Care Family Members Research Articles

Training for migrant live-in care workers in Austria: results from an online survey

Abstract Background In Austria, almost 60.000 migrant “24-hour” live-in caregivers work in two- or four-week shifts, travelling between Austria and their countries of origin (mostly Romania, Slovakia, Croatia, Hungary and more) to care for frail older people at home. As opposed to other social and healthcare professions, live-in care workers do not require any formal training at all to be able to work in Austria. Methods With the aim of gaining an in-depth insight into the working conditions of live-in caregivers and with the aim of recording their problems and needs, an online survey including 40 questions was conducted from 15 July to 15 September 2023 in four languages (Slovak, Romanian, Bulgarian and German). The study is part of the MigraCare project which focuses on improving working and living conditions for migrant live in care workers. Results Results show that many live-in caregivers are not fully aware of their job profile: what are nursing and medical tasks they are only allowed to do when delegated by professional healthcare staff? Most respondents have to take on tasks that are outside their job profile. Many state that it is difficult to care for people with dementia. In addition, some caregivers report physical and psychological violence and sexual harassment. Most wish for training possibilities regarding topics like dementia, communication with client and family, legal framework regarding their job in the long-term care sector and others. Conclusions Live-in care workers wish for continuous education activities and for a better relationship with the family relatives and the care recipient. Based on the results of the survey short multilingual training videos have been developed easily accessible on a video platform for live-in care workers. Also, a connection to community nurses has been established in order to improve communication between care recipient, family members and live-in care workers. Key messages • Results from an online survey show that live-in care workers face challenges at work which are partly due to an unclear job profile as well as communication problems with the care recipient. • Results of an online survey show that live-in care workers wish for education and training opportunities (mother tongues) in the field of dementia care, communication with family or legal framework.

Together but still alone - A qualitative study exploring how family members of persons with incurable oesophageal or gastric cancer manage everyday life

BackgroundCancer affects not only the person with the disease but those around them. Being a family member is described as strenuous and, often, associated with stress, anxiety and feelings of loneliness. There is a heightened risk of distress for family of those with fast-progressing, severe oesophageal or gastric cancer. Early palliative care involving family is vital yet often overlooked. In order to include family members in early palliative care their management in everyday life needs to be explored.MethodQualitative inductive interview study using content analysis guided by Graneheim and Lundman.ResultThe analysis resulted in the overarching theme “Managing the disease together but still alone”. Three categories were identified: Adapting to the disease, Taking control of the situation, Processing emotions. Each category described family members management in various aspects of everyday life together with the ill person and alone.ConclusionThe results may contribute to an awareness of family members’ management of large parts of everyday life and, further, their feelings of loneliness, and indicates that family members should be included early in oesophageal or gastric cancer palliative care. Further studies are needed to develop the content of such family-inclusive early palliative care.

Preventing risk of placement breakdown and hospital admission in the management of distressed behaviour in dementia care: A qualitative case study with family and care-home staff.

Objectives: Behaviours such as hitting-out and declining personal care are commonly exhibited by people living with dementia and are associated with care-giver stress and anxiety and care home placement breakdowns. Traditionally, pharmacological approaches have been used to manage behaviour; however, research indicates limited effectiveness. National guidelines recommend use of non-pharmacological interventions as first line treatment for distress, but further research is required to elucidate the components that lead to improved care for people living with dementia. This study aims to explore what works, examining case studies in which a non-pharmacological clinical intervention, the Newcastle Model, was used to understand and manage distressed behaviour in dementia care within care home settings. Method: A qualitative case study design was used. Three cases were selected from the Edinburgh Behaviour Support Service for their success in preventing care home placement breakdown during a distressed behaviour intervention in NHS Scotland. Family members and staff involved in the interventions within these cases were interviewed (N = 6). Thematic analysis was used to analyse data. Findings: All participants reported positive outcomes from the intervention. Three key themes were identified, each with subthemes. Participants described a supportive, non-judgmental environment which allowed them to integrate knowledge about dementia and tailor interventions to the specific needs of the individual living with dementia. There was also a sense of family and staff coming together to unite with shared goals. A preliminary model of all of themes and their interactions is presented. Conclusion: The study supports use of biopsychosocial, formulation-led approaches in the understanding and treatment of complex behavioural presentations in community care settings. It suggests that clinicians should endeavour to facilitate safe and open environments for care home staff and family members, in order to promote attribution change and person-centered care, and to help mediate differences and conflict between staff and family members.

Effects of visit restriction in the COVID-19 pandemic: Experiences and perceptions of intensive care nurses.

The visit restrictions imposed as a result of COVID-19 precluded the entrance of the patient's family into the confines of the intensive care unit. This study evaluated the experiences of intensive care nurses (ICNs) regarding COVID-19 visit restrictions and their opinions on these restrictions. From May 2023 to July 2023, semi-structured interviews with 15 ICNs from intensive care units in a tertiary public hospital in Türkiye were conducted. Data were analysed using qualitative content analysis with an inductive approach. Reporting of the study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The analysis revealed two main themes, 'widespread negative impacts of visit restrictions' and 'adaptive strategies to the visitation ban', and seven sub-themes supporting the main themes. Nurses perceived that the visit restrictions imposed during the COVID-19 pandemic had a severe negative effect on patients, their relatives, themselves and the care environment. They also did not support visit restriction in future pandemics. The COVID-19 visitation policy weakened the involvement of family members in patient care and created serious challenges in the intensive care setting. The study revealed an urgent need for patient-centred, family-sensitive and consistently applied protocols in future pandemics. In future pandemics, strategies such as the benefit-benefit ratio of the visit, the provision and use of adequate personal protective equipment, and vaccination requirements should be considered in visiting decisions of patients hospitalized because of infection. Participation of nurses responsible for patient care in decisions regarding visitor practices should be supported.

A journey through transitional care-family members' experiences post a life-threatening situation: A qualitative study.

Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post-care, and finally, returning home. To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post-care, and returning home. The study employed a qualitative design, with data collected via semi-structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital. Family members' experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non-linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury. The study suggested that family members with a next of kin who experienced life-threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit-survivors significantly impacts their lives and the healthcare systems should prioritise providing high-quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well-being.

Simple Mobility Tests Predict Use of Assistive Devices in Older Adults.

Assistive devices (ADs) for ambulation are commonly provided to improve safety and independence in older adults. Despite the common use of these devices, there are no standard prescribing guidelines, and non-health care providers, including caregivers and family members, often make decisions about the need for ADs. Identifying factors or a single screening test associated with AD use would benefit clinicians and non-health care caregivers in making decisions to adopt an AD for patients, clients, and family members. The purpose of this cross-sectional study was to identify the test that best predicts ADs for ambulation and non-AD use among community-dwelling individuals. Eighty-five older adults (81.6 ± 8.2 years old) who underwent outpatient physical therapy participated in this study. They participated in a series of tests, including the Timed Up and Go, handgrip and quadriceps strength, the 30-second chair-rise test, the 5-m fast gait speed, the Functional Independence Measure, the locomotive syndrome tests (stand-up test, 2-step test [2ST], and the Locomo-5 Checklist), and numeric pain scales. Mann-Whitney U tests were used to identify differences between those who did and did not use an AD for ambulation. Logistic regression analyses were used to examine which test best predicted AD use. 80% of participants (n = 68) used an AD for ambulation. There were significant differences in all test variables between users and nonusers (P = .033 to P < .001), except for quadriceps strength, age, and pain (all P > .05). Only the 2ST was a significant predictor of AD use, with a cutoff distance of the toe-to-toe stride shorter than 93% of body height (sensitivity: 72%, and specificity: 82%, P = .048). Simple functional measures differed between those who did and did not use ADs for ambulation; however, only the 2ST predicted AD status. Individuals who cannot step 93% of their body height may be appropriate for an AD. If comprehensive clinical evaluations are not available to make decisions about AD use, the 2ST can be used to make clinical recommendations for an AD for ambulation.

Associations between Post-Intensive Care Syndrome Domains in Cardiac Arrest Survivors and Their Families One Month Post-Event.

Background: Post-intensive care syndrome (PICS) affects many critical care survivors and family members. Nevertheless, the relationship between PICS-relevant domains in cardiac arrest (CA) survivors and psychological distress in their family members (henceforth, PICS-F) remains underexplored. Methods: We enrolled consecutive CA patients admitted between 16 August 2021 and 28 June 2023 to an academic medical center, along with their close family members, in prospective studies. Survivors' PICS domains were: physical dependence (Physical Self-Maintenance Scale, PSMS), cognitive impairments (Modified Telephone Interview for Cognitive Status, TICS-M), and post-traumatic stress disorder (PTSS) symptoms (PTSD Checklist-PCL 5), as well as PICS-F (PCL-5 Total Score). Hierarchical multivariate linear regressions examined associations between PICS-F and survivors' PICS domains. Results: Of 74 dyads (n = 148), survivors had a mean (SD) age of 56 ± 16 years, with 61% being male and with a median hospital stay of 28 days. Family members (43% spouses) were slightly younger (52 ± 14 years), predominantly female (72%), and of minority race/ethnicity (62%). A high prevalence of PICS assessed 28.5 days (interquartile range 10-63) post-CA was observed in survivors (78% physical dependence, 54% cognitive impairment, 30% PTSS) and in family members (30% PTSS). Survivor PTSS was significantly associated with family member distress (β = 0.3, p = 0.02), independent of physical dependence (β = 0.0, p = 0.9), cognitive impairment (β = -0.1, p = 0.5), family member characteristics, and duration of hospitalization. Conclusions: Both CA survivors and their family members showed substantial evidence of likely PICS. Survivor PTSS is notably associated with family member distress, highlighting the need for dyadic interventions to enhance psychosocial outcomes.

Turnover Intention among Staff Who Support Older Adults Living Alone in Japan: A Cross-Sectional Study

Older adults in Japan traditionally rely on family members for care. However, the growing number of older people living alone has increased staff burden in community general support centers (CGSCs), which provide care for older people in Japan. This study aimed to identify factors linked to turnover intention among CGSC staff. Of 1002 staff invited to participate, 283 completed a survey (response rate: 28.2%). Logistic regression analysis of 183 valid questionnaires examined demographic, job-related, and attitudinal factors associated with turnover intention. The results showed that the perceived difficulty of supporting older adults living alone was the main predictor of turnover intention. Staff reporting high perceived difficulty levels were more likely to consider leaving. Negative attitudes toward supporting this population also increased turnover risk. These findings highlight a pressing need for targeted interventions to strengthen the ability of CGSC staff to manage the challenges of caring for isolated older individuals. Addressing staff perceptions and providing essential training and resources could reduce turnover rates and increase the quality of care for this vulnerable group.

Expectation, emotion and the built environment: experiences of occupying hospital spaces as a loved one nears the end of life

Following a 3-year long research project that gathered 146 views, including those of palliative care patients, family members, medical staff, administrators, architects and government representatives, this paper explores the hypothesis...

Older People Living Alone and Their Strategies to Face Life: Case Studies from Yogyakarta and West Sumatra

Across Indonesia, the dominant model for care and support in later life is for older people to live with or near younger family members. However, coresidence with an adult child or other close relative is not always attainable or preferred. There are conditions where older people live alone and cannot fully depend on their family members for care and support, be it for matters related to physical, economic, psychological, or spiritual needs. We examine how older people who live alone, live their lives and what strategies they pursue in facing life. The data presented in this paper are a subset of a larger comparative study on Older People’s Care Networks, which covered five disparate sites across Indonesia. This article focuses on evidence from West Sumatra and Yogyakarta. As our case studies illustrate, older people living alone is a diverse category, ranging from those with children, to those who are de facto childless or actually childless. Their security or vulnerability cannot simply be deduced from their household composition, but they require the understanding of how people create, maintain, and develop supportive networks and how they use agency in actively managing dependence, independence, and interdependence over the life course and in later life.

Lived experiences of frail patients undergoing coronary artery bypass grafting: a phenomenological study

Abstract Background Frailty is an important issue in cardiovascular surgery. To provide individualised care to the needs of frail patients undergoing coronary artery bypass graft (CABG) surgery, it is needed to determine the patients' surgical experiences. Qualitative studies examining the experiences of frail patients undergoing surgery are limited (1,2). In addition, there is no study examining the surgical experiences of frail patients undergoing CABG surgery in our country. Purpose To examine frail patients' lived experiences of CABG surgery in early period. Methods In this qualitative study, a phenomenological approach was used. The study was conducted between 28.06.2021 and 18.02.2022 at the cardiovascular surgery department of a training and research hospital in Turkey. The study sample consisted of 14 patients who had CABG surgery and were determined to be frail in the preoperative period using the Modified Fried Frailty Index. Criterion sampling method, one of the purposeful sampling methods, was used in sample selection. The "Semi-Structured Interview Form" was used to collect the data. Data collection was carried out in the early pre-discharge period. The interviews were audio recorded and transcribed verbatim. The data were analysed using the MAXQDA 2020 program. Content analysis and thematic analysis were used in the analysis of the data. Results The mean age of the patients was 65.6±8.84 (min:45-max:76) years. Nine of the patients were female, 13 were married, 13 were primary school graduates, and 9 were lived together with a partner. Thirteen of the patients had comorbid diseases, 12 had hypertension and 11 had diabetes mellitus. The mean length of hospital stay was 19.79 days±5.59 and the mean length of stay in the intensive care unit was 8.64 days±4.46 days. 13 patients had postoperative complications. Four main themes were identified: i) "problems", ii) "coping", iii) "perceptions toward CABG" and iv) "expectations", in addition to nine sub-themes related to these main themes. Pain, postoperative complications such as bleeding, shortness of breath, infection, fear and anxiety were the most frequently expressed problems. The importance of support from health care professionals and family members was emphasised the most in terms of coping. In the theme of perception toward surgery, the surgical process being more difficult than expected and postoperative relief were the most mentioned issues. When the expectations of patients were examined, the importance of effective communication during the surgical process was highlighted the most. Conclusions Frail patients had both positive and negative experiences in the postoperative period, highlighting the significance of effective nursing care. The individualised patient-specific nursing care was required. Cardiovascular surgery nurses should evaluate patients in terms of frailty and consider the frailty status of patients while providing care.

TelMedAI

Telemedicine is the practice of technology-enabled remote communication between patient and doctor. This phenomenon in healthcare has the potential to make services affordable and save time and money. Besides telemedicine allows care givers and family members to join conversations with doctors. Indian government initiated the National Telemedicine Network (NTN) to serve remote areas in healthcare by integrating existing healthcare facilities.Literature has revealed that existing works lack in an integrated approach for patient speech translation in language-independent fashion and automatic detection of disease and symptoms based on speech.There is a need for an automated system using Artificial Intelligence (AI) to recognize patient's speech and identify symptoms based on given audio description. We proposed a framework known as TelMedAI which is designed to recognize patient speech to comprehend disease symptoms besides converting the speech text into desired language. The framework is useful for realizing a telemedicine system. Speech to Speech (STS) module takes the patient's audio content into English audio. STS module exploits the Bi-LSTM model with an encoder, decoder and attention mechanism for translation. Then Google Speech API is used to convert English audio into English text. Then the framework exploits Natural Language Processing (NLP) to improve the quality of text. Afterwards, the disease and symptoms miner module eventually recognizes a list of diseases and corresponding symptoms. We proposed an algorithm known as Learning based Disease and Symptom Recognition from Patient Speech (LbDSRPS). This algorithm has the functionality to develop TelMedAI which helps doctors in telemedicine. Our empirical study has revealed that TelMedAI takes technology-driven telemedicine research forward significantly. The highest accuracy achieved by the proposed framework is 68.13% which is much better than the baseline LSTM model used for voice translation.

Nurses' perceptions of involving family members in the care of mental health care users.

Family involvement in mental health care is a therapeutic intervention in the management of mental illness. The global concern in long-term mental health is that families find it difficult to accept mental illness when their loved ones are admitted to receive care, treatment and rehabilitation. To describe nurses' perceptions of involving family members in the care of mental health care users in long-term institutions. A quantitative descriptive design was used. The population comprised nurses working at three mental health institutions (MHIs). Probability simple random sampling was used to select 360 respondents. Data were collected using self-administered questionnaires. The findings revealed that most (86.9%) of the nurses acknowledged that challenges affect families' involvement in mental health care. A total of 91.4% of nurses complained that family members' involvement was insufficient and (80.6%) indicated that poor family contact affects the provision of quality mental health care. Therefore, the respondents believed that the families' involvement has an impact on the management of mental illness. Engaging family members in mental health care helps both health professionals and families to participate in patient-centred care and mental health care services. However, MHCUs benefit when their families are involved.Contribution:The study contributed to mental health nursing as its results can be used to measure the quality of health services improvements, by involving the family members during hospitalisation of their loved ones for mental health care.

Core socioDemographic data variables in ICU Trials (CoDe-IT): a protocol for generating core data variables using a Delphi consensus process

IntroductionSociodemographic variables influence health outcomes, either directly (ie, gender identity) or indirectly (eg, structural/systemic racism based on ethnoracial group). Identification of how sociodemographic variables can impact the health of critically...

Using FRAME to adapt an evidence‐based dyadic intervention program for people living with dementia in residential aged care: A pilot feasibility study

AbstractIntroductionThe purpose of this study was to examine the feasibility of adapting and translating an evidence‐based occupational therapist‐delivered program shown to be effective in the community to residential aged care (RAC). The program aims to improve quality of care and quality of life for people living with dementia and the wellbeing of the family care partner.MethodsThis study took place in a not‐for‐profit RAC home in Adelaide, South Australia. Mixed methods, specifically questionnaires, activity logs, focus group, and one‐on‐one interviews were used to evaluate the feasibility of the program implementation. Staff working in the participating home, occupational therapists trained to deliver the program, and residents and their family carer partners were included. Quantitative data were analysed using proportions, means, and standard deviations. Qualitative data were analysed using a thematic approach.Consumer and Community InvolvementThis study was conducted together with a consumer (person living with dementia) and a carer representative (family member of someone residing in RAC). These representatives provided input towards the study design, interpretation of study data, discussion of results, and recommendations for future consideration.ResultsSmall changes to the program improved feasibility and acceptability for delivery in RAC. While the care home staff required added support during implementation, the intervention therapists felt that the program could be delivered in this setting. Family care partners of residents with dementia felt that the program may be better suited if provided upon entry to RAC or in early stages of dementia.ConclusionAdapting a community‐based dementia care program to RAC can be safe and feasible. Program adaptations are necessary for feasibility. Further adaptations and evaluations of associated outcomes (related to residents with dementia and their family care partners) are needed to assess the program effectiveness in larger scale.Plain language summarySpending quality time with family members in residential aged care is important. However, many struggle to know what to say or do when visiting a family member who lives with dementia. Programs that teach families about how to communicate with people living with dementia, how to support them to take part in important everyday living activities, or how to understand why changes in behaviours may occur have not been available in residential aged care. This paper describes how we adapted one such evidence‐based program from community to residential aged care settings. We consulted with people living with dementia, carers, and families and found that the program could also be valuable in this care setting. Residential aged care staff described how the program is very different to what is usually available in residential aged care, but they were optimistic that with the right support, it could be a valuable way to support residents with dementia and their families. Family members of residents with dementia and therapists delivering the program felt that residents in early stages of living in residential aged care and/or early stages of dementia could benefit the most from these programs. We found that including family members in the intervention process can be useful and empowering for families and residents. Future work should also focus on involving other staff members caring for residents in the process. Communication between staff and families is the key for program delivery and success and treating each person as an individual.

Experiences of family caregivers in the home care to people with pressure injuries

Objectives: To analyze the experience of family caregivers in the home care for people with pressure injuries (PI). Methods: Qualitative and descriptive research carried out with family members who received support from the home care service and who were the main informal caregivers of people with PI from stage 3 onwards. A sociodemographic questionnaire and semi-structured interview were applied with the following stimulus for narration: tell me about your experience in the home care to your family member with PI? Data were analyzed according to Bardin's content analysis. Results: Four categories emerged: 1) Performance of family members in PI care; 2) Support of the home care service to the family and patients with PI; 3) Overload of family caregivers; 4) Satisfaction in repaying the care received. Conclusion: This study showed the importance of support to home care service and the difficulties experienced by family members in caring for people with PI, including financial and physical overload; lack of preparation of the caregiver to deal with PI; family conflicts; and the centralization of care responsibility, predominantly performed by women. However, many see in care the opportunity to return the love received, despite all physical and mental fatigue.

Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: systematic review of randomised controlled trials

Abstract Introduction Incontinence is a common, distressing condition, most prevalent in older people. There is an unmet need for effective interventions to support continence. This review focuses on non-pharmacological interventions to reduce incontinence among homebound older people. Aim: to identify interventions with potential to be delivered by care workers, nurses or family members in a person’s home. Methods Multiple databases were searched until 15 September 2023 for randomised controlled trials reporting home-based interventions for incontinence for older people (≥65 years) living at home. Two reviewers independently screened titles, abstracts and papers against inclusion criteria, then assessed for the Risk of Bias (RoB2). A third reviewer resolved the discrepancies. Primary data were extracted and synthesised. Results A full-text review of 81 papers identified seven eligible papers (1996–2022, all USA), including n = 636 participants (561 women and 75 men). Two studies focusing on multicomponent behavioural interventions showed benefit, as did one study of transcutaneous tibial nerve stimulation self-administered through electrode-embedded socks. Three, which included cognitively impaired people, reported improvement with toileting assistance programmes, but the effects were not all significant. Results were inconclusive from a study examining the effects of fluid intake adjustments. Interventions were delivered by nurses, three in collaboration with family caregivers. No faecal incontinence interventions met the criteria. Conclusion There is scant evidence for continence supporting interventions delivered in older people’s own homes. With an ageing population often reliant on family or social care workers well-placed to support continence promotion and policy drives for services to support older people remaining at home, this evidence gap needs addressing.

Predictors of family-focused practices among mental health workers in Quebec.

Engaging family members in the ongoing care of individuals with mental illness is a practice known to bolster the client's recovery journey and enhance the overall wellbeing of both children and families involved. Despite its potential benefits, there remains a dearth of understanding surrounding the implementation of family-focused practices (FFP) by mental health professionals serving adults, as well as the factors that could either promote or hinder such practices. This knowledge gap is particularly pronounced within North American settings. The goal of this study was to identify potential hindering and enabling factors of FFP used in adult mental health services. A sample of 512 professionals working with adult mental health clients, from all regions of Quebec, Canada, with a variety of disciplinary backgrounds and working in different work settings, completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Multinominal logistic regression analysis was performed to assess the impact of several factors - organizational, professional, and personal - on the degree of family-based practices of mental health workers. Findings of this study show that the strongest predictors for the adoption of higher FFP levels among adult mental health professionals in Quebec, are being employed on a full-time basis, perceiving a higher level of skills, knowledge, and confidence toward FFP, and having a supportive workplace environment. Results underscore the need to address both organizational and worker-related aspects to effectively promote better FFP in mental health services.

Partnership to tackle MH crisis for people with disabilities launched

The United Health Foundation, the philanthropic foundation of the UnitedHealth Group has awarded the nonprofit disability rights advocacy organization, The Arc of the United States, a three‐year, $2.5 million grant to improve mental health care for people with intellectual and developmental disabilities (IDD), a news release by The Arc stated. Up to 40% of people with IDD have co‐occurring mental health conditions, and this critical funding will help address their unmet mental health needs. Currently, only 1 in 10 children and adolescents with IDD and mental health disorders receive specialized services. These statistics highlight the need for training and awareness to ensure providers and caregivers are equipped to support the mental health needs of people with disabilities. This includes expanding access to quality mental health care services, improving coordination between disability and health systems, training over 2,000 providers and caregivers to recognize mental health needs in people with IDD, and launching public awareness campaigns to counteract stigma and misconceptions. A key component of the grant is partnering with the National Council for Mental Wellbeing to adapt its evidence‐based Mental Health First Aid program with information on IDD. Over three years, the United Health Foundation grant will help train caregivers, health care professionals, first responders, educators and family members to recognize the mental health needs of people with IDD and decrease the number of mental health crisis incidents experienced by this population.

Qualitative Insights Into Patients' and Family Members’ Experiences of In-Hospital Medication Management After a Critical Care Episode

BackgroundPatient recovery after a critical illness can be protracted, requiring a care continuum that extends along a patient pathway from the critical care unit, hospital ward and into the community care setting. High-quality care on patient transfer from critical care, including medication safety, is facilitated by education for patients and families, family engagement, support systems and healthcare professional-patient communication. Currently, there is uncertainty on how healthcare professionals can and should engage with critical care patients and family members about their medication. Research QuestionWe aimed to explore the views and experiences of critical care patients and family members about their involvement, communication, understanding, and decision making related to their medication following transfer from critical care to the hospital ward. Study Design and MethodsQualitative study, using semi-structured interviews, conducted with critical care patients and family members after transfer from critical care to a hospital ward in a large National Health Service hospital Trust. Anonymized transcripts of interviews were thematically analysed using a coding framework developed from understandings of patient and family engagement in their medication. ResultsTwenty-seven participants (15 patients and 12 family members of patients) completed the interviews. We identified five themes and 15 sub-themes, providing an overview of patients and family members’ views on their medication management during their acute illness and ongoing recovery. Themes identified were: Impact of acute illness and treatment burden on pre-existing illness; Pre-existing knowledge and capability; Beliefs about persons roles and expectations; Care continuity and individualised information exchange; and Engagement in practice. InterpretationCritical care patients and family members want to engage with healthcare professionals about their medication. Health care professionals must take an individualized approach to communication and timing, acknowledging the dynamic interplay between patients and family members, using multimodal forms of communication.