The Vortex: Families’ Experiences With Death in the Intensive Care Unit

2002 ◽  
Vol 11 (3) ◽  
pp. 200-209 ◽  
Author(s):  
Karin T. Kirchhoff ◽  
Lee Walker ◽  
Ann Hutton ◽  
Vicki Spuhler ◽  
Beth Vaughan Cole ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Experiences ◽  
Healthcare Providers ◽  
Family Members ◽  
Terminal Condition ◽  
Loved One ◽  
The Family ◽  
Downward Spiral ◽  
Eventual Loss

• Background Lack of communication from healthcare providers contributes to the anxiety and distress reported by patients’ families after a patient’s death in the intensive care unit.• Objective To obtain a detailed picture of the experiences of family members during the hospitalization and death of a loved one in the intensive care unit.• Methods A qualitative study with 4 focus groups was used. All eligible family members from 8 intensive care units were contacted by telephone; 8 members agreed to participate.• Results The experiences of the family members resembled a vortex: a downward spiral of prognoses, difficult decisions, feelings of inadequacy, and eventual loss despite the members’ best efforts, and perhaps no good-byes. Communication, or its lack, was a consistent theme. The participants relied on nurses to keep informed about the patients’ condition and reactions. Although some participants were satisfied with this information, they wished for more detailed explanations of procedures and consequences. Those family members who thought that the best possible outcome had been achieved had had a physician available to them, options for treatment presented and discussed, and family decisions honored.• Conclusions Uncertainty about the prognosis of the patient, decisions that families make before a terminal condition, what to expect during dying, and the extent of a patient’s suffering pervade families’ end-of-life experiences in the intensive care unit. Families’ information about the patient is often lacking or inadequate. The best antidote for families’ uncertainty is effective communication.

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

2014 ◽  
Vol 23 (3) ◽  
pp. 751-757 ◽  
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

scholarly journals The Experiences of Family Members of Ventilated COVID-19 Patients in the Intensive Care Unit: A Qualitative Study

2021 ◽  
pp. 104990912110069
Author(s):  
Chiahui Chen ◽  
Elaine Wittenberg ◽  
Suzanne S. Sullivan ◽  
Rebecca A. Lorenz ◽  
Yu-Ping Chang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Providers ◽  
Family Members ◽  
Support Needs ◽  
Early Referral ◽  
Telephone Interviews ◽  
The Family ◽  
Care Family

Background: Visitor restrictions caused challenges for family members when their loved ones had coronavirus disease (COVID-19) and were ventilated. Limited studies have reported on family members’ experiences and support needs. Aim: To explore the experiences and support needs of family members of ventilated COVID-19 patients in the intensive care unit (ICU). Design: Exploratory, qualitative design, using in-depth individual telephone interviews, and analyzed using thematic analysis. Setting/Participants: Ten family members of adult COVID-19 patients in the ICU. Result: Seven key themes represented family members’ experiences: (a) reactions to the COVID-19 diagnosis, (b) COVID-19 as a destabilizing force on the family unit, (c) COVID-19’s effects on bereavement outcomes, (d) desperately seeking information, (e) family member needs, (f) conflicting feelings about video calls, and (g) appreciation of care. Family members’ feelings about the patient’s diagnosis and how the virus was contracted exacerbated their stress and anxiety. They struggled to feel informed about care that they could not witness and had difficulty understanding information. Family members reported that video calls were unhelpful. While these experiences made them question the quality of care, they expressed their appreciation of the frontline healthcare providers taking care of their loved ones. Conclusion: The stress and uncertainty of family members of critically ill patients with COVID-19 were influenced by their inability to feel connected to the patient and informed about care. Healthcare providers should assess each individual family’s burden and preferences, and this should include establishing structured, timely, and consistent communication regarding patient care during the pandemic including early referral to palliative care.

Healing experience for family caregivers after an intensive care unit death

2019 ◽  
pp. bmjspcare-2018-001561 ◽  
Author(s):  
Susan DeSanto-Madeya ◽  
Dan Willis ◽  
Julie McLaughlin ◽  
Aristotle Boslet
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Caregivers ◽  
Phenomenological Study ◽  
Healthcare Providers ◽  
Loved One ◽  
Hermeneutic Phenomenological ◽  
Telephone Interviews ◽  
Hermeneutic Phenomenological Study ◽  
Purposive Sample

ObjectivesFamily caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.MethodsSemi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU. Qualitative analysis techniques were used to identify common themes central to the experience of healing across all interviews.ResultsSeven themes were interpreted from the data: searching for clarity from a time of uncertainty; riding an emotional rollercoaster; seeking peace in one’s decisions; moving forward with each new day; taking comfort in the memories; valuing layers of support; and discovering life on one’s own.ConclusionBy identifying and gaining an understanding of healing following the death of a loved one in the ICU, nursing and other healthcare providers have an opportunity to promote healing and positively impact family caregiver’s bereavement.

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.

Family and Clinician Experiences of Sympathy Cards in the 3 Wishes Project

2020 ◽  
Vol 29 (6) ◽  
pp. 422-428
Author(s):  
Alyson Takaoka ◽  
Meredith Vanstone ◽  
Thanh H. Neville ◽  
Sophia Goksoyr ◽  
Marilyn Swinton ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Focus Groups ◽  
Family Members ◽  
Loved One ◽  
Symptoms Of Depression ◽  
Shared Humanity ◽  
Clinician Experiences ◽  
Conventional Content Analysis ◽  
Bereaved Family

Background A recent randomized trial of bereaved family members of patients who died in an intensive care unit identified symptoms of depression and posttraumatic stress in recipients of semistructured condolence letters. Objectives To explore family member and clinician experiences with receiving or sending handwritten sympathy cards upon the death of patients involved in a personalized end-of-life intervention, the 3 Wishes Project. Methods Interviews and focus groups were held with 171 family members and 222 clinicians at 4 centers to discuss their experiences with the 3 Wishes Project. Interview transcripts were searched to identify participants who discussed sympathy cards. Data related to sympathy cards were independently coded by 2 investigators through conventional content analysis. Results Sympathy cards were discussed during 32 interviews (by 25 family members of 21 patients and by 11 clinicians) and 2 focus groups (8 other clinicians). Family members reported that personalized sympathy cards were a welcome surprise; they experienced them as a heartfelt act of compassion. Clinicians viewed cards as an opportunity to express shared humanity with families, reminding them that they and their loved one were not forgotten. Signing cards allowed clinicians to reminisce individually and collectively with colleagues. Family members and clinicians experienced sympathy cards as a meaningful continuation of care after a patient’s death. Conclusions Inviting clinicians who cared for deceased patients to offer personalized, handwritten condolences to bereaved family members may cultivate sincere and individualized expressions of sympathy that bereaved families appreciate after the death of patients involved in the 3 Wishes Project.

Care of the family of the ICU patient

1989 ◽  
Vol 9 (8) ◽  
pp. 42-44 ◽  
Author(s):  
CA Meijs
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Loved One ◽  
The Family

A nurse working in intensive care may easily forget the first impact this environment makes and therefore may unintentionally overlook a family's needs. It is hoped that this article will help nurses recognize the importance of easing stress within the family as well as provide the tools to meet the needs of each family whose loved one enters an intensive care unit.

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.

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