A Whirlpool of Stress in Families of Intensive Care Unit Patients: A Qualitative Multicenter Study

2021 ◽  
Vol 41 (3) ◽  
pp. 55-64
Author(s):  
Bahman Aghaie ◽  
Monireh Anoosheh ◽  
Mahshid Foroughan ◽  
Esa Mohammadi ◽  
Anoshirvan Kazemnejad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Family Care ◽  
Critical Care Nurses ◽  
Private Hospitals ◽  
Negative Beliefs ◽  
Semistructured Interviews

Background Family members of patients admitted to the intensive care unit must tolerate high levels of stress, making them emotionally and physically vulnerable. However, little is known about the kinds of stress family members may experience. Objective To explore perceived stress in the families of patients admitted to the intensive care unit. Methods This qualitative content analysis study involved 23 family members of patients admitted to intensive care units. Participants were drawn from family members of patients hospitalized in intensive care units of 3 public and 2 private hospitals. Data were collected through semistructured interviews. Results Three themes emerged from the data: “distrust,” “repeated stress exposure,” and “a whirlpool of persistent negative emotional-physical state.” The first theme had 2 categories: “fearful mindset” and “negative beliefs about professional caregivers.” The second theme also had 2 categories: “fear of the future” and “sustained accumulation of tensions.” The third theme had 3 categories: “impaired mental health,” “impaired physical health,” and “impaired family function.” Conclusions The findings of this study may help critical care nurses better understand the nature and sources of family stresses during a patient’s intensive care unit stay. Supervisory nurses should alert their staff to these issues so that family care programs can address them, thereby reducing family members’ risk of posttraumatic stress disorder and post–intensive care syndrome-family.

Family-Centered Communication and Acute Stress in Israeli Intensive Care Units

2019 ◽  
Vol 28 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Freda DeKeyser Ganz ◽  
Gilat Yihye ◽  
Nicole Beckman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Perceived Stress ◽  
Acute Stress ◽  
Family Members ◽  
Personal Characteristics ◽  
Perceived Stress Scale ◽  
Stress Scale ◽  
Family Centered

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.

scholarly journals Relatives' experience of intensive care: the other side of hospitalization

2007 ◽  
Vol 15 (4) ◽  
pp. 598-604 ◽  
Author(s):  
Urizzi Fabiane ◽  
Adriana Katia Corrêa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Member ◽  
Care Delivery ◽  
Family Members ◽  
Family Care ◽  
The Other ◽  
Daily Routine ◽  
Reference Framework ◽  
Critical Patients

This study aims at understanding the experience concerning family members of patients in the Intensive Care Unit (ICU), with the purpose of contributing to care humanization in this context. Considering the nature of the research object, this research was carried out to understand the phenomenon Being a family that experiences the hospitalization of a family member in ICU. Phenomenology was used as a methodological reference framework. Seventeen family members of adult patients in the Intensive Care Unit (ICU) at the Santa Casa in Londrina were interviewed from September to December 2004. Through analysis of these interviews, some theme categories emerged: difficult, painful, speechless experience; experiencing and recognizing somebody's life: approaching the patient's suffering; break-up of the family's daily routine; fear of having a family member die; ICU: a fearsome scene, but necessary; concern with family care. Some issues related to the family's attendance in the ICU were discussed, contributing to the establishment of humanized care delivery to critical patients and their families' uniqueness.

Visiting Preferences of Patients in the Intensive Care Unit and in a Complex Care Medical Unit

2004 ◽  
Vol 13 (3) ◽  
pp. 194-198 ◽  
Author(s):  
Colleen E. Gonzalez ◽  
Diane L. Carroll ◽  
Jeanne S. Elliott ◽  
Patricia A. Fitzgerald ◽  
Heather J. Vallent
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Family Members ◽  
Structured Interview ◽  
Complex Care ◽  
Medical Unit ◽  
Healthcare Environment ◽  
Perceived Satisfaction

• Background Within the challenging healthcare environment are nurses, patients, and patients’ families. Families want proximity to their loved ones, but the benefits of such proximity depend on patients’ conditions and family-patient dynamics. • Objectives To describe patients’ preferences for family visiting in an intensive care unit and a complex care medical unit. • Methods Sixty-two patients participated in a structured interview that assessed patients’ preferences for visiting, stressors and benefits of visiting, and patients’ perceived satisfaction with hospital guidelines for visiting. • Results Patients in both units rated visiting as a nonstressful experience because visitors offered moderate levels of reassurance, comfort, and calming. Patients in the intensive care unit worried more about their families than did patients in the complex care medical unit but valued the fact that visitors could interpret information for the patients while providing information to assist the nurse in understanding the patients. Patients in the intensive care unit were more satisfied with visiting practices than were patients in the complex care medical unit, although both groups preferred visits of 35 to 55 minutes, 3 to 4 times a day, and with usually no more than 3 visitors. • Conclusions These data provide the input of patients in the ongoing discussion of visiting practices in both intensive care units and complex care medical units. Patients were very satisfied with a visiting guideline that is flexible enough to meet their needs and those of their family members.

SATISFACCIÓN DE LOS FAMILIARES DE PACIENTES INGRESADOS EN LA UNIDAD DE CUIDADOS INTENSIVOS DE EMERGENCIA

SCIENTIARVM ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 37-42
Author(s):  
Ángel Mamani Ruelas ◽  
◽  
Katherine Quispe Medina ◽  
Claudia Butrón Vargas ◽  
Felipe Apaza Huamán ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Members ◽  
Family Care ◽  
Family Satisfaction ◽  
Care Quality ◽  
International Studies ◽  
Waiting Room ◽  
Cross Sectional ◽  
Degree Of Satisfaction

The appreciation of care by families is of great importance in the evaluation of the quality of care in an intensive care unit (ICU). This study used the adaptation of the Family Satisfaction with Care in the Intensive Care Unit questionnaire: FS-ICU (24). Our objective was to know the degree of satisfaction of family members for the care received from the patient admitted to the Emergency Intensive Care Unit (UCIE) as well as with the decision-making process for patient care. This is a cross-sectional, observational, descriptive and prospective study for 5 months. A sample of 69 main relatives of patients admitted to the unit with more than 24 hours of stay was studied, applying the FS-ICU (24) questionnaire. The following results were obtained: In relation to the care of the patient in the ICUE, 68.12% of relatives perceived an excellent or very good concern for the patient, a very good pain management in 49.28%, very good management of dyspnea in 40%, regarding family care, 43.48% considered it very good, with good emotional support in 46.38%. 47.83% considered the coordination of care as good, as well as the concern of the staff. When assessing professional care, the nurse's skills and competencies were considered very good at 43.48%, and communication as good at 43.48%; The doctor's skills and competencies were also very good at 43.48%. Regarding the environment of the UCIE, it was considered good in 44,935, the waiting room as sufficient in 47.83%, and the amount of care as very good in 43.48%. We conclude that most family members have a high degree of satisfaction, result that is similar to international studies; it also gives us aspects to improve such as the waiting room and the privacy of the patients. keywords: Satisfaction; Care; Quality; Intensive Care Unit; Emergency; FS-ICU.

Half the family members of intensive care unit patients do not want to share in the decision-making process: A study in 78 French intensive care units*

2004 ◽  
Vol 32 (9) ◽  
pp. 1832-1838 ◽  
Author(s):  
Élie Azoulay ◽  
Frédéric Pochard ◽  
Sylvie Chevret ◽  
Christophe Adrie ◽  
Djilali Annane ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Family Members ◽  
Decision Making Process ◽  
The Family

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

2020 ◽  
Vol 34 (9) ◽  
pp. 1263-1273 ◽  
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.

scholarly journals THE APPLICATION OF CLINICAL JUDGMENT AND DECISION MAKING OF CRITICAL CARE NURSES IN INTENSIVE CARE UNITS (ICUs)

2019 ◽  
Vol 2 (1) ◽  
pp. 1-14
Author(s):  
Indah Mei Rahajeng ◽  
Faridatul Muslimah
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses ◽  
Short Period

Background Intensive Care Unit (ICU) is the hospital setting in which applied specific application of clinical decision making and judgement. The critical patient conditions in ICU may drive nurses to make decision and clinical judgement in short period of time. The approach of clinical decision making which appropriate to be applied in the critical circumstances is important to be identified, thus it could become a guidance for novice and expert critical nurses. Aim The aim of this study was to explain how clinical decision making is applied in Intensive Care Unit (ICU)  Method A systematic review of 22 articles was carried out, articles were retrieved from CINAHL, MEDLINE, PUBMED and DISCOVERED databases. The articles were critically reviewed and analized to answer this study’s aim. Result The critically review of the articles were categorized in themes: 1) application of Tanner’s clinical judgment model  in ICU, 2) Types of decisions in ICU, 3) Theoretical approach: implementation of decision-making in ICU, 4) Case illustration of decision-making scheme in ICU, 5) Influencing factors of decision-making in ICU, 6) Supporting tools for clinical decision-making in ICU, 7) Understanding of attributes and concepts may enhance the quality of the clinical decision-making process in ICU, 8) Implications for nursing education and practice of understanding clinical decision making in ICU. Conclusions Critical care nurses usually combine different techniques in making decisions; analytical methods including the hypothetic-deductive method, pattern recognition, intuition, narrative thinking, and decision analysis theory are potentially applied. Clinical decision activities in ICU appear in many clinical situations, such as intervention decisions, communication decisions, and evaluation decisions. There are several factors influencing clinical decision-making in intensive care units, including nurses’ experience, the patient’s situation, the layout of the ICU, shift work, inter-professional collaboration practice, physical and personnel resources. The application of clinical decision making could be supported by systematic tools, and the nurses’ knowledge about the concepts and attributes used in ICUs affect their clinical decision-making abilities.     Keywords: clicinal decision making, critical care nurse, ICU

scholarly journals Providing End-of-Life Care to Patients: Critical Care Nurses’ Perceived Obstacles and Supportive Behaviors

2005 ◽  
Vol 14 (5) ◽  
pp. 395-403 ◽  
Author(s):  
Renea L. Beckstrand ◽  
Karin T. Kirchhoff
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Critical Care Nurses ◽  
Control Group ◽  
Life Care ◽  
Supportive Behaviors

• Background Critical care nurses care for dying patients daily. The process of dying in an intensive care unit is complicated, and research on specific obstacles that impede delivery of end-of-life care and/or supportive behaviors that help in delivery of end-of-life care is limited. • Objective To measure critical care nurses’ perceptions of the intensity and frequency of occurrence of (1) obstacles to providing end-of-life care and (2) supportive behaviors that help in providing end-of-life care in the intensive care unit. • Methods An experimental, posttest-only, control-group design was used. A national, geographically dispersed, random sample of members of the American Association of Critical-Care Nurses was surveyed. • Results The response rate was 61.3%, 864 usable responses from 1409 eligible respondents. The highest scoring obstacles were frequent telephone calls from patients’ family members for information, patients’ families who did not understand the term lifesaving measures, and physicians disagreeing about the direction of a dying patient’s care. The highest scoring supportive behaviors were allowing patients’ family members adequate time alone with patients after death, providing peaceful and dignified bedside scenes after death, and teaching patients’ families how to act around a dying patient. • Conclusions The biggest obstacles to appropriate end-of-life care in the intensive care unit are behaviors of patients’ families that remove nurses from caring for patients, behaviors that prolong patients’ suffering or cause patients pain, and physicians’ disagreement about the plan of care.

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