Family Members’ Experiences With Bereavement in the Intensive Care Unit

Background Losing a loved one in the intensive care unit can be challenging for families. Providing bereavement support may assist in the grieving process. Objective To describe family members’ experiences with bereavement after the death of a loved one in the intensive care unit. Methods This secondary analysis used an exploratory, descriptive design to study family members’ experiences with bereavement. Family members of patients from 2 intensive care units in a tertiary medical center in the western United States participated. Audiotaped telephone interviews using a semistructured questionnaire were conducted. A qualitative, descriptive technique was used for data analysis. Two independent raters coded transcripts of audiotaped interviews with family members about their bereavement experiences. Results Seventeen family members participated in the study. Most participants were female (n = 12; 71%) and spouses of deceased patients (n = 14; 82%), and their mean (SD) age was 62.4 (10.0) years. Three themes emerged: (1) bereavement was an individual experience; (2) situations occurring during the intensive care unit encounter remained significant for family members beyond a year after the death; and (3) social, cultural, spiritual, and religious events after the death hold importance for families of patients in the intensive care unit. Conclusions Bereavement is a challenging experience for families of deceased intensive care unit patients. The themes identified in this study add insight into the experiences of these family members. The results of this study may guide future interventions to help support bereaved families of intensive care unit patients.

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Bereavement Experiences of Families in the Cardiac Intensive Care Unit

American Journal of Critical Care ◽

10.4037/ajcc2022859 ◽

2022 ◽

Vol 31 (1) ◽

pp. 13-23

Author(s):

Alyssa E. Erikson ◽

Kathleen A. Puntillo ◽

Jennifer L. McAdam

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Emotional Processing ◽

Medical Center ◽

Secondary Analysis ◽

Semistructured Interview ◽

Bereavement Support ◽

Cardiac Intensive Care Unit ◽

Loved One ◽

Cardiac Intensive Care

Background Losing a loved one in the intensive care unit is associated with complicated grief and increased psychologic distress for families. Providing bereavement support may help families during this time. However, little is known about the bereavement experiences of families of patients in the cardiac intensive care unit. Objective To describe the bereavement experiences of families of patients in the cardiac intensive care unit. Methods In this secondary analysis, an exploratory, descriptive design was used to understand the families’ bereavement experiences. Families from 1 cardiac intensive care unit in a tertiary medical center in the western United States participated. Audiotaped telephone interviews were conducted by using a semistructured interview guide 13 to 15 months after the patient’s death. A qualitative, descriptive technique was used for data analysis. Two independent researchers coded the interview transcripts and identified themes. Results Twelve family members were interviewed. The majority were female (n = 8, 67%), spouses (n = 10, 83%), and White (n = 10, 83%); the mean age (SD) was 58.4 (16.7) years. Five main themes emerged: (1) families’ bereavement work included both practical tasks and emotional processing; (2) families’ bereavement experiences were individual; (3) these families were resilient and found their own resources and coping mechanisms; (4) the suddenness of a patient’s death influenced families’ bereavement experiences; and (5) families’ experiences in the intensive care unit affected their bereavement. Conclusions This study provided insight into the bereavement experiences of families of patients in the cardiac intensive care unit. These findings may be useful for professionals working with bereaved families and for cardiac intensive care units considering adding bereavement support.

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Healing experience for family caregivers after an intensive care unit death

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2018-001561 ◽

2019 ◽

pp. bmjspcare-2018-001561 ◽

Cited By ~ 2

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.

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

American Journal of Critical Care ◽

10.4037/ajcc2002.11.3.200 ◽

2002 ◽

Vol 11 (3) ◽

pp. 200-209 ◽

Cited By ~ 103

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.

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

American Journal of Critical Care ◽

10.4037/ajcc2020733 ◽

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.

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To Identify the Causes of Stress among Nurses Working in Intensive Care Unit of Ittefaq Hospital Lahore

International Journal of Social Sciences and Management ◽

10.3126/ijssm.v4i2.17159 ◽

2017 ◽

Vol 4 (2) ◽

pp. 96-109 ◽

Cited By ~ 3

Author(s):

Salma Johan ◽

Hajra Sarwar ◽

Iram Majeed

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Work Environment ◽

Family Members ◽

Daily Routine ◽

Statistical Tools ◽

Insight Into ◽

Doctors And Nurses

The study is aimed at identifying the causes of stress amongst daily routine of nurses working in the ICU unit of Ittefaq Hospital Lahore. A questionnaire was developed and distributed to gain an insight into factors which may be causing stress to the nurses. The results were analyzed using statistical tools. An overall finding of the study is that all the nurses were suffering from stress however, the reasons of stress are different. Consensus was that three biggest causes of stress are prolonged shifts and extra duties, shortage of staff and excessive workload.The other major causes of stress identified are inappropriate or poor communication between doctors and nurses, lack of support and motivation, unexpected deaths or patients undergoing painful procedures, lack of breaks, lack of cooperation from peers and supervisors/managers. The patients themselves can also be a source of stress for example, problematic patients or their aggressive family members as well as improper work environment also contribute to stress.There is a dire need to develop stress alleviating programs and therapies at the hospitals. Nurses, doctors and managers should be encouraged to participate in such programs towards building stress-free work environment where patients can be served better. Int. J. Soc. Sc. Manage. Vol. 4, Issue-2: 96-109

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Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study

Journal of Clinical Nursing ◽

10.1111/jocn.15402 ◽

2020 ◽

Author(s):

Jonas Karlsson ◽

Thomas Eriksson ◽

Berit Lindahl ◽

Isabell Fridh

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Lived Experiences ◽

Family Members ◽

Loved One

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The Experiences of Family Members During the Critical Illness of a Loved One Admitted to an Intensive Care Unit

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/1446 ◽

2017 ◽

Vol 19 (1) ◽

pp. 56-68 ◽

Cited By ~ 2

Author(s):

Jennifer de Beer ◽

P Brysiewicz

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critical Illness ◽

Family Members ◽

Loved One

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Double Trouble: Patients With Both True and False Arrhythmia Alarms

Critical Care Nurse ◽

10.4037/ccn2020363 ◽

2020 ◽

Vol 40 (2) ◽

pp. 14-23

Author(s):

Stella Chiu Nguyen ◽

Sukardi Suba ◽

Xiao Hu ◽

Michele M. Pelter

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medical Center ◽

Academic Medical Center ◽

Secondary Analysis ◽

Altered Mental Status ◽

False Alarms ◽

Number Of False Alarms ◽

Academic Medical ◽

Using Data

Background Patients with both true and false arrhythmia alarms pose a challenge because true alarms might be buried among a large number of false alarms, leading to missed true events. Objective To determine (1) the frequency of patients with both true and false arrhythmia alarms; (2) patient, clinical, and electrocardiographic characteristics associated with both true and false alarms; and (3) the frequency and types of true and false arrhythmia alarms. Methods This was a secondary analysis using data from an alarm study conducted at a tertiary academic medical center. Results Of 461 intensive care unit patients, 211 (46%) had no arrhythmia alarms, 12 (3%) had only true alarms, 167 (36%) had only false alarms, and 71 (15%) had both true and false alarms. Ventricular pacemaker, altered mental status, mechanical ventilation, and cardiac intensive care unit admission were present more often in patients with both true and false alarms than among other patients (P < .001). Intensive care unit stays were longer in patients with only false alarms (mean [SD], 106 [162] hours) and those with both true and false alarms (mean [SD], 208 [333] hours) than in other patients. Accelerated ventricular rhythm was the most common alarm type (37%). Conclusions An awareness of factors associated with arrhythmia alarms might aid in developing solutions to decrease alarm fatigue. To improve detection of true alarms, further research is needed to build and test electrocardiographic algorithms that adjust for clinical and electrocardiographic characteristics associated with false alarms.

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Building organizational compassion among teams delivering end-of-life care in the intensive care unit: The 3 Wishes Project

Palliative Medicine ◽

10.1177/0269216320929538 ◽

2020 ◽

Vol 34 (9) ◽

pp. 1263-1273 ◽

Cited By ~ 2

Author(s):

Meredith Vanstone ◽

Marina Sadik ◽

Orla Smith ◽

Thanh H Neville ◽

Allana LeBlanc ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

End Of Life ◽

End Of Life Care ◽

Qualitative Content Analysis ◽

Family Members ◽

Life Care ◽

Dying Patients ◽

Qualitative Descriptive

Background: The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians. Aim: To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit. Design: Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework. Setting/participants: Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders. Results: The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians. Conclusions: Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.

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