Perceptions Of Family Members Research Articles

Family perceptions related to isolation during COVID-19 hospitalization.

During the COVID-19 pandemic, visitor limitations were implemented in hospitals and long-term-care facilities to prevent transmission of the virus from patients to family members. It is unknown how the context of visitor limitations due to COVID-19 influenced the state of emotions and experiences in family members unable to physically visit their loved ones in person during hospitalization. This article details a study of the perceptions of family members related to being isolated from patients who are hospitalized with confirmed positive COVID-19.

Family support and quality of community mental health care: Perspectives from families living with mental illness.

Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members. While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members. Cross-sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship-paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ-N) and Quality in Psychiatric Care-Community Out-Patient (QPC-COP) and Community Out-Patient Next of Kin (QPC-COPNK). STROBE checklist was used. Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient-healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals. Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally.

The perception of family members regarding patient's vertigo and imbalance

Introduction and objectivesFamily members play a major role in the assessment and final result of the treatments of patients. The goal of the present study was to evaluate how much the perception of patients’ family members could be trusted regarding the vertigo and imbalance which they experienced. Materials and methodsA cross-sectional study was conducted on 110 patients and their family members who were referred to the Central Vestibular Clinic in Mashhad from April 2018 to September 2019. Family members were categorized as spouses, children, and other relatives of patients. Patients and their family members separately completed the Dizziness Handicap Inventory (DHI) by the paper and pencil method. DHI has a high reliability, validity, and internal consistency. ResultsMean DHI scores of patients and their family members were 45.35±20.24 and 42.01±22.83, respectively. The correlation between DHI scores of patients and family members, except children, were significant (p<.05). ConclusionA relatively weak to moderate relationship between the perception of patients and their family members, except children, was found. They were more aware of the physical aspects of vertigo and imbalance than the emotional ones.

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.

Do-not-resuscitate decision making for terminally ill older patients in the emergency department: An explorative, descriptive inquiry of Chinese family members

Many terminally ill older adults depend on family members to make medical decisions in China. Many family members find it difficult to make do-not-resuscitate (DNR) decisions in emergency departments (ED). Currently, factors that affect DNR decision making by family members for older adults needing emergency care have not been well studied. This qualitative inquiry explores factors influencing DNR decision-making among family members of terminally ill older adults in ED. Semi-structured in-depth interviews were conducted for a 12-family member of terminally ill older adults at ED in China. Results of the conventional content analysis showed that family members made DNR decisions based on a wide of reasons: (a) subjective perception of family members, (b) conditions of the terminally ill older adults, (c) external environmental factors, and (d) internal family factors. The findings of this study expand our knowledge and understanding of factors influencing DNR decision-making by family members of terminally ill older adults in ED.

Hypno Family Melalui Metode Psychodrama Untuk Mengoptimalkan Potensi Dalam Menjalankan Peran Sebagai Anggota Keluarga

This research is motivated by a large number of human psychological problems that have an impact on economic problems, environmental problems, crime issues, family chaos, political problems, and security issues or vice versa. The purpose of this study is to improve maturity in attitude and thinking with a responsibility to optimize the potential in carrying out roles in the family. This research method is research and development (R&amp;D). The subjects of this study were several students at various campuses in Yogyakarta. The results showed that the implementation model of the Hypno family through the psychodrama method includes: (1) digging up data related to family perceptions; (2) digging up data on negative perceptions of family members followed by acceptance therapy; (3) tells about changes in the attitude of family members; (4) forming and strengthening character using Asmaul Husna. Hypno family through the psychodrama method can optimize the potential in carrying out the role of family members. This can be seen from the affective assessment by making observations and reinforced by interviews with each participant. Each participant felt a real change in the family.

Breaking the Mold: Safely Delabeling Penicillin Allergies in Hospitalized Children.

Children are often reported to have antibiotics allergies, with up to 35 million people, or 10% of the US population, labeled as allergic to an antibiotic.1 In fact, 75% of children with reported antibiotic allergies are identified before the age of 3 years.2 Recent studies have revealed that the majority of symptoms reported as an allergy by parents are non–immunoglobulin E–mediated adverse reactions or symptoms of a viral illness, such as rash, abdominal pain, vomiting, diarrhea, or other benign symptoms.3,4 Additionally, >90% of patients with a reported penicillin allergy have negative skin testing results.1,5,6 Several studies in adults and children reveal risk-stratified management, wherein those at low risk for a true allergy skip skin testing in favor of direct oral challenge, is safe and effective.7 Delabeling penicillin allergies in children without true allergies is critical because penicillin allergy labels are associated with worse clinical outcomes, increased adverse drug events, more multidrug-resistant infections, and increased health care costs.7–9 Although risk-stratified management of drug allergies is now standard of care,7,8 implementation of this best practice in the hospital setting is lacking. In this issue of Hospital Pediatrics , researchers report a single-center, hospital-based quality improvement (QI) project aimed at performing risk stratification of penicillin allergies, with subsequent delabeling of children who do …

Tensions in support for family caregivers of people with dementia in Singapore: A qualitative study.

Family members as informal caregivers are considered the first line of support for people with dementia across the world. In Singapore, caregiving expectations revolve around the cultural expectations of providing care in the home environment. However, studies in Singapore have identified a lack of family support for primary caregivers. Family support has been discussed in the literature as the provision of care for people with dementia, and rarely as a resource for family caregivers. To understand family support among primary caregivers in Singapore, 24 semi-structured interviews were conducted. Thematic analysis found four themes: excuses for lack of physical support for the caregiver, tensions between cultural expectations of caregiving and the provision of support, unmet emotional support, and lack of awareness of dementia and caregiving needs. Caregivers rationalized and forgave the absence of physical support but were frustrated when the lack of support impacted people with dementia. This was seen as a lack of fulfilling cultural obligations of caring for elderly parents. The caregivers also felt frustrated with the lack of emotional support provided to them, but these were unspoken between the caregiver and the family members. Insufficient and unhelpful support giving was exacerbated with the perception of family members' limited understanding of the demands of caregiving. The findings offer four practical suggestions to address unmet support needs. First, public education is needed to enhance general knowledge about the symptoms and progression of dementia. Second, help is needed to address miscommunication about support within the family. Third, the development of guidebooks is needed to help family caregivers communicate with family members about their various support needs. Fourth, the relationship between cultural expectation and caregiving must be understood within the context of modernity and urbanism.

Healthcare Professionals' Perspective on Implementing a Detector of Behavioural Disturbances in Long-Term Care Homes.

The number of Canadians with dementia is expected to rise to 674,000 in the years to come. Finding ways to monitor behavioural disturbance in patients with dementia (PwDs) is crucial. PwDs can unintentionally behave in ways that are harmful to them and the people around them, such as other residents or care providers. Current practice does not involve technology to monitor PwD behaviours. Events are reported randomly by nonstaff members or when a staff member notices the absence of a PwD from a scheduled event. This study aims to explore the potential of implementing a novel detector of behavioural disturbances (DBD) in long-term care homes by mapping the perceptions of healthcare professionals and family members about this technology. Qualitative information was gathered from a focus group involving eight healthcare professionals working in a tertiary care facility and a partner of a resident admitted in the same facility. Thematic analysis resulted in three themes: (A) the ability of the DBD to detect relevant dementia-related behavioural disturbances that are typical of PwD; (B) the characteristics of the DBD and clinical needs and preferences; (C) the integration of the DBD into daily routines. The results tend to confirm the adequacy of the DBD to the day-to-day needs for the detection of behavioural disturbances and hazardous behaviours. The DBD was considered to be useful and easy to use in the tertiary care facility examined in this study. The participants intend to use the DBD in the future, which means that it has a high degree of acceptance.

Not without my attending: a survey of patient and family member attitudes and perceptions about concurrent and overlapping surgery

Background ContextRecent media coverage of overlapping surgery has led to several studies investigating public perception of concurrent and overlapping surgery, both of which involve a single attending surgeon working on two separate cases in two separate operating rooms. In concurrent surgery, the critical periods of the surgeries overlap, while in overlapping surgery they do not. The literature revealed a general lack of knowledge about these practices and strong disapproval of their use by the public. PurposeTo determine the comfort level of spine surgery patients and their family members toward concurrent and overlapping surgery. Study Design/SettingThis cross-sectional survey study was performed at an urban, adult academic spine surgery clinic. Patient SamplePatients and their companions who were waiting to be seen at their initial clinic visit or follow-up visit were approached to participate in the study. Outcome MeasuresThe survey queried respondents’ baseline knowledge of and comfort level with concurrent and overlapping surgery, in addition to comfort level with different levels of surgical trainees on a 5-point Likert scale. MethodsA five-section, 36-item questionnaire was administered by a research assistant to respondents over a 3-month period spanning June 2019 – August 2019. A research assistant described the terms overlapping surgery and concurrent surgery to participants of the survey using diagrams and a preformulated script after self-reported knowledge questions. Statistical analysis was performed using the chi-square test for categorical variables, and Kendall's tau-c rank correlation coefficient with ordinal independent variables for correlations. ResultsKnowledge about concurrent and overlapping surgery was low in our study population (8.22% and 6.16%, respectively). Over half of respondents reported that they felt comfortable with overlapping surgery (58.22%). Most respondents reported that they would like their surgeon to disclose the participation of surgical trainees (residents and fellows) in their surgery (98%). In addition, the 4th and 5th years of surgical training were associated with a significant increase in patient comfort with surgical trainee participation. There was no difference in response distribution between patients versus nonpatients. ConclusionsKnowledge about concurrent and overlapping surgery remains poor in our study population. Lack of general knowledge about overlapping surgery can be a serious impediment to obtaining informed consent, and further study is required to determine the best methods to raising patient awareness.

Experiences and perceptions of family members of emergency first responders with post-traumatic stress disorder: a qualitative systematic review protocol.

The objective of this review is to understand the perceptions and experiences of family members of emergency first responders with post-traumatic stress disorder. Research indicates that rates of post-traumatic stress disorder in emergency first responders are approximately double civilian rates; however, little is known about the effects of post-traumatic stress disorder on family members. This review seeks to identify qualitative research on families' experiences and perceptions. This review will consider all studies of family members of current or former emergency first responders with diagnosed or undiagnosed post-traumatic stress disorder of any level of severity. All possible familial configurations and family members will be considered, including nuclear, separated, and blended families, of a current or former emergency first responder. There will be no age restrictions on emergency first responders or their family members, or limitations on recency of service. Emergency first responders may include police, ambulance workers, paramedics, firefighters, or rescue personnel, with no restriction on geographic location. The databases to be searched will include PubMed, PsycINFO, Embase, CINAHL, PTSDpubs, and Scopus, as well as handsearching of relevant journals. Unpublished studies and gray literature will be searched via PTSDpubs and OpenGrey. The search will aim to find English-language publications with no time limits. Titles and abstracts will be reviewed and then full texts, all screened by two independent reviewers against the inclusion criteria. Any conflicting views will be resolved by discussion or a third reviewer. Results will be critically appraised for methodological quality. Data extraction results will be synthesized and evaluated for credibility and dependability. PROSPERO CRD42020196605.

Implementation of the Family HELP Protocol: A Feasibility Project for a West Texas ICU.

The purpose of this project was to determine if bedside intensive care unit (ICU) nurse buy-in to the Family Hospital Elder Life Program (HELP) protocol was sufficient to make implementation feasible at one county hospital in West Texas. Surveys were anonymous with ballot box collection being available to the bedside ICU nurses for one week each. Questions were based on literature findings of expected outcomes, identified barriers and facilitators, Calgary Family Intervention Method framework domains, and the Centers for Disease Control and Prevention Framework for program evaluation. Outcome measures were taken from the stated aims of the project and evaluated from paired baseline and summative survey questions. Survey participation was approximately half of nurses employed in the studied ICU. Analysis of the surveys showed a positive perception of family presence decreasing patient delirium symptoms, and a positive perception of the Family HELP protocol. The results described a high perception of family members as partners in care and high intention to implement the Family HELP protocol, indicating strong support of a full implementation of the protocol. The high level of bedside nurse buy-in present in this study has large implications for successful implementation of the Family HELP protocol in the near future, with sustainability and continued use supported by potential inclusion of the task in the electronic health record charting.

Context of The Inclusion of Children with Autistic Spectrum Disorder in Early Childhood Education

The Autism Spectrum Disorder (ASD) is a Neurodevelopment Disorder which involves a few deficits pertaining to social and communication skills, as well as repetitive and restrictive behaviors. Brazilian law nº 12.764 of 2012 guarantees and protects the rights of those with ASD. This study’s main objective is to describe the process of inclusion of children with ASD in public institutions of Early Childhood Education in the city of São Luís, Maranhão state, based on the perception of family members and the staff from said institutions. An exploratory descriptive research with a qualitative approach was conducted in two Early Childhood Education institutions with attending ASD children. Participants were 4 family members of children with ASD and 16 staff members who worked with the ASD children in the institutions. After receiving the consolidated opinion from the Ethics Committee (CEP/CONEP/UFMA, Nº 2.891.951), data were collected through semi structured interviews consisting of two scripts: one for family members, and the other for staff. Results showed that although the majority of children with ASD were well treated and accepted by staff and other children without disabilities, there are still many barriers to overcome in the context of Inclusive Education in Early Childhood Education. Among these barriers are those caused by stigmas related to the disorder in question, as well as the fear and/or rejection by parents and other family members of the interaction between their non-disabled children and those with ASD. Most people working with ASD children still feel unprepared. There is a lack of partnership between the studied institutions and the family members of children with ASD, which leads to another barrier to their inclusion in Early Childhood Education.

"Why Couldn't I Go in To See Him?" Bereaved Families' Perceptions of End-of-Life Communication During COVID-19.

The COVID-19 pandemic has resulted in rapid changes to end-of-life care for hospitalized older adults and their families, including visitation restrictions. We examined bereaved families' perceptions of the quality of end-of-life communication among Veterans, families and staff in Veterans Affairs (VA) medical centers during the COVID-19 pandemic. Qualitative descriptive study using data from a survey of bereaved family members of Veterans administered from March-June 2020. Data were analyzed using qualitative content analysis. VA medical centers with the highest numbers of COVID-19 cases during the study period. Next-of-kin of 328 Veterans who died in one of 37 VA medical centers' acute care, intensive care, nursing home, or hospice units. Open-ended survey questions (response rate = 37%) about family member's perceptions of: (1) communication with the healthcare team about the patient, (2) communication with the patient, and (3) use of remote communication technologies. Bereaved family members identified contextual factors perceived to impact communication quality including: allowing family at the bedside when death is imminent, fears that the patient died alone, and overall perceptions of VA care. Characteristics of perceived high-quality communication included staff availability for remote communication and being kept informed of the patient's condition and plan of care. Low-quality communication with staff was perceived to result from limited access to staff, insufficient updates regarding the patient's condition, and when the family member was not consulted about care decision-making. Communication quality with the patient was facilitated or impeded by the availability and use of video-enabled remote technologies. Communication between patients, families, and healthcare teams at the end of life remains critically important during times of limited in-person visitation. Families report that low-quality communication causes profound distress that can affect the quality of dying and bereavement. Innovative strategies are needed to ensure that high-quality communication occurs despite pandemic-related visitation restrictions.

A comparative study of the perceptions of family members patients hospitalized in intensive and cardiac care units (CCU and ICU) in regard to the importance of family needs in Golestan University of Medical Sciences 2020.

Introduction:Intensive care units (ICUs) cause double stress and tension in hospitalized patients' family members. Improving care quality in these wards requires estimating the importance of the families' needs by the nurses. Therefore, the present research was designed to determine and compare the perceptions of family members of the patients hospitalized in the ICUs and cardiac care units (CCUs) about the importance of family needs and their relationship with some factors in the Golestan University of Medical Sciences, 2020.Methods:This was a descriptive-analytical study. Eighty-eight companions of the patients admitted in the ICU and 88 companions of the patients admitted in the CCU were studied by stratified sampling, proportional, and then, available allocation. To analyze the data, Mann–Whitney, Kruskal–Wallis, and multivariate analysis of variance in the SPSS 18 statistical software were used (the significance level was 0.05).Results:The results revealed that in both the ICUs, the variable “the family relationship of hospitalized patients' companions” and their needs was found to be significantly different in general. This difference in all dimensions was related to the relationship between the spouse and the patient. Generally, there was no significant difference between the gender of the patient's companion and the importance of family needs in the CCU ward, but this difference was significant in general and in all dimensions in the ICU ward so that the importance of all the needs was more in the female companions.Conclusion:This study proved that the need in the “confidence” dimension is the most important need of the family of patients admitted to the two wards (CCU) and (ICU).

Effectiveness of Mental Health Intervention for Suicide Prevention

Background: Various mental health interventions like priority in-patient care, ECT, psychotherapies, pharmacotherapies, etc. have been tried throughout the world to decrease the morbidity and mortality associated with suicide behavior. Aims: To establish the effectiveness of mental health intervention for preventing suicide, for those at risk and to understand the perception of patients and family members about the usefulness of interventions for preventing suicide. Material and methods: The patients admitted to the Psychiatry Intensive Care Unit (PICU) at the Institute of Human Behavior and Allied Sciences (IHBAS), in view of suicide behavior, during the 12 months period from 1st July 2018 to 30th June 2019 were included in the study. A target population of 88 patients was taken up for cross-sectional follow-up assessment. They were assessed for suicide behavior for the period of 12 months prior to and subsequent to the hospitalization. Results: A statistically significant difference was found in both, the number of patients attempting suicide before and after hospitalization (N = 88, Chi-square = .2, p-value &lt; 0.04), as well as in the mean number of attempts before and after hospitalization (N = 88, p-value &lt;0.01). Also, three fourth of patients/family members were completely satisfied with the care provided while the remaining one-fourth were only partially satisfied. Conclusion: This study has established not only the usefulness of timely mental health intervention for the prevention of suicide as perceived by family or patients but also provides statistical evidence for the effectiveness of such mental health interventions.

Family resilience: perception of family members of psychoactive substance dependents

Objective:to understand the perception of family members of psychoactive substance dependents on the elements of the functioning of their family in family resilience.Method:a qualitative approach study, based on the theoretical interpretive framework of family resilience from a systemic perspective. The participants were eleven family members of psychoactive substance dependents from a Psychosocial Care Center - Alcohol and Drugs, from a city in the state of São Paulo. For data collection, semi-structured interview, genogram and ecomap were used. Data analysis was based on the Content Analysis technique, thematic category.Results:from the interviews, three thematic categories were formulated: mobilization in search of support and social support; positive perspectives that would strengthen the family, and assertive communication. These categories point to references to the mobilization and unity of the family in search of social support in the intra-family, extended family and extra-family contexts and positive perspectives, such as persistence, perseverance, hope, faith and religiousness.Conclusion:the situation of having a psychoactive substance dependent in the family seemed to mobilize coping devices and attempts to overcome them through the resilience forces. The results may favor the daily clinical reasoning of the health professionals, helping them to recognize and value the identified resilience attributes.

Feasibility of an Intervention Study to Support Families When Their Loved One Has Life-sustaining Therapy Withdrawn.

This investigation addressed family member perceptions of preparation for withdrawal of life-sustaining treatment in the intensive care unit. These families are at a high risk for psychosocial and physical sequelae. The quantitative results of this mixed methods study are reported. A control group received usual care and an educational booklet component of the intervention. The experimental group received the above plus exposure to comfort cart items and additional psychological support. Twenty-eight family members enrolled over a 13-month period. Sixty-one percent (10 intervention, 7 control) completed the follow-up. Fourteen family members (82%) recalled the booklet. Some family members reported moderate to severe depression (12.5%), anxiety (12.5%), and stress (12.6%). Satisfaction with care (83.7%-85.2%) and family member well-being (44.1) were within the norm. Short Form-36 physical component score was higher than the norm, and the mental component score was lower than the norm. This study demonstrated feasibility and acceptability of the interventions and follow-up questionnaires when families make the difficult decision to withdraw treatment. Strategies are suggested to strengthen statistical power.

Aspiraciones y expectativas de las familias de ascendencia extranjera en el País Vasco: educación, formación, trabajo y movilidad social

En este artículo se presentan los principales resultados de un estudio sobre los hijos e hijas de la inmigración en el País Vasco. Concretamente nos detenemos en las aspiraciones y expectativas que se generan en el seno familiar, tanto desde el punto de vista de los progenitores como desde sus descendientes con respecto a su futuro. A partir de una metodología mixta, abordamos las opiniones y percepciones de los miembros de las familias de ascendencia extranjera en relación a aquellos elementos que intervienen en una trayectoria educativa encaminada al éxito como garante de una movilidad social ascendente. El análisis muestra que el capital social y cultural son considerados por las familias elementos para lograr una mayor integración económica y social. Los progenitores afirman por medio de sus discursos la importancia de la educación, el conocimiento del euskera y una red social fuerte compuesta por personas autóctonas.&#x0D; Recibido: 18 mayo 2020Aceptado: 16 noviembre 2020

How do family members perceive re-integration of male state patients into their families in South Africa? A qualitative analysis.

BackgroundState patients are admitted to a psychiatric hospital after being declared as such by the magistrate courts as a result of not found fit to stand trial for the offence they had committed. After successful rehabilitation of state patients at the psychiatric hospital, they need to be re-integrated into their families. Family members’ perceptions regarding re-integration of male state patients are not largely explored in the scientific body of knowledge.AimThe aim of the study was to determine the perceptions of family members regarding reintegration of male state patients into their families.SettingThis study was conducted in Vhembe District of Limpopo province, South Africa.MethodA qualitative approach using explorative, descriptive and contextual designs was adopted. In-depth interviews were conducted with 10 family members who were purposefully sampled, and data were thematically analysed using Tech Open Coding method.ResultsThree themes emerged, namely, family members understand re-integration; family members’ expectations from a mental healthcare user; and threat to re-integration as perceived by family members.ConclusionData revealed that family members have varied perceptions regarding re-integration. These perceptions were based on the behaviour displayed or an offence committed by the mental healthcare user before admission and how participants experienced it. The study recommends that an investigation is to be conducted on the kind of support family members need regarding re-integration of state patients into their families.