scholarly journals How to guide the underage family members through the labyrinth of the ICU? Development of the “Ariadne”, a psychological assessment and support protocol

2021 ◽  
Author(s):  
Elina Demetriadou ◽  
Mikaella Kokkinou ◽  
Eleni Epiphaniou ◽  
Chrysanthi Leonidou ◽  
Theodoros Kyprianou
Keyword(s):  
Critically Ill ◽  
Mental Health Professionals ◽  
Psychological Assessment ◽  
Critically Ill Patients ◽  
Family Members ◽  
Support Service ◽  
Psychological Support ◽  
Structured Interviews ◽  
Children And Adolescent

Background: Critical illness and hospitalization in the Intensive Care Unit have been linked to adverse psychological effects for patients and their families. Although psychological support for adult family members gained growing research interest, studies regarding psychological support for the underage family members are still sporadic. Aim: The aim of this study was to develop a protocol for an innovative psychological assessment and support service (named “Ariadne”) for the underage family members (4 – 17 years old) of critically ill patients. Method: The following phases were implemented: a) Defining the needs of service’s users (underage family members and their guardians), b) Identifying potential assessment and intervention methods through semi-structured interviews with field experts and c) Consensus development with mental health professionals. Results: Users’ needs assessment phase highlighted the necessity for developing the service. Semi-structured interviews with field experts identified service implementation difficulties, psychological assessment, and intervention practices. The consensus meeting further specified the assessment and intervention practices that guided the development of the protocol. Limitations: The study was conducted at a single centre, limiting the generalization of findings. Furthermore, a possible recruitment bias should also be considered. Conclusion: This study introduces a novel methodology embedded in a complete protocol aiming to deliver in-vivo and tele-psychological services to children and adolescent family members of critically ill patients. The procedure implemented to develop the protocol, is expected to serve as gold-standard for the development of future psychological assessment and support protocols in under-investigated research areas.

scholarly journals EXTENDING THE PSYCHOLOGICAL SUPPORT SERVICES TO THE UNDERAGE FAMILY MEMBERS OF CRITICALLY ILL PATIENTS: THE ARIADNE PROGRAM

2015 ◽  
Vol 3 (Suppl 1) ◽  
pp. A647
Author(s):  
E Demetriadou ◽  
M Kokkinou ◽  
E Epiphaniou ◽  
G Christodoulou ◽  
N Stylianides ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Support Services ◽  
Family Members ◽  
Psychological Support

scholarly journals An ICU liaison nurse support service is valuable and important for critically ill patients, their family members and ward nurses

2020 ◽  
Vol 33 ◽  
pp. S5-S6
Author(s):  
Lotta Johansson ◽  
Linda Sjoholm ◽  
Viktoria Sjostedt ◽  
Ann-Sofie Brandén ◽  
Pernilla Boerenbeker ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Family Members ◽  
Support Service ◽  
Liaison Nurse

Families Living with Mental Illness

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Aditi Rana
Keyword(s):  
Mental Illness ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Family Members ◽  
Primary Caregivers ◽  
Well Being ◽  
Structured Interviews ◽  
Indian Context ◽  
The Family ◽  
Partner Research

Mental illness is a growing reality of our times. Usually in a typical Indian family, the parents act as the primary caregivers for the child suffering from mental disorder. For adult sufferers, it can also be siblings or offspring, and  at times even spouse or partner. Research on the experiences of families of mentally ill people has been minimal in the Indian context. This study aims to shift the focus from the mentally ill patients to the suffering of the caregivers and families of the patient keeping in mind the interconnected well being of the family in a collectivist culture. Following a qualitative approach, narratives have been taken from the family members of mentally ill (narratives of 8 families with mentally ill person) and also the mental health professionals (two) through semi structured interviews. The findings suggest that the family members suffer from a significant amount of stress accompanied by burden. Also, they feel secluded from the society and experience a lack of assistance to deal with the mentally ill member of the family.

Feeding critically ill patients: current concepts

2001 ◽  
Vol 21 (4) ◽  
pp. 60-69 ◽  
Author(s):  
EB Trujillo ◽  
MK Robinson ◽  
DO Jacobs
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutrient Intake ◽  
Nutritional Support ◽  
Physiological State ◽  
Support Service ◽  
Critical Care Nurses ◽  
Metabolic Complications ◽  
Key Points ◽  
Early Use

Provision of nutritional support to critically ill patients can be challenging. Critical care nurses must be aware of which patients require specific nutritional support, when to initiate nutritional support, and by which route to provide nutritional support. Consultation with a dietitian or nutritional support service can help facilitate this process. The key points in addressing these questions are (1) the nutritional status of the patient or the length of time he or she has been without significant nutrient intake, (2) whether the patient has a hypermetabolic condition that warrants the early use of nutritional support, and (3) the function of the patient's gastrointestinal tract. What to feed depends on the physiological state of the patient. Adjusting the nutrient composition of the feeding solution may prevent metabolic complications and may improve the overall outcome for the patient.

In vivo Elimination of Clonidine by Continuous Venovenous Hemofiltration in Critically Ill Patients

2020 ◽  
Vol 49 (5) ◽  
pp. 622-626
Author(s):  
Huub L.A. van den Oever ◽  
Marieke Zeeman ◽  
Polina Nassikovker ◽  
Carmen Bles ◽  
Fred A.L. van Steveninck ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Venovenous Hemofiltration ◽  
Kidney Dysfunction ◽  
Sieving Coefficient ◽  
The Mean ◽  
Ventilated Patients

Background: Clonidine is an α2-agonist that is commonly used for sedation in the intensive care unit. When patients are on continuous venovenous hemofiltration (CVVH) in the presence of kidney dysfunction, the sieving coefficient of clonidine is required to estimate how much drug is removed by CVVH. In the present study, we measured the sieving coefficient of clonidine in critically ill, ventilated patients receiving CVVH. Methods: A total of 20 samples of plasma and ultrafiltrate of 3 patients on CVVH, using a standard 1.5 m2 polyacrylonitrile AN69 membrane, during continuous clonidine infusion were collected. After correction for the effect of predilution, we calculated the sieving coefficient for clonidine. Results: The mean sieving coefficient of clonidine was 0.52 (SD 0.097). Conclusion: Using a polyacrylonitrile AN69 membrane in a CVVH machine, the in vivo sieving coefficient of clonidine was 0.52.

scholarly journals Proposal of a Pharmacokinetically Optimized Dosage Regimen of Antibiotics in Patients Receiving Continuous Hemodiafiltration

2011 ◽  
Vol 55 (12) ◽  
pp. 5804-5812 ◽  
Author(s):  
Takehito Yamamoto ◽  
Nobuhiro Yasuno ◽  
Shoichi Katada ◽  
Akihiro Hisaka ◽  
Norio Hanafusa ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Clearance ◽  
Minor Effect ◽  
Optimal Dosage ◽  
Continuous Hemodiafiltration ◽  
Unbound Fraction ◽  
Artificial Plasma

ABSTRACTThe aim of the study was to quantitatively predict the clearance of three antibiotics, amikacin, vancomycin, and teicoplanin, during continuous hemodiafiltration (CHDF) and to propose their optimal dosage in patients receiving CHDF. For this goal,in vitroCHDF experiments with a polyacrylonitrile (PAN) membrane were first performed using these antibiotics, and then the clearances were compared within vivoCHDF situations determined in 16 critically ill patients. Thein vitroCHDF clearances were described as the product of the outflow rate of a drain (Qoutflow) and the drug unbound fraction in artificial plasma, indicating that drug adsorption to the PAN membrane has minor effect on drug clearance in our settings. The observedin vivoclearances also agreed very well with the predicted values, with a product ofQoutflowand plasma unbound fraction, when residual creatinine clearance (CLCR) was taken into account (within a range of 0.67- to 1.5-fold for 15 of 16 patients). Based on these results, a nomogram of the optimized dosages of amikacin, vancomycin, and teicoplanin was proposed, and it was evident thatQoutflowand residual CLCRare major determinants of the dosage and dosing interval for these antibiotics. Although the applicability needs to be confirmed with another type of membrane or higherQoutflow, our nomogram can help determine the dosage setting in critically ill patients receiving CHDF.

scholarly journals The use and usefulness of ICU diaries to support family members of critically ill patients

2021 ◽  
Vol 61 ◽  
pp. 168-176
Author(s):  
Robin S. Mickelson ◽  
Susan E. Piras ◽  
Linda Brown ◽  
Carisa Carlile ◽  
Kelly S. Drumright ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Family Members ◽  
Support Family

Critical-care medicine and the acute-care laboratory

1990 ◽  
Vol 36 (8) ◽  
pp. 1552-1556 ◽  
Author(s):  
J R Hall
Keyword(s):  
Critical Care ◽  
Data Management ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ex Vivo ◽  
Hospital Costs ◽  
Cost Effective ◽  
Critical Care Medicine ◽  
Time Utilization

Abstract Critical-care medicine today is practiced by anesthesiologists, internists, pediatricians, and surgeons. Outcome from today's management of critically ill patients is very good, yet associated costs are very high. Over one-half of the hospital costs of critically ill patients emanates from the intensive-care unit (ICU), although the ICU stay accounts for less than 20% of their time in the hospital. Outside of the operating room, the ICU is the most expensive location for patient care in the hospital, and laboratory tests are the most expensive single item. Plans for cost containment should incorporate the following: more effective data management, education of practitioners about appropriateness and costs of tests, conversion from laboratory measurements to appropriate in vivo and ex vivo measurements, and real-time utilization assessment. To provide high-quality, cost-effective critical care in the future, laboratorians and clinicians must work together today to meet the challenges of technology, data management, and staff education.

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