Emotional responses of family members during a critical care hospitalization

1994 ◽  
Vol 3 (1) ◽  
pp. 70-76 ◽  
Author(s):  
C Kleiber ◽  
M Halm ◽  
M Titler ◽  
LA Montgomery ◽  
SK Johnson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Emotional Response ◽  
Family Members ◽  
Emotional Responses ◽  
Nursing Interventions ◽  
Supportive Behaviors

BACKGROUND: The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed. OBJECTIVE: To examine emotional responses of family members and their descriptions of supportive behaviors of others during a critical care hospitalization. METHODS: An exploratory design was used to study 52 subjects with critically ill family members in the pediatric, neonatal, medical, surgical and cardiovascular intensive care units in a large tertiary care hospital. The subjects kept daily logs of their feelings and the supportive behaviors of others. Thematic analysis was used to identify major themes. RESULTS: Analysis revealed a broad range of powerful emotions throughout the intensive care unit stay. Negative and positive emotions such as despair and joy were sometimes identified by subjects within a 24-hour period. Although fear, worry, anger and exhaustion were dominant themes during the first 24 hours and when the family received bad news about the patient, there was no pattern of emotional response evident as the stay progressed. Some differences between subjects drawn from the medical and neonatal intensive care units were evident. CONCLUSIONS: The findings suggest that family members of critically ill patients experience deep emotional turmoil throughout the intensive care unit stay. Specific nursing interventions to promote adaptive coping are needed throughout the experience.

Postoperative Delirium: A Literature Review of Management in Intensive Care Unit

2021 ◽  
Vol 1 (3) ◽  
pp. 44-48
Author(s):  
Cendy Legowo
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Postoperative Delirium ◽  
Mechanistic Explanation ◽  
Clinical Results ◽  
Care Plan ◽  
Prevention And Treatment

Perioperative delirium is a wide-ranging problem that directly affects primary clinical results. The anesthesiologist must understand how to define and diagnose delirium, identify patients at high risk of delirium, identify predisposing factors to adjust the care plan appropriately, and manage delirium in the acute postoperative period. Delirium is an organ dysfunction in critically ill patients, independently associated with improved morbidity. Research on delirium in hospitalized patients (including critically ill patients) has increased exponentially in the last decade. This study emphasizes the need for a mechanistic explanation of delirium to help advance the research that ultimately leads to its prevention and treatment. In this study, multinational and multidisciplinary clinicians, and researchers from the fields of critical care medicine, psychiatry, anesthesiology, neurology, and pharmacy sought to collaborate in the management of delirium in the intensive care unit (ICU).

Admission of the very elderly to the intensive care unit: Family members’ perspectives on clinical decision-making from a multicenter cohort study

2015 ◽  
Vol 29 (4) ◽  
pp. 324-335 ◽  
Author(s):  
Daren K Heyland ◽  
Peter Dodek ◽  
Sangeeta Mehta ◽  
Deborah Cook ◽  
Allan Garland ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Cohort Study ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Family Members ◽  
Very Elderly

Background: Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. Aim: To describe family members’ perspectives about care provided to very elderly critically ill patients. Design: Multicenter, prospective, cohort study. Participants and setting: In total, 535 family members of patients aged 80 years or older admitted to 22 intensive care units for more than 24 h. Results: Family members reported that the “patient be comfortable and suffer as little as possible” was their most important value and “the belief that life should be preserved at all costs” was their least important value considered in making treatment decisions. Most family members (57.9%) preferred that life support be used for their family member, whereas 24.1% preferred comfort measures only, and 14.4% were unsure of their treatment preferences. Only 57.3% reported that a doctor had talked to them about treatment options for the patient. Overall, 29.7% of patients received life-sustaining treatments for more than 7 days and 50.3% of these died in hospital. Families were most satisfied with the skill and competency of nurses and least satisfied with being included and supported in the decision-making process and with their sense of control over the patient’s care. Conclusion: There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.

Postoperative Delirium: A Literature Review of Management in Intensive Care Unit

2021 ◽  
Vol 1 (3) ◽  
pp. 44-48
Author(s):  
Cendy Legowo
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Postoperative Delirium ◽  
Mechanistic Explanation ◽  
Clinical Results ◽  
Care Plan ◽  
Prevention And Treatment

Perioperative delirium is a wide-ranging problem that directly affects primary clinical results. The anesthesiologist must understand how to define and diagnose delirium, identify patients at high risk of delirium, identify predisposing factors to adjust the care plan appropriately, and manage delirium in the acute postoperative period. Delirium is an organ dysfunction in critically ill patients, independently associated with improved morbidity. Research on delirium in hospitalized patients (including critically ill patients) has increased exponentially in the last decade. This study emphasizes the need for a mechanistic explanation of delirium to help advance the research that ultimately leads to its prevention and treatment. In this study, multinational and multidisciplinary clinicians, and researchers from the fields of critical care medicine, psychiatry, anesthesiology, neurology, and pharmacy sought to collaborate in the management of delirium in the intensive care unit (ICU).

Meeting needs of family members of critically ill patients in a Spanish intensive care unit

1997 ◽  
Vol 13 (1) ◽  
pp. 12-16 ◽  
Author(s):  
C. Zazpe ◽  
M.A. Margall ◽  
C. Otano ◽  
M.P. Perochena ◽  
M.C. Asiain
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Family Members

Sedation, Pain Management, and Pharmacology

2019 ◽  
pp. 87-99
Author(s):  
Sophie Samuel ◽  
Jennifer Cortes
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Pain Management ◽  
Infectious Diseases ◽  
Operating Room ◽  
Critically Ill ◽  
Residency Training ◽  
Critically Ill Patients ◽  
Clinical Vignettes

The study of pharmacology enables the principle method of intervention for critically ill patients. Because many variables exists that affect the efficacy and indications for drug intervention, a thorough knowledge of pharmacology is needed in the intensive care unit, just as it is needed in the operating room. Because pharmacology effects every system it may potentially be included in every type of question. In order to achieve a pharmacologic focus, much of this chapter emphasizes and infrequently seen but non-isoteric contact. Overall, chapter is designed to evaluate pharmacologic knowledge with highly clinical vignettes for the reader. Additionally, the reader will find an emphasis on practice pharmacologic elements of managing infectious diseases and complexities of sedation, which anesthesiologists will find reminiscent of the residency training with a critical care “twist”.

Transfusion Requirements in Critical Care (TRICC)

2018 ◽  
pp. 114-118
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cardiac Ischemia ◽  
Red Cell ◽  
Transfusion Threshold ◽  
Chronic Anemia ◽  
Transfusion Requirements

This case focuses on red cell transfusions in critically ill patients by asking the question: When should patients in the intensive care unit (ICU) with anemia receive red cell transfusions? For most critically ill patients, waiting to transfuse red cells until the hemoglobin (Hgb) drops below 7 g/dL is at least as effective as, and likely preferable to, transfusing at an Hgb less than 10 g/dL. These findings may not apply to patients with chronic anemia, who were excluded from the trial. The results also may not apply to patients with active cardiac ischemia, who were poorly represented in the trial and had nonsignificantly worse outcomes with a transfusion threshold of 7.

scholarly journals The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Eline G. M. Cox ◽  
Marisa Onrust ◽  
Madelon E. Vos ◽  
Wolter Paans ◽  
Willem Dieperink ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Operating Characteristics ◽  
Tertiary Teaching ◽  
Nurses And Physicians

Abstract Background Prognostic assessments of the mortality of critically ill patients are frequently performed in daily clinical practice and provide prognostic guidance in treatment decisions. In contrast to several sophisticated tools, prognostic estimations made by healthcare providers are always available and accessible, are performed daily, and might have an additive value to guide clinical decision-making. The aim of this study was to evaluate the accuracy of students’, nurses’, and physicians’ estimations and the association of their combined estimations with in-hospital mortality and 6-month follow-up. Methods The Simple Observational Critical Care Studies is a prospective observational single-center study in a tertiary teaching hospital in the Netherlands. All patients acutely admitted to the intensive care unit were included. Within 3 h of admission to the intensive care unit, a medical or nursing student, a nurse, and a physician independently predicted in-hospital and 6-month mortality. Logistic regression was used to assess the associations between predictions and the actual outcome; the area under the receiver operating characteristics (AUROC) was calculated to estimate the discriminative accuracy of the students, nurses, and physicians. Results In 827 out of 1,010 patients, in-hospital mortality rates were predicted to be 11%, 15%, and 17% by medical students, nurses, and physicians, respectively. The estimations of students, nurses, and physicians were all associated with in-hospital mortality (OR 5.8, 95% CI [3.7, 9.2], OR 4.7, 95% CI [3.0, 7.3], and OR 7.7 95% CI [4.7, 12.8], respectively). Discriminative accuracy was moderate for all students, nurses, and physicians (between 0.58 and 0.68). When more estimations were of non-survival, the odds of non-survival increased (OR 2.4 95% CI [1.9, 3.1]) per additional estimate, AUROC 0.70 (0.65, 0.76). For 6-month mortality predictions, similar results were observed. Conclusions Based on the initial examination, students, nurses, and physicians can only moderately predict in-hospital and 6-month mortality in critically ill patients. Combined estimations led to more accurate predictions and may serve as an example of the benefit of multidisciplinary clinical care and future research efforts.

Effectiveness of Nursing Interventions to Prevent Dry Eye in Critically Ill Patients

2019 ◽  
Vol 28 (4) ◽  
pp. 299-306
Author(s):  
Diego Dias de Araujo ◽  
Daniel Vinicius Alves Silva ◽  
Carolina Amaral Oliveira Rodrigues ◽  
Patricia Oliveira Silva ◽  
Tamara Goncalves Rezende Macieira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Dry Eye ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Nursing Interventions ◽  
Blink Rate ◽  
Artificial Tears ◽  
Adult Intensive Care Unit

Background Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition. Objective To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb). Methods In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70). The study inclusion criteria were as follows: admission to the intensive care unit, age of 18 years or older, no diagnosis of dry eye at admission, receipt of mechanical ventilation, blink rate of less than 5 times per minute, and a score of 7 or less on the Glasgow Coma Scale. On 5 consecutive days, a single researcher who was unaware of the treatment assignment assessed the participants’ eyes using the fluorescein eye stain test and the Schirmer test for dry eye. Results Dry eye developed in 21% of participants who received liquid artificial tears versus 9% of participants who received artificial tears gel (P = .04). Conclusions In this study, artificial tears gel was superior to liquid artificial tears in preventing the development of dry eye. These results may help nurses deliver evidence-based eye care aimed at reducing the risk of dry eye in critically ill patients.

Perception of nurses regarding family needs of critically ill patients in a tertiary hospital of Kathmandu: A cross-sectional study

2019 ◽  
Vol 8 (1) ◽  
pp. 8-12
Author(s):  
Sabita Pandey ◽  
Roshanee Shrestha ◽  
Narayani Paudel
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Care Unit ◽  
Family Members ◽  
Cross Sectional Study ◽  
Family Needs ◽  
Sectional Study ◽  
Cross Sectional

Background: Getting serious illness and being admitted in critical care unit is always stressful to patient and family members. Meeting the needs of family members of patients in the intensive care unit is a primary responsibility of intensive care unit staff and an important criterion in assessment of quality of care. Objectives: The aim of this study was to assess the family members’ needs of critically ill patients as perceived by nurses. Methodology: A descriptive cross sectional study was conducted among 50 nurses from different critical care unitsof Kathmandu Medical College Teaching Hospital using purposive sampling technique. Structured questionnaire was developed by referring to “Critical Care Family Needs Inventory”in our context for data collection and collected data was analyzed by using Statistical Package for Social Sciences version 16. Results: The mean age of the respondents was 24.98 ± SD 2.77.Regarding education and experience, 58% respondents had proficiency certificate level and 42% had bachelor level education and mean working experience in critical care unit was 37.54 months. Regarding the importance of family needs, 86% nurses perceived “explanation about the critical care unit environment before admitting the patient in critical care unit” as very important need for the relatives. Likewise, 58% nurses perceived “to know which staff members could give what type of information” and “to be alone at any time” as the least important needs. Conclusion: The study found that clear explanation about the critical care environment to the relatives is very important to gain co-operation from them in treatment of critically ill patients. Hence, staff of critical care unit needs to be aware in meeting the needs of relatives.

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