Information and support needs of adult family members of patients in intensive care units: an Iranian perspective

Background Intensive care unit stays can be stressful for patients’ family members. Family-centered communication has 6 components: fostering relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. Whether these communication components decrease family members’ stress is unknown. Objective To describe levels of family-centered communication and associations with acute stress while patients are in the intensive care unit. Methods A convenience sample of 130 family members of patients in 2 intensive care units in a Jerusalem, Israel, tertiary medical center received a family-centered communication questionnaire, the Perceived Stress Scale, and a personal characteristics questionnaire. Results Most respondents were women (n = 79, 60.8%), children of the patient (n = 67, 51.9%), and familiar with the patient’s diagnosis (n = 111, 85.4%). Mean (SD) participant age was 45.7 (13.6) years. Most considered the patient medically stable (n = 75, 57.7%). Mean (SD) intensive care unit stay was 7.45 (5.8) days. Mean (SD) total and item scores for family-centered communication were 98.75 (18.21) and 3.80 (0.70), respectively; for the Perceived Stress Scale, 19.63 (5.92) and 1.96 (0.59), respectively. Relationship building (r = −0.31, P = .002), participation in care management (r = −0.32, P = .001), and emotional support (r = −0.29, P = .003), and were significantly related to stress. Conclusions Stress levels were mild to moderate and communication scores were moderate to high. Better nurse communication with family members was associated with decreased acute stress, irrespective of personal characteristics or perceptions of the patient’s medical status.

Download Full-text

Family members’ experiences in adult intensive care units: a systematic review

Scandinavian Journal of Caring Sciences ◽

10.1111/scs.12675 ◽

2019 ◽

Vol 33 (3) ◽

pp. 569-581 ◽

Cited By ~ 1

Author(s):

Masoomeh Imanipour ◽

Frank Kiwanuka ◽

Sanaz Akhavan Rad ◽

Ronald Masaba ◽

Yisak Hagos Alemayehu

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Intensive Care Units ◽

Family Members

Download Full-text

Patient, Family, and Physician Satisfaction With Planning for Direct Discharge to Home From Intensive Care Units: Direct From ICU Sent Home Study

Journal of Intensive Care Medicine ◽

10.1177/0885066617731263 ◽

2017 ◽

Vol 35 (1) ◽

pp. 82-90 ◽

Cited By ~ 4

Author(s):

Joyce Nga Hei Lam ◽

Vincent I. Lau ◽

Fran A. Priestap ◽

John Basmaji ◽

Ian M. Ball

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Family Members ◽

Patient Discharge ◽

Health Care Team ◽

Physician Satisfaction ◽

Allied Health Professionals ◽

New Era ◽

Attending Physician ◽

Direct Discharge

Background: In the new era of decreasing hospital bed availability, there is an increasing rate of direct discharge to home (DDH) from intensive care units (ICUs), despite sparse literature informing this practice. Objectives: To evaluate patient, family, and ICU attending physician satisfaction with planning for DDH from the ICU and intensivists’ current DDH practices and perceptions. Methods: Prospective cohort study, using convenience sampling, of adult patients undergoing DDH from an ICU between February 2016 and February 2017 using a modified FS-ICU 24 satisfaction survey completed by patients, family members, and attending physicians at the time of patient discharge to home from the ICU. Results: Seventy-two percent of patients, 37% of family members, and 100% of ICU physicians recruited completed the survey. A majority of patients (89%) and families (78%) were satisfied or very satisfied with DDH. Only 6% of patients and 8% of families were dissatisfied to very dissatisfied with DDH. Conversely, ICU physician satisfaction varied, with only 5% being very comfortable with DDH and the majority (50%) only somewhat comfortable. Twenty percent of staff consultants were uncomfortable to very uncomfortable with the practice of DDH. Thirty-one percent of staff physician respondents felt that patient and family discomfort would be barriers to DDH. Compared to physicians and other allied health professionals, nurses were identified as the most helpful members of the health-care team in preparation for DDH by 98% of patients and 92% of family members. The DDH rates have increased for the past 12 years in our ICUs but declined during the study period (February 2016 to February 2017). Conclusions: Patients and family members are satisfied with the practice of DDH from ICU, although ICU physician satisfaction is more variable. Physician comfort may be improved by data informing which patients may be safely DDH from the ICU.

Download Full-text

MONITOR-IC study, a mixed methods prospective multicentre controlled cohort study assessing 5-year outcomes of ICU survivors and related healthcare costs: a study protocol

BMJ Open ◽

10.1136/bmjopen-2017-018006 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018006 ◽

Cited By ~ 5

Author(s):

Wytske Geense ◽

Marieke Zegers ◽

Hester Vermeulen ◽

Mark van den Boogaard ◽

Johannes van der Hoeven

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Mixed Methods ◽

Healthcare Costs ◽

Family Members ◽

Support Needs ◽

Icu Patients ◽

Care And Support ◽

Long Term Consequences

IntroductionDue to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors’ HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs.MethodsThe MONITOR-IC study is a multicentre prospective controlled cohort study, carried out in ICUs in four Dutch hospitals. Patients will be included between July 2016 and July 2021 and followed for 5 years. We estimated to include 12000 ICU patients. Outcomes are the HRQoL, physical, cognitive and mental symptoms, ICU survivors’ care and support needs, healthcare use and related costs. A control cohort of otherwise seriously ill patients will be assembled to compare long-term patient-reported outcomes. We will use a mixed methods design, including questionnaires, medical data from patient records, cost data from health insurance companies and interviews with patients and family members.Ethics and disseminationInsights from this study will be used to inform ICU patients and their family members about long-term consequences of ICU care, and to develop prediction and screening instruments to detect patients at risk for PICS. Subsequently, tailored interventions can be developed and implemented to prevent and mitigate long-term consequences. Additionally, insights into the ratio between HRQoL of ICU patients and related healthcare costs during 5 years after ICU admission can be used to discuss the added value of ICU care from a community perspective. The study has been approved by the research ethics committee of the Radboud University Medical Center (2016-2724).Clinical trial registrationNCT03246334

Download Full-text