamento de filhos na UTI neonatal. Método: trata-se de estudo qualitativo, descritivo, envolvendo 20 pais a partir de entrevistas semiestruturadas e analisadas por meio da técnica de Análise Conteúdo na modalidade Análise Temática. Resultados: evidenciou-se que os pais compreendem que suas presenças colaboram para a recuperação da saúde do filho, diminuindo o tempo de internação. Conclusão: mostrou-se a educação em saúde realizada pelos profissionais uma excelente estratégia que serviu para instruir e sensibilizar os genitores quanto à importância das suas presenças durante o internamento, tornando-lhes corresponsáveis pelos cuidados voltados ao filho. Descritores: Recém-Nascido; Hospitalização; Unidades de Terapia Intensiva Neonatal; Pais; Mães; Educação em Saúde. ABSTRACT Objective: to verify the knowledge of parents about the importance of their presence during the hospitalization of children in the neonatal intensive care unit. Method: this is a qualitative, descriptive study, involving 20 parents from semi-structured interviews and analyzed through the technique of Content Analysis in the Thematic Analysis modality. Results: it was evidenced that the parents understand that their presences collaborate to recover the health of the child, reducing the time of hospitalization. Conclusion: it was shown the health education carried out by the professionals an excellent strategy that served to educate and sensitize the parents about the importance of their presence during the hospitalization, making them co-responsible for the care for the child. Descriptors: Newborn; Hospitalization; Neonatal Intensive Care Units; Parents; Mothers; Health education. RESUMEN Objetivo: averiguar el conocimiento de padres y madres sobre la importancia de sus presencias durante el internamiento de hijos en la UTI neonatal. Método: se trata de estudio cualitativo, descriptivo, involucrando a 20 padres a partir de entrevistas semiestructuradas y analizadas por medio de la técnica de Análisis Contenido en la modalidad Análisis Temático. Resultados: se evidenció que los padres comprenden que sus presencias colaboran para la recuperación de la salud del hijo, disminuyendo el tiempo de internación. Conclusión: se mostró la educación en salud realizada por los profesionales una excelente estrategia que sirvió para instruir y sensibilizar a los genitores en cuanto a la importancia de sus presencias durante el internamiento, haciéndoles corresponsables por los cuidados dirigidos al hijo. Descritores: Recién Nacido; hospitalización; Unidades de Cuidado Intensivo Neonatal; Padres; Madres; Educación en Salud.

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