Experiences Of Family Members Research Articles

The lived experiences of family members who visit their relatives in Covid-19 intensive care unit for the first time: A phenomenological study

BackgroundCOVID-19 patient experiences in the intensive care unit (ICU) are marked by family separation. Families understand the importance of isolation and hospital visiting policies, but they consider it necessary to visit their loved ones and use personal protective equipment. ObjectiveTo describe the lived experiences of family members in their first contact with a relative in a COVID-ICU. MethodsA phenomenological study was conducted using Cohen's method. The subjects were interviewed using an open-question format to allow them full freedom of expression. Twelve family members were recruited between February and March 2021. ResultsAnalysis of the qualitative data resulted in five major themes: (1) fear of contagion related to donning/doffing procedures, (2) positive emotions related to first contact with the hospitalized relative, (3) concern for the emotional state of the hospitalized relative, (4) impact of the COVID-ICU and comparisons between imagination and reality regarding the severity of the disease, and (5) recognition of and gratitude toward healthcare professionals. ConclusionsIt has been confirmed that visits to the ICU reduce anxiety among family members. Our findings constitute an internationally relevant contribution to understanding of the needs of relatives who meet loved ones for the first time while wearing personal protective equipment.

Experiences of residents, family members and staff in residential care settings for older people during COVID-19: A mixed methods study.

AimThe aim of this study was to explore the COVID‐19 pandemic as it was experienced by people on the front line in residential care settings for older people in the Republic of Ireland (ROI).BackgroundThe COVID‐19 pandemic had a disproportionate effect in residential care settings for older people in Ireland.MethodsA two‐phased mixed methods study was conducted, consisting of an online survey administered shortly after the first wave of the virus to staff, residents and family members and one‐to‐one interviews with family members shortly after wave 2 of the virus.ResultsIsolation, loss of connectedness as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. Family input to care was suspended, with adverse consequences.ConclusionThe pandemic had an extremely adverse impact on residents, family members and staff in care settings for older people.Implications for Nursing ManagementStrategies to ensure that residents' physical, emotional and social needs and staffs' professional and personal needs are appropriately supported during future waves of the pandemic should now be implemented.

Better understanding care transitions of adults with complex health and social care needs: a study protocol

BackgroundAdults with chronic conditions who also suffer from mental health comorbidities and/or social vulnerability require services from many providers across different sectors. They may have complex health and social care needs and experience poorer health indicators and high mortality rates while generating considerable costs to the health and social services system. In response, the literature has stressed the need for a collaborative approach amongst providers to facilitate the care transition process. A better understanding of care transitions is the next step towards the improvement of integrated care models. The aim of the study is to better understand care transitions of adults with complex health and social care needs across community, primary care, and hospital settings, combining the experiences of patients and their families, providers, and health managers.Methods/designWe will conduct a two-phase mixed methods multiple case study (quantitative and qualitative). We will work with six cases in three Canadian provinces, each case being the actual care transitions across community, primary care, and hospital settings. Adult patients with complex needs will be identified by having visited the emergency department at least three times over the previous 12 months. To ensure they have complex needs, they will be invited to complete INTERMED Self-Assessment and invited to enroll if positive. For the quantitative phase, data will be obtained through questionnaires and multi-level regression analyses will be conducted. For the qualitative phase, semi-structured interviews and focus groups will be conducted with patients, family members, care providers, and managers, and thematic analysis will be performed. Quantitative and qualitative results will be compared and then merged.DiscussionThis study is one of the first to examine care transitions of adults with complex needs by adopting a comprehensive vision of care transitions and bringing together the experiences of patients and family members, providers, and health managers. By using an integrated knowledge translation approach with key knowledge users, the study’s findings have the potential to inform the optimization of integrated care, to positively impact the health of adults with complex needs, and reduce the economic burden to the health and social care systems.

Uncertainty, shock and anger: Recent loss experiences of first-wave COVID-19 pandemic in Italy.

The aim of this study is to explore qualitatively bereavement experiences of family members who have lost a significant other to coronavirus disease 2019 (COVID‐19) in relation to mourners' needs and resources. Twenty individuals bereaved by the first wave of COVID‐19 from the most heavily impacted Italian region were interviewed via video call between 1 and 3 months after their loss. Through a thematic analysis, four main themes were identified: reconstructions of the loss experience, responses to grief, resources and looking forward. The suddenness of the death and lack of farewell by means of a funeral prevented participants from realizing the loss and undertaking a meaning‐making process. When anger was the main reaction to the loss, mourners focussed all their attention on denouncing medical and government institutions. Acceptance occurred particularly in those who found a way to share their grief and use it as a turning point. Participants relied mainly on informal support offered virtually, but mourners may have sought out in‐person comfort in the long term. The results of this study propose new insights for COVID‐19 bereavement support and trace the path for health promotion within a community shook by a communal grief experience. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement

What about the family? Onboarding athletes’ entourage into professional sport organizations

Effective onboarding practices benefit both the incoming members and the organization as a whole. However, to date, existing onboarding literature has focused exclusively on the incoming members, with little attention to those in their social network, such as family members (e.g., partners, parents/guardians). The purpose of this study was to explore onboarding practices within a professional sport context (i.e., National Basketball Association), with a specific emphasis on understanding the experiences of family members involved in the transition process with an athlete. A qualitative approach was undertaken, involving semi-structured interviews with people who facilitated or had undergone onboarding: organizational representatives (n = 11), athletes (n = 5), and family members (n = 6). Findings demonstrated the importance of resource and information sharing, valuing family members, and developing social capital for successful onboarding, and identified several considerations (e.g., timing, acquisition type) and barriers (e.g., member turnover, status hierarchy). Ultimately, although organizations acknowledged the importance of purposefully onboarding family members, none prioritized the task or had a systematic process in place. These findings reinforce the importance of considering significant others when onboarding professional athletes and provide suggestions for future research directions and practical advancements within the elite sport context. Lay summary: Family members, such as partners and parents/guardians, play an important role in assisting professional athletes through career transitions. While family members experience similar stressors during transition periods, they are often not considered in the onboarding process. Results highlight that family members require purposeful onboarding from sporting organizations to be successfully integrated into a new environment. IMPLICATIONS FOR PRACTICE The current findings emphasize the importance of being purposeful and prioritizing family members during the onboarding process of professional athletes. For successful onboarding to occur, organizations should know who will be onboarded and subsequently, provide tailored resources to ensure they feel informed and valued. It is integral that systematic and formal mentoring efforts (e.g., forming a mentoring network) are put in place to foster a sense of connection amongst family members within an organization.

POS-598 THE PERCEPTION OF THE INTERNATIONAL PATIENT SAFETY 6 GOALS BY THE PATIENT: THE EXPERIENCE OF A BRAZILIAN NEPHROLOGY AND DIALYSIS CENTER

In recent years, patient involvement has been increasingly recognized as an essential component in the restructuring of healthcare processes, with the aim of improving patient safety. From patient and family-centered care, it is possible to achieve improvements in the experience of patients and family members in the health care process.

Beyond the call of duty: A Qualitative study into the experiences of family members acting as a Nearest Relative in Mental Health Act assessments

Abstract Research shows that tensions between family carers and professionals become acute where the issue of compulsory admission to hospital is at stake. In England and Wales, a specific family member is appointed to safeguard the interests of a person assessed under the Mental Health Act 1983. This currently occurs through the Nearest Relative (NR) role. The Government is proposing to replace this with a Nominated Person role, chosen by the service user. Drawing on the concept of carer burden, this study reports on the views of nineteen NRs in England to discover their experiences of being involved in a Mental Health Act assessment. Participants identified that they undertook the role due to a sense of duty. Their experiences were mixed with participants highlighting both feelings of distress during the assessment and feelings of relief once their relative had been detained. Participants reported feeling conflicted when their relative was detained and feelings of frustration towards mental health services. The findings have implications for proposals to reform the Mental Health Act 1983. They show that education and support programmes should be created for NRs/Nominated Persons and that research is needed to assess whether such support is effective at reducing carer burden.

Barriers and facilitators of early mobilisation for intensive care unit delirium: perspectives from patients, family members and carers. A qualitative study protocol

Background/Aims One-third of patients develop delirium following admission to an intensive care unit. Intensive care unit delirium is associated with poor patient outcomes, including long-term disability and high mortality. Early mobilisation contributes towards the prevention and reduction of intensive care unit delirium. However, the implementation of early mobilisation is infrequent. The aim of this protocol is to explore participants' experiences of the barriers to, and facilitators of, early mobilisation in the adult intensive care unit specific to people experiencing delirium. Methods Three moderators will carry out up to six focus groups including up to five participants in each group. Focus group discussions will be used to explore the experiences of patients, carers and family members using Microsoft Teams. Participants will be recruited from the charity ICUsteps using a purposive sampling technique. Results Discussions will be audio-recorded and simultaneously transcribed verbatim using the otter.ai programme. Member check approval will be sought to ensure accuracy of data. Framework analysis using a thematic methodology will identify themes in the data. Conclusions It is anticipated that the findings of this study will contribute towards further understanding the implementation of early mobilisation in order to improve measures for prevention and management of delirium in the adult intensive care unit.

The experiences of wives following acquired brain injury (ABI). A qualitative analysis exploring realisations of change following the ABI of a “loved one.”

ABSTRACT The experiences of family members following Acquired Brain Injury (ABI) are well established, with spouses in particular facing multiple relational and personal changes. Qualitative studies have analysed accounts pertaining to a range of sequelae, however, “change” itself has yet to be addressed. This study explored the experiences of realisation of change for married women living with their husbands following ABI. Nine participants took part in semi-structured interviews focussing on becoming aware of changes in both their spouse and themselves post-injury. An Interpretative Phenomenological Analysis (IPA) was completed, arriving at two overarching themes; “bravery to face changes” and “lost and trapped in an unsolvable maze,” with accompanying subthemes. Participants generally experienced realisation of change gradually, in some cases finding strategies to control their exposure to distress. They often referred to “acceptance,” which held varied meanings, and metaphors appeared to aid personal meaning making. Relationship changes generated both dilemmas and the feeling of being trapped. Overall, this study contributes greater insights into the experiential mechanisms underpinning realisation of change in spouses after brain injury.

Attachment-based CBT models for psychosis: a PPI-informed approach for acute care settings

Abstract People with psychosis often have prolonged in-patient1 admissions at high personal and economic costs. This is due in part to cognitive, affective and behavioural processes that delay recovery and discharge. For many, these processes are affected by enduring insecure attachment styles. People with insecure attachment struggle to manage strong feelings when unwell, and ward staff may struggle to know how best to offer support. Here, we outline the model of interpersonal process in cognitive therapy, and how this may be adapted to capture beliefs and behaviours associated with insecure attachment. Psychological interventions in acute care often fail due to implementation issues. For this reason, and in line with current guidance on developing complex interventions, we report on a series of Patient and Public Involvement (PPI) consultations with people with lived experience of psychosis, family members and ward staff on the potential utility of these attachment-based CBT models. The PPI meetings highlighted three themes: (1) the need to improve staff–patient interactions on wards; (2) continuity in staff–patient relationships is key to recovery; and (3) advantages and barriers to an attachment-based CBT approach. We conclude by describing how the models can be implemented in routine clinical practice, and generalised across services where interpersonal cognitive and behavioural processes may contribute to delays in people’s recovery. Key learning aims (1) We need to adapt CBT models and skills to meet the needs of people in acute care. (2) People with psychosis, family members and ward staff highlight the need to improve staff–patient interactions on wards. (3) Attachment-based CBT models may be effective in conceptualising and responding more effectively to difficult interactions in these settings.

Constructivist Grounded Theory or Interpretive Phenomenology? Methodological Choices Within Specific Study Contexts

Constructivist research methodologies are useful in discerning meanings of experience to subsequently inform and improve healthcare practice. For researchers who philosophically align with the constructivist paradigm, numerous methodologies are available from which to choose to address research questions. However, it can be challenging for researchers, especially novice ones, to choose the most appropriate methodology that aligns with the current state of knowledge of the identified topic, proposed research question, and the study purpose. To reduce the confusion faced by health researchers when choosing an appropriate methodology for a specific study, this paper compares two popular qualitative health research approaches: constructivist grounded theory and interpretive phenomenology. Philosophical underpinnings and the epistemological and ontological evolution of each methodology are explored with similarities and differences highlighted. Manifestation of the philosophical foundations of constructivist grounded theory and interpretive phenomenology are described in relation to data collection, analysis, and the research findings. To illustrate distinctions of each approach and support researchers in the navigation of methodological decision-making, a specific healthcare study context is presented: the rural family members’ experiences of a relative’s interhospital transfer for advanced critical care services. This study context is increasingly being recognized as an important area of healthcare research and practice. However, gaps in knowledge persist, specifically in relation to the experiences of rural family members when a critically ill relative requires an interhospital transfer to a distant urban center for advanced critical care services. Improved understanding of such experiences is necessary to inform the care provided to rural family members, potentially mitigating short and long-term negative consequences for these individuals. Within this example, the importance of the research purpose and research question within a specific study context is underscored as central to appropriate methodological decision-making.

Depression among nurses working in ministry of health hospitals in RAS AL khaimah united arab emirates

Nurses are front line workers in the healthcare services. A heavy workload as a career can leave them overworked and stressed which gives high risk of developing negative mental states like depression. For individuals with depression, the severity of depressive symptoms increases and their ability to function is affected as well. A high standard of nursing care is only possible if nurses can maintain sound physical and mental health. In the United Arab Emirates, there are no published data regarding the prevalence of depression among nurses. Hence, this study sought to identify the prevalence of depression among nurses working in the Ministry of Health (MOH) hospitals in Ras Al Khaimah, United Arab Emirates, and to assess the association of demographic variables with the prevalence of depression. The selected MOH hospitals were Saqr Hospital, Ibrahim Bin Hamad Obaidullah Hospital, and Obaidullah Geriatric Hospital. A crosssectional descriptive study design was used and the data was collected from 136 nurses through a self-administered Beck Depression Inventory-II (BDI-II). The overall prevalence of depression, according to the BDI-II, was 17.6% in the present study, mild depression was 6.6%, moderate depression was 8.8%, and severe depression was 2.2%. Overall results showed that the prevalence of depression among nurses working in the MOHAP hospitals of Ras Al Khaimah were low. A significant association (p<0.05) with nationality, work experience, marital status, and financial dependence of family members of the nurses were found with depression. In order to conclude the prevalence of depression among nurses working in MOHAP hospitals of Ras Al Khaimah, the findings provided useful baseline data for policymakers regarding decisions that can positively affect the health of nurses and patients. Encouraging nurses' mental wellbeing will help optimize patient health outcomes too.

Lived experiences of family members caring for a relative with mental illness

BackgroundMental illness may cause a variety of psychosocial problems, such as decreased quality of life for the affected individual’s family members and an increased social distance for the individual and family members caring for a relative with mental illness. PurposeTo gain an understanding of the lived experiences of family members caring for a relative with mental illness in Giyani, Limpopo province. Design and MethodsA qualitative, exploratory, descriptive and contextual research design was utilised. Data were collected through in-depth individual interviews with eight participants, observations, and field notes. Data were analysed utilising Tesch’s open-coding method, and an independent coder assisted in the analysis process. ResultsThe results revealed that family members caring for a relative with mental illness were alert about safety aspects related to their relative with mental illness. Participants experienced that their relative was not mentally stable, as evidenced by erratic behaviour. They also experienced challenges in caring for a relative with mental illness and engaged coping strategies in caring for a relative with mental illness. ConclusionBased on the findings from this study, it was recommended that support interventions for these families by providing mental health education, strengthening the families’ existing coping strategies, and building their resilience. The implications for practice for psychiatric nurses and stakeholders in social services were highlighted in supporting the families of relatives with mental illness.

The experience of families in face of the finiteness of their children in the process of adopting palliative care.

To reveal the experience of family members after learning their child would adopt palliative care. Phenomenological research on Heidegger's perspective. The participants were eleven family members of children who were recommended palliative care in the Pediatric Intensive Care Unit from a university hospital in southern Brazil. The statements were obtained in a semi-structured interview, from January to November/2017, and submitted to Heidegger's theoretical-philosophical analysis. Research approved by the institution's Ethical Committee. The communication of palliative care triggers the perception of the child's existencial facticity in the Family, revealing reactions explained in the thematic dimensions: "Coping with the finiteness of the child when confronted with the proposal of adopting palliative care" and "The need for compassionate and attentive care". Phenomenology allows us to understand the parent's existential purpose. An understanding perspective can help interdisciplinary teams to communicate the adoption of palliative care in a sensitive and ethical way, focusing on the best interest of the child.

The family in the intensive care unit in the face of a situational crisis

Objectiveto explore the experience of family members of a relative hospitalised in the Intensive Care Unit and recognise their emotions and needs and describe the phases or milestones they go through and the strategies they use to cope with the situations that arise. MethodQualitative study developed under the grounded theory method proposed by Anselm Strauss and Juliet Corbin. During the period from July 2017 to July 2019, semi-structured interviews were conducted with 26 relatives of hospitalised patients in fifteen third-level private clinics in the city of Manizales and Medellín, Colombia. In the latter, 200 h of participant observation were performed in ICUs of two private third-level clinics. The analysis procedure consisted of a microanalysis of the data and the process of open, axial, and selective coding of the information was continued. ResultsWe identified that the experience of relatives when they accompany their sick relative in the Intensive Care Unit is represented in two categories: family disorganisation which is characterised by generating a change and mismatch in family dynamics and, family reorganisation in which a restoration of order is sought to cope with the situation. ConclusionsThe family in the Intensive Care Unit develops a situational crisis characterised by intense, varied, and negative emotions and needs that wear down the relatives. Faced with this, family members undertake a reorganisation process to restore the order of family dynamics to cope with the situation and overcome difficulties.

Experiences lived by family members of people who committed suicide: approach to biographic narratives.

To understand the experiences of family members of people who committed suicide and describe the typologies of the biographical cases through the approach of biographical interviews and analysis. Qualitative research, with a reconstructive approach to Rosenthal's biographical cases, based on Schutz's phenomenological sociology. Biographical narrative interviews were conducted between November/2017 and February/2018, in a city in southern Brazil, with eleven family members of people who survived suicide. The analysis followed the phases of Rosenthal's biographical case reconstruction. The reconstruction of two biographical cases were presented. The results point to two distinct typologies: maternal role in the face of suicide and social stigmatization; use of the cultural meaning of family as a resource for coping with suicide. It is important to listen to these family members, as the understanding of their experiences can support health professionals in the implementation of care actions.

ANALYSIS OF THE EFFECTIVENESS OF THE IMPLEMENTATION OF AN EXPERIMENTAL MODEL OF TRAINING FUTURE EDUCATORS OF PRESCHOOL EDUCATION INSTITUTIONS TO INTERACT WITH FAMILIES OF COMBATANTS

The article is devoted to substantiating the effectiveness of the implementation of an experimental model of training future educators of preschool education institutions to interact with families of combatants. According to the results of the formative experiment, the implementation of the model developed by us for training future teachers of preschool education institutions to interact with the families of combatants makes it possible to significantly improve their readiness for such interaction. In the experimental group, where the content and procedural procedures provided for in the model were implemented, we recorded significant quantitative and qualitative changes in the distributions according to the levels of formation of both individual components and the general readiness of future educators to interact with the families of combatants. It was determined that today in the process of professional training of future teachers of preschool education institutions in the subject content of their educational and professional activities, ways of formation and development of their readiness to interact with families of combatants are not sufficiently updated. We found that the introduction of the approaches developed and tested by us allows to significantly increase the level of development and formation of personal determinants of future educators in their readiness to interact with the families of combatants, which is confirmed by the results of the conducted formative experiment. It was established that ways of increasing the effectiveness of the formation of future educators in the ability to choose pedagogically appropriate, adequate to the specifics and peculiarities of the functioning of the families of combatants, methods and techniques of actualizing the sensory experience of family members require additional research; personal determinants that provide the possibility of self-change, self-improvement, and self-development; their ability to quickly adapt to the conditions that arise in the process of the educator’s interaction with the families of combatants; the ability to develop and implement professional strategies in interaction with families of combatants.

Experiences of families of adolescents with gender incongruence in the light of the Calgary Models for Families.

to know the experiences of family members of adolescents with gender incongruence. this is a qualitative case study, supported by the Calgary Family Assessment and Intervention Models theoretical-methodological framework. Data collection took place through semi-structured interviews, participant observation in family groups and document analysis, with eight family members. Data analysis was performed following the precepts of content analysis. with family assessment, two categories emerged: "Challenges in the face of gender transition", which highlighted the problems related to the expectations created at birth, new names, pronouns and gender fluidity and the fear of prejudice, and "Supporting aspects in the face of the possibility of gender transition", which revealed family support as a strong point. knowing the experiences allowed us to understand the challenges that family members face when facing physical and emotional aspects of their children's gender transition. It was noticed that the act of seeking help and offering support is important for a healthy transition. The findings provided a better understanding of family issues and provided suggestions on how nursing can develop care for this population.

Use of Diaries for Family Members of Intensive Care Unit Patients to Reduce Long-Term PTSD: A Pilot Study.

Many family members whose loved ones stay in the intensive care unit (ICU) have post-traumatic stress disorder (PTSD) after the hospitalization. A mixed-methods longitudinal randomized trial studying family members of medical ICU (MICU) patients was conducted. Participants were randomized into 2 groups (intervention and control). Post-traumatic stress symptoms checklist-14 scores for the intervention group trended downward over time, but no differences were detected in PTSD risk between the intervention and control groups. The ICU experience for family members is traumatizing. A simple gesture of providing ICU diaries for them to use during the ICU stay may help reduce their emotional burden and requires further investigation.

“Family Connections”, a DBT-Based Program for Relatives of People with Borderline Personality Disorder during the COVID-19 Pandemic: A Focus Group Study

The COVID-19 pandemic has had a significant impact on the family environment due to the difficulties that have been generated by job losses, deaths, increase rates of family and domestic violence, poor mental health outcomes, and estrangement in personal relationships. “Family Connections” (FC) is an internationally renowned DBT-based program that supports the families and caregivers of people with borderline personality disorder. The study took place at a Specialized Health Centre in Spain. A focus group with seven participants was organized for people who had previously attended an FC group. The participants were asked about their experiences during the confinement periods that was caused by COVID-19 as well as their experiences and opinions on relatives, skills practiced, their need to and the advantages of attending the group, and satisfaction with the FC group. The qualitative research web program Dedoose was used for the thematic analysis of the data. The results showed that the participants experienced various experiences during confinement; validation and radical acceptance were determined to be the most useful skills; the importance of professionals and the content as well as the sincerity of attendees and having a safe space were determined to be the greatest benefits of the programs; and the participants all indicated great satisfaction of the program. This study allowed us to explore the experiences of family members of people with BPD with their loved ones during the confinement period caused by the COVID-19 pandemic. We evaluated the use of the FC program skills in the family environment during confinement, and we analyzed the acceptability and satisfaction with the FC program.