Communication with patients and families in the ICU

2016 ◽  
Author(s):  
Leslie P. Scheunemann ◽  
Robert M. Arnold
Keyword(s):  
Intensive Care ◽  
Family Members ◽  
Ethics Committees ◽  
Family Satisfaction ◽  
Interdisciplinary Teams ◽  
Care Practice ◽  
Family Meeting ◽  
Icu Patients ◽  
Good Communication ◽  
The Family

Regular, consistent communication with families of intensive care unit (ICU) patients is important for family satisfaction, patient-centred decision-making, and reducing the emotional burden of the ICU stay on family members. In fact, the family meeting can appropriately be considered a core procedure of intensive care practice. Good communication requirements include the appropriate clinicians and family members, providing a quiet and undisturbed setting, and choosing appropriate goals for each meeting. Clinicians should strive to develop skills for listening, observing family dynamics, and responding to emotions. ICU administrators should consider building processes of care to promote regular, consistent communication and partnerships with interdisciplinary teams, such as ethics committees and palliative care that can supplement these skills.

Communication in the process of humanization of the assistance at intensive care unit: experience of relatives and cares

2010 ◽  
Vol 4 (4) ◽  
pp. 1587
Author(s):  
Natália Celião Leite ◽  
Josilene De Melo Buriti Vasconcelos ◽  
Wilma Dias de Fontes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Members ◽  
Structured Interview ◽  
Communication Process ◽  
Icu Patients ◽  
Efficient System ◽  
The Family ◽  
Terapia Intensiva ◽  
Nursing Professionals

ABSTRACTObjectives: to report the experience of the nursing team and family members of ICU patients as regards communication; to learn the meaning they attribute to the communication process. Methodology: a quantitative and qualitative exploratory study carried out at the Intensive Care Unit of the school hospital. Consisting of 15 family members and 15 nursing professionals who happened to be available there during the data collection, the sample resulted from semi-structured interview guidance. The data were analyzed by means of descriptive statistics, taking into account the absolute and percentage numbers, and the technique of the Collective Subject Discourse, with presentation throughout graph, table and charts. Results: the data showed gaps in the communication, which are inherent to some professionals who neither practice nor value the communication process with the family, mainly as regards the need to prepare them for the ICU environment and the real conditions of their family members. Conclusion: the need to adopt an efficient system of communication with relatives of ICU patients is widely known. Thus, the nurse will be adopting new ways of caring, which include valuing the family members as integrating part of the nursing care, with view to humanizing the assistance. Descriptors: communication; humanization of the assistance; intensive care unit. RESUMOObjetivos: relatar a experiência da equipe de enfermagem e de familiares de pacientes internados em uma UTI, na perspectiva da comunicação; apreender o significado por eles atribuído ao processo de comunicação. Métodologia: estudo exploratório, quantiqualitativo, realizado na Unidade de Terapia Intensiva de hospital escola. A amostra foi formada por 15 familiares e 15 profissionais de enfermagem que se encontravam no local, por ocasião da coleta de dados, a qual ocorreu por meio de um roteiro de entrevista semi-estruturado. Os dados foram analisados por meio da estatística descritiva, levando-se em conta os números absolutos e percentuais, e da técnica do Discurso do Sujeito Coletivo, com apresentação em gráfico, tabela e quadros. Resultados: os dados mostram lacunas na comunicação, as quais são inerentes a alguns profissionais que não praticam e não valorizam o processo de comunicação com a família, principalmente no que diz respeito à necessidade de prepará-los para compreender o ambiente da UTI e as reais condições de seus familiares. Conclusão: é notória a necessidade de se adotar um sistema eficaz de comunicação com os familiares de pacientes internados na UTI. Assim, o enfermeiro estará adotando novas formas de cuidar, que incluem a valorização dos familiares como parte integrante do cuidado de enfermagem na perspectiva da humanização da assistência. Descritores: comunicação; humanização da assistência; unidade de terapia intensiva.RESUMENObjetivos: relatar la experiencia del equipo de enfermería y parientes de pacientes de UTI, en cuanto a la comunicación; aprender el significado que ellos atribuyen al proceso de comunicación. Metodología: estudio exploratorio, cuantitativo y cualitativo, realizado en la Unidad de Terapia Intensiva del hospital escuela. Formada por 15 parientes y 15 profesionales de enfermería que se encontraban disponibles en el sitio durante el recogimiento de los datos, la muestra resultó de la rutina de una entrevista semi-estructurada. Los datos fueron analizados a través de la estadística descriptiva, llevándose en cuenta los números absolutos y porcentajes, la técnica del Discurso del Sujeto Colectivo, con presentación en gráfico, tabla y cuadros. Resultado: los datos enseñan brechas en la comunicación, las cuales son propias de algunos profesionales que no practican y no valoran el proceso de comunicación con la familia, principalmente en cuanto a la necesidad de les preparar a entender el ambiente de la UTI y las reales condiciones de sus parientes. Conclusión: es notoria la necesidad de adoptarse un sistema de comunicación eficiente con los parientes de pacientes de UTI. Así, el enfermero estará adoptando nuevas maneras de cuidar, las cuales incluyen la valoración de los parientes como parte del cuidado de enfermero, con vista a la humanización de la asistencia. Descriptores: comunicación; humanización de la asistencia; unidad de terapia intensiva. 

scholarly journals Developing Family Satisfaction with Care in Adult Critical Care Public Hospital Terengganu, Malaysia

2021 ◽  
pp. 31-35
Author(s):  
Wan Nor Aliza Wan Abdul Rahman ◽  
Abdul Karim Othman ◽  
Yuzana Mohd Yusop ◽  
Asyraf Afthanorhan ◽  
Hasnah Zani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Shared Decision Making ◽  
Family Members ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Shared Decision ◽  
Cross Sectional ◽  
The Family

In admissions to the intensive care unit (ICU), there is a high possibility of a life-threatening condition and possible emotional distress for family members. When the family is distressed and hospitalized, a significant level of stress and anxiety will be generated among family members, thereby decreasing their ability to make responsible decisions. As a result, the family members need full and up-to-date details, helping them to retain hope, and this contributes to lower stress levels. While there is growing evidence of the effectiveness of shared decision-making for family members who are directly involved in decisions, particularly regarding shared decision-making in the Malaysian context, there is less evidence that supported decisions help overall outcome. This study aims to developing the family satisfaction with decision making in the Intensive Care Unit (FS-ICU)-33 Malay language version of family member’s satisfaction with care and decision making during their stay at the intensive care units. A quantitative, cross-sectional validation study and purposive sampling was conducted from 1st November 2017 and 10 October 2018 to January 2020 among 208 of family members.  The family members of the ICU patients involved in this study had an excellent satisfaction level with service care. Higher satisfaction in ICU care resulting in higher decision-making satisfaction and vice versa.

scholarly journals Comparing the Perceptions of Nurses and Patients’ Families About the Expectations of Patients’ Families in Intensive Care Unit

2020 ◽  
Vol 24 (1) ◽  
pp. 68-79
Author(s):  
Akram Shahrokhi ◽  
◽  
Mahdi Ranjbaran ◽  
Somayeh Zarei ◽  
◽  
...  
Keyword(s):  
Intensive Care ◽  
Work Experience ◽  
Pearson Correlation ◽  
Family Members ◽  
Family Needs ◽  
Chi Square ◽  
Icu Patients ◽  
The Family ◽  
Pearson Correlation Test ◽  
Care Family

Background: Properly identifying the expectations of family members of patients admitted to Intensive Care Units (ICUs) is a necessity for nurses. Objective The present study aimed to determine and compare the expectations of ICU patients’ families according to the perceptions of ICU nurses and family members. Methods: In this descriptive-analytical study, 147 families of ICU patients and 137 ICU nurses of hospitals in Qazvin were selected as study samples through a census method. Data were collected using Molter’s Critical Care Family Needs Inventory (CCFNI), and data analysis was performed using the Pearson correlation test, one-way ANOVA and chi-square at a significant level of P<0.05. Findings: The overall score of CCFNI and its subscales for the family members were significantly higher than in the nurses (P<0.001). The degree of importance and prioritization of family expectations were different between patients’ families and nurses. The reason for patient hospitalization had a significant association with the overall score of CCFNI and its subscales. Moreover, the family history of hospitalization showed a significant correlation with the CCFNI subscales of information and proximity (P<0.05). The age and work experience of nurses had a significant association with the CCFNI subscales of information, assurance, and comfort (P<0.05). Conclusion: Family members of ICU patients and nurses have different perceptions of the expectations of patients’ families. Nurses need to consider the expectations of patients’ family members.

scholarly journals Family satisfaction with critical care in the UK: a multicentre cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028956 ◽  
Author(s):  
Paloma Ferrando ◽  
Doug W Gould ◽  
Emma Walmsley ◽  
Alvin Richards-Belle ◽  
Ruth Canter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Family Member ◽  
Family Members ◽  
Severity Of Illness ◽  
Patient Characteristics ◽  
Family Satisfaction ◽  
General Icus ◽  
The Family ◽  
The Uk

ObjectiveTo assess family satisfaction with intensive care units (ICUs) in the UK using the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire, and to investigate how characteristics of patients and their family members impact on family satisfaction.DesignProspective cohort study nested within a national clinical audit database.SettingStratified, random sample of 20 adult general ICUs participating in the Intensive Care National Audit & Research Centre Case Mix Programme.ParticipantsFamily members of patients staying at least 24 hours in ICU were recruited between May 2013 and June 2014.InterventionsConsenting family members were sent a postal questionnaire 3 weeks after the patient died or was discharged from ICU. Up to four family members were recruited per patient.Main outcome measuresFamily satisfaction was measured using the FS-ICU-24 questionnaire.Main resultsA total of 12 346 family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. Overall and domain-specific family satisfaction scores were high (mean overall family satisfaction 80, satisfaction with care 83, satisfaction with information 76 and satisfaction with decision-making 73 out of 100) but varied significantly across adult general ICUs studied and by whether the patient survived ICU. For family members of ICU survivors, characteristics of both the family member (age, ethnicity, relationship to patient (next-of-kin and/or lived with patient) and visit frequency) and the patient (acute severity of illness and receipt of invasive mechanical ventilation) were significant determinants of family satisfaction, whereas, for family members of ICU non-survivors, only patient characteristics (age, acute severity of illness and duration of stay) were significant.ConclusionsOverall family satisfaction in UK adult general ICUs was high but varied significantly. Adjustment for differences in family member/patient characteristics is important to avoid falsely identifying ICUs as statistical outliers.Trial registration numberISRCTN47363549

Withdrawal of Life Support: How the Family Feels, and Why

2000 ◽  
Vol 16 (1_suppl) ◽  
pp. S40-S44 ◽  
Author(s):  
Sean P. Keenan ◽  
Cathy Mawdsley ◽  
Donna Plotkin ◽  
Gregory K. Webster ◽  
Fran Priestap
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Family Members ◽  
Next Of Kin ◽  
Icu Patients ◽  
The Family ◽  
Self Administered Questionnaire

The objectives of this study were to develop an instrument to assess the satisfaction of family members with withdrawal of life support (WLS), and to determine which factors are associated with greater levels of satisfaction. To do this, we developed a self-administered questionnaire that was sent to the next-of-kin of intensive care unit (ICU) patients dying following WLS. Over a six-month period, 69 patients died following WLS in the ICU. Three letters were returned “address unknown”, 33 did not respond, and 33 responded, of whom 29 agreed to participate (29/66 = 44% of those contacted). Of these, 24 (83%) strongly agreed with the patient's death being compassionate and dignified, one moderately agreed, one mildly agreed, one was neutral and two strongly disagreed. Items associated with greater satisfaction included: the process of WLS being well explained, WLS proceeding as expected, patient appearing comfortable, family/friends prepared for the decision, appropriate person initiating discussion, adequate privacy during WLS, chance to voice concerns. The study suggests factors that are important to consider in ensuring family comfort with the process of withdrawing life support.

Psychological distress among the family members of Intensive Care Unit (ICU) patients: A scoping review

2021 ◽  
Author(s):  
Azura Abdul Halain ◽  
Li Yoong Tang ◽  
Mei Chan Chong ◽  
Noor Airini Ibrahim ◽  
Khatijah Lim Abdullah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Distress ◽  
Scoping Review ◽  
Family Members ◽  
Icu Patients ◽  
The Family

Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

2018 ◽  
Vol 38 (3) ◽  
pp. 18-26 ◽  
Author(s):  
Shawn E. Cody ◽  
Susan Sullivan-Bolyai ◽  
Patricia Reid-Ponte
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Family Members ◽  
Management Style ◽  
Family Management ◽  
Care Providers ◽  
Bedside Rounds ◽  
The Family ◽  
The Future

Background The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. Objectives To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. Methods A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. Results Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. Conclusion What health care providers say to patients’ families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information.

Delivering Cognitive Behavioral Therapy for Post–Intensive Care Syndrome–Family via a Mobile Health App

2021 ◽  
Vol 30 (6) ◽  
pp. 451-458
Author(s):  
Amy Petrinec ◽  
Cindy Wilk ◽  
Joel W. Hughes ◽  
Melissa D. Zullo ◽  
Yea-Jyh Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cognitive Behavioral Therapy ◽  
Mobile Health ◽  
Behavioral Therapy ◽  
Family Members ◽  
Intervention Group ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Icu Patients ◽  
Post Intensive Care Syndrome

Background Family members of intensive care unit (ICU) patients are at risk for post–intensive care syndrome– family (PICS-F), including symptoms of anxiety, depression, and posttraumatic stress. Cognitive behavioral therapy is the first-line nonpharmacologic treatment for many psychological symptoms and has been successfully delivered by use of mobile technology for symptom self-management. Objectives To determine the feasibility of delivering cognitive behavioral therapy through a smartphone app to family members of critically ill patients. Methods This was a prospective longitudinal cohort study with a consecutive sample of patients admitted to 2 adult ICUs and their family members. The control group period was followed by the intervention group period. The intervention consisted of a mobile health app preloaded on a smartphone provided to family members. The study time points were enrollment (within 5 days of ICU admission), 30 days after admission, and 60 days after admission. Study measures included demographic data, app use, satisfaction with the app, mental health self-efficacy, and measures of PICS-F symptoms. Results The study sample consisted of 49 predominantly White (92%) and female (82%) family members (24 intervention, 25 control). Smartphone ownership was 88%. Completion rates for study measures were 92% in the control group and 79% in the intervention group. Family members logged in to the app a mean of 18.58 times (range 2-89) and spent a mean of 81.29 minutes (range 4.93-426.63 minutes) using the app. Conclusions The study results confirm the feasibility of implementing app-based delivery of cognitive behavioral therapy to family members of ICU patients.

Reducing Stress, Coping, and Communicating Effectively: Tips for Family Members and Patients

2010 ◽  
Author(s):  
Michael T Compton ◽  
Beth Broussard
Keyword(s):  
Family Environment ◽  
Family Members ◽  
Effective Communication ◽  
Stressful Event ◽  
Stress Coping ◽  
Good Communication ◽  
The Family ◽  
Supportive Family ◽  
Receive Treatment ◽  
Reducing Stress

As discussed in previous chapters, psychosis often first begins in late adolescence or young adulthood. Thus, many people who experience a first episode of psychosis live with and rely on their families for support. In addition to providing a place to live and other basic support, families are key in the recovery process because they love and care for the person with the illness and they want to help. Family members may need to provide emotional support, arrange for treatment, and find new ways to cope with the signs and symptoms of psychosis or other problems that result from the illness. Families are a very important part of the team that is necessary to properly manage psychosis. In fact, now that more effective antipsychotic medicines and psychosocial treatments are available, many people with psychosis often can receive treatment in the community and with their families rather than having extended stays in the hospital. Families play a major role in helping their loved ones manage their illness. As a result, it is vital to create a supportive family environment by reducing stress, coping, and communicating effectively. This chapter focuses on three essential domains of a supportive family environment: reducing stress, enhancing coping, and ensuring effective communication. First, we begin by defining …Families play a major role in helping their loved ones manage their illness. As a result, it is vital to create a supportive family environment by reducing stress, coping, and communicating effectively.… stress and the ways that the early stages of psychosis can lead to stress. We discuss three ways to reduce stress in the family as well as three related ways the family can help the patient to reduce stress. Second, we define coping and talk about the importance of coping with a stressful event, like an episode of psychosis in a family member. We offer three ways of coping effectively for family members as well as three ways that patients can practice effective coping. Third, we address the value of good communication and how the symptoms of psychosis can sometimes interfere with productive communication patterns. We then provide eight points of advice for effective communication within the family.

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