Intensive Care Family Research Articles

Family needs of patients in intensive care unit a literature review

The intensive care room is a room full of pressure for the patient being treated and the family caring for it and focuses more on the physical needs of the patient so that the family feels neglected by the service. Health services do not pay attention to family needs. To identify the needs of the patient's family in the intensive care unit. We used five databases, namely Google Scholar, Science Direct, PubMed, SpringerLink, and ProQuest using the PRISMA Flowchart for our study. The study design was cross-sectional, cohort and qualitative, year of publication 2017-2022, and discussed the needs of the patient's family in the intensive care room. A total of 13 articles were selected for analysis, examining 5 family needs, namely assurance, information, comfort, support and proximity. They were using instruments such as CCFNI, NMI, and NFNI. This instrument is proven to have been used globally to measure the needs of families in intensive care. Priority of family needs with CCFNI and NFNI instruments, namely assurance with proximity. Fulfilment of family needs using NMI instruments, information as a need that is met by health services. The priority of family needs is assurance so that it prioritizes physiological needs above other needs.

Professionals' narratives of interactions with patients' families in intensive care.

Background: ICU patients’ family members are in a new, uncertain, and vulnerable situation due to the patient’s critical illness and complete dependence on the ICU nurses and physicians. Family members’ feeling of being cared for is closely linked to clinicians’ attitudes and behavior.Aim: To explore ICU nurses’ and physicians’ bedside interaction with critically ill ICU patients´ families and discuss this in light of the ethics of care.Research design: A qualitative study using participant observation, focus groups, and thematic narrative analysis.Participants and research context: Data were gathered from July 2017 to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven focus groups with ICU nurses and physicians.Ethical considerations: The Regional Committee for Medical and Health Research Ethics and the Norwegian Centre for Research Data approved the study. Findings: Quality of ICU family care depends on nurses’ and physicians’ attitudes, behavior, and personality traits. Three main themes were identified: being attentive, an active approach, and degree of tolerance.Discussion: The findings are discussed in light of the ethics of care and empirical research from the intensive care environment.Conclusions: This study shows that attentive, active, and tolerant clinicians represent a culture of ethical care that gives families greater freedom of action and active participation in patient care. Clinicians must not bear sole responsibility for this culture; it must have a firm basis in the hospital and ICU and be established through training, interprofessional reflection, and support of clinicians.

Measuring family-centred care practices in adult intensive care units: The EMPATHIC-F questionnaire.

Engaging relatives in the care of critically ill patients is associated with better outcomes. It is crucial to empower relatives to provide feedback. Valid satisfaction instruments are essential to identify best practices and areas for improvement. The aim of the study was to adapt the Spanish version of the EMpowerment of PArents in The Intensive Care-30 (EMPATHIC-30) questionnaire in adult intensive care units (ICUs) and psychometrically test the EMpowerment of PAtients in The Intensive Care-Family (EMPATHIC-F) questionnaire to measure family satisfaction. This is a cross-sectional, prospective study conducted in two adult ICUs. Participants were relatives of patients who were discharged alive from the ICUs with an ICU length-of-stay >24 hours. The EMPATHIC-F questionnaire is divided into five domains that are related to the family-centred care principles. Responses are provided on a 6-point ordinal Likert scale, a score of >5 is considered acceptable. Patients' relatives confirmed the adaptation of the instrument. A total of 262 relatives responded to the EMPATHIC-F questionnaire (97% response rate). The empirical structure of the instrument was established by confirmatory factor analysis confirming 30 statements within five theoretically conceptualized domains: information, care and treatment, family participation, organization, and professional attitude. On item level, two statements scored a mean below 5.0. Cronbach's α at the domain level was between .64 and .75. Congruent validity was adequate between the five domains and four general satisfaction items (r's .26-.54). The non-differential validity was confirmed with no significant effect size between three patients' demographic characteristics and the domains. The EMPATHIC-F questionnaire is a reliable and valid quality performance indicator to measure the perceptions of family members in adult ICU settings. The EMPATHIC-F questionnaire can be used to benchmark and provides a framework for standardized quality improvement towards the development of a family-centred care philosophy within adult ICUs.

Application of the READY framework supports effective communication between health care providers and family members in intensive care

Effective communication between intensive care health care providers and family is crucial to support surrogate or shared decision-making and to individualise care. Despite its importance in health care standards and policy, the quality of communication with families in intensive care is regarded as suboptimal. Furthermore, an intensive care admission is an extremely stressful event for families, which may impact their understanding and subsequent decision-making. Communicating with family members is a routine practice in intensive care; however, health care providers often receive no formal communication training. To date, family-focused communication interventions in intensive care have targeted end-of-life care and are not generalisable across all types of family–health care provider communication interactions. Mugweni et al. recently reported the results of a multiprofessional training intervention involving 26 health care professionals to improve the delivery of different news to families during pregnancy and at birth. A critique of this article has been undertaken to inform routine communication with critically ill family members and optimise the delivery of care in intensive care units.

Involving families in intensive care

The place of families in intensive care is still too often underestimated. However, the involvement of family members would have multiple benefits for patients, but also for those around them. Family participation is a promising concept that needs to be studied on the ground and on a large scale, in order to prove itself and guide health professionals in their daily practice.

A Literature Review: Stress Management in The Family of Intensive Care Patients

ABSTRACT Introduction: Intensive care unit is a unit with a complex case and a stressor strainer. When patients enter intensive care families have a variety of stressors such as rapid decision making and costs are not small. The role of nurse as educator is very important in reducing family anxiety with patients treated in intesive units. Mothers of intensive care babies feel a great deal of anxiety over their child's condition, so there needs to be a good system support for the healing of her and her baby. Various ways nurses do in reducing stress experienced by the patient's family such as good communication between nurses and families of patients with intensive care. This review aims to get a picture of stress management that can be done on the family of intensive care patients. Methods: A literature review was conducted in the fields of ebscho, sience direct, elseiver, sage journals, scopus, and proquest, limited the range of the last 10 years from 2007-2017. The final sample included 18 articles. Results: The literature found that the causes of family stressors include rapid decision-making, fear of family emergency conditions, maintenance costs and length of care. Good communication and good information and skill support can decrease the stress experienced by intensive care patients' families. Conclussions: Intensive care is a unit with high complexity, unstable conditions and sophisticated technology. Conditions that require rigorous monitoring not only cause stressors for the patient, but become a stressor for the patient's family.

Families' participation in intensive care

The participation of families in intensive care is a practice which is still insufficiently developed. However, it is something which patients and their families would like to see implemented. The nurses are on the front line in this innovative form of care.

Barriers to regaining control within a constructivist grounded theory of family resilience in ICU: Living with uncertainty.

To discuss families' experiences of their interactions when a relative is admitted unexpectedly to an Australian intensive care unit. The overwhelming emotions associated with the unexpected admission of a relative to an intensive care unit are often due to the uncertainty surrounding the condition of their critically ill relative. There is limited in-depth understanding of the nature of uncertainty experienced by families in intensive care, and interventions perceived by families to minimise their uncertainty are not well documented. Furthermore, the interrelationships between factors, such as staff-family interactions and the intensive care unit environment, and its influence on families' uncertainty particularly in the context of the Australian healthcare system, are not well delineated. A grounded theory methodology was adopted for the study. Datawerecollected between 2009-2013, using in-depth interviews with 25 family members of 21 critically ill patients admitted to a metropolitan, tertiary-level intensive care unit in Australia. This paper describes the families experiences of heightened emotional vulnerability and uncertainty when a relative is admitted unexpectedly to the intensive care unit. Families uncertainty is directly influenced by their emotional state, the foreign environment and perceptions of being 'kept in the dark', as well as the interrelationships between these factors. Staff are offered an improved understanding of the barriers to families' ability to regain control, guided by a grounded theory of family resilience in the intensive care unit. The findings reveal in-depth understanding of families' uncertainty in intensive care. It suggests that intensive care unit staff need to focus clinical interventions on reducing factors that heighten their uncertainty, while optimising strategies that help alleviate it. Families are facilitated to move beyond feelings of helplessness and loss of control, and cope better with their situation.

What is Important to Families in Intensive Care Once a Decision has been Made to Withdraw Treatment

Objective: How doctors and nurses talk with families about decisions that lead to treatment withdrawal in intensive care is important and has been well explored. However less is known about what family members perceive as important once this decision has been made. This study explores the needs of family members during and after treatment has been withdrawn in intensive care. Methods: An interpretive qualitative design was undertaken. Purposive sampling identified 112 deceased patients of whom 62 met the study criteria. From this sample, 17 in-depth interviews were conducted with 21 family members who had been bereaved in the previous 6-12 months. Thematic analysis was performed on the transcribed interviews. Results: Whilst family members were able to broadly recollected conversations with doctors and nurses about the decision to withdraw treatment, there were detailed accounts of what was important to family members after that decision was made. In this, family members recalled wanting to: alleviate further suffering, re-establish identity of, and re-connect relationships with, the dying person.Bereaved family members spoke about the activities they undertook to realize these. At interview, family members demonstrated on-going distress about situations perceived as preventing achievement of these. Conclusions: Families have existential and relational needs during and after treatment withdrawal in intensive care. Doctors and nurses must recognize the importance of assessing these family goals, identifying information that enables families to choose how such needs can be met, and developing skills to manage situations when these needs cannot be met.

How dointensive carenurses perceive families in intensive care? Insights from the United Kingdom and Australia

To compare how intensive care nurses in the UK and Australia (AU) perceive families in intensive care units (ICUs). International healthcare research and practice is often based on an underlying assumption of a person- or family-centred ideology. While nurses in ICUs acknowledge the importance of patients' families, a true integration of families as units of care is often not realised. Data from ICU nurses from two international studies: (1) a constructivist grounded theory study in the UK and (2) a quasi-experimental non-equivalent clinical study in AU. Data were collected in tertiary adult ICUs in the UK and AU. Nurse-to-patient ratio for high-acuity patients was 1:1 in both units. Twenty ICU nurses in five focus groups (UK study) and 197 surveys were sent out to ICU nurses in AU (response rate 26%). Evidence from both studies makes visible the contribution of family care in adult ICUs. Nurses remaining in control and initiating family member care involvement are less likely to perceive families as a burden. The AU study indicated that when nurses partner with families to deliver care, there was a minimal effect on their workload. The nurses concluded that inviting family members to be a part of the patient's care should be usual practice in ICUs. Nurses should promote, facilitate and invite the integration of families in care in today's healthcare system. This is mandatory as families are the caring resource for these patients during an often prolonged recovery trajectory. Families are more likely to be successfully integrated into a more active involvement with ICU patients when they are not perceived as a burden. Inviting and supporting family members is not necessarily time-consuming and starts the journey of supporting ICU survivors' recovery journey.