Relatives Of Intensive Care Patients Research Articles

Negative impact of intensive care on family caregivers

Relatives of intensive care patients make an important contribution to recovery and perform a variety of tasks. Due to the demands on the relatives and their services in the ICU and after their discharge, stressful psychological, physical, social, and financial consequences can arise or worsen. Relatives often compensate deficiencies in treatment, especially through a lack of communication and a lack of continuity of care. Seamless care for patients in the ICU and afterwards reduces avoidable consequences for relatives. Structured communication between relatives and the treatment team as well as active involvement in nursing treatments can alleviate stress symptoms and the feeling of powerlessness. Prescient discharge management for ICU patients and their relatives reduces PICS risk. Specific and comprehensive offerings of advice and support for relatives can help to perform and process the effort between everyday life and care tasks.

The Effect of Anxiety Levels of Relatives of Intensive Care Patients on Psychosocial Needs

Yoğun bakım ünitesinde yatış sürecinde hasta yakınlarının bilgi, güven, destek, yakınlık ve rahatlık alt başlıkları ile sunulan psikososyal gereksinimleri mevcuttur. Bu psikososyal gereksinimler kişisel farklılıklar göstermektedir. Bu çalışmada, bazal anksiyete düzeyi yüksek ve düşük olan hasta yakınlarının gereksinimlerinin incelenmesi amaçlandı. Çalışma 3.basamak yoğun bakımda 1 Kasım 2018 - 28 Şubat 2019 tarihleri arasında tanımlayıcı araştırma olarak dizayn edildi. Çalışmaya dahil olma gönüllülük esasına dayanmakta olduğundan araştırmaya katılmayı kabul etmeyen 18 yaşın altında olan, dil farklılığı nedeniyle iletişim güçlüğü olan, postoperatif takip amacı ile yatırılan ve 48 saatten daha kısa yatışı bulunan hasta yakınları çalışma dışı bırakıldı. Çalışmada, ‘Kritik Bakım Aile İhtiyaçları Envanteri (CCFNI) ve ‘Beck Anksiyete Ölçeği’ kullanıldı. Belirlenen tarih aralığında yoğun bakım ünitesine yatan 303 hastadan 91’inin yakını çalışmaya dahil edildi. Anksiyete düzeylerine göre hasta yakınları ‘anksiyete düzeyi yüksek’ ve anksiyete düzeyi düşük’ olarak 2 gruba ayrıldı. Güven, bilgi, yakınlık, destek ve rahatlık alt grupları ayrı ayrı değerlendirildiğinde anksiyetesi yüksek olan bireylerde tüm gereksinimlerin daha yüksek olduğu tespit edildi. Her iki grup için de gereksinim sıralaması benzer olup, sırasıyla; bilgi, destek, yakınlık, güven ve rahatlık gereksinimlerinin bulunduğu tespit edildi. Yoğun bakımda yatan hasta yakınlarının bazal anksiyete düzeylerinin yüksek olması, güven, bilgi, yakınlık, destek ve rahatlık gereksinimlerini arttırmaktadır. Hasta yakınlarının ihtiyaçlarının anksiyete düzeyleri ile birlikte değerlendirilmesi uygun gözükmektedir. Bu dönemde hasta yakınları ile yanlış anlaşılmaların önlenmesi için iletişime önem verilmelidir.

Mental Health of Adolescent Relatives of Intensive Care Patients: Benefits of an Open Visitation Policy

Background Symptoms of anxiety and depression are common in adolescents with a loved one in an intensive care unit (ICU) and are known precursors of posttraumatic stress disorder (PTSD). Objectives To assess the prevalence of PTSD and associated factors in adolescent (age 12–17 years) relatives of patients in an ICU with an open visitation policy. Methods One year after the patient was discharged from the ICU, eligible adolescent relatives completed a satisfaction survey, anxiety history questionnaire, and psychometric evaluations (Hospital Anxiety and Depression Scale and 8-item Children’s Revised Impact of Event Scale). Results Thirty-two patients intubated for >2 days and with a Simplified Acute Physiology Score II >30 were included. Forty-six adolescents with first- to third-degree relationships to the patient, and in regular contact (≥monthly) with the patient before hospitalization, were enrolled. The prevalence of PTSD among the adolescents was 33%. Adolescents who visited the ICU were less likely to report feelings of regret than those who did not visit the ICU (2% vs 9%, P = .01). A past sense of threat (odds ratio [95% CI], 19.4 [1.9-201.2]; P = .01) and anxiety and depression symptoms (odds ratio [95% CI], 9.6 [1.4-63.7]; P = .02) were independent factors associated with probable PTSD. Conclusions A cautiously prepared open visiting policy should be maintained for adolescents with a relative in the ICU, because it could prevent feelings of regret and subsequent PTSD. Adolescents with risk factors should be screened and followed up.

The needs of the relatives in the adult intensive care unit: cultural adaptation and psychometric properties of the Chilean-Spanish version of the Critical Care Family Needs Inventory

Introduction The admission of a patient to an intensive care unit is an extraordinary event for their family. Although the Critical Care Family Needs Inventory is the most commonly used questionnaire for understanding the needs of relatives of critically ill patients, no Spanish-language version is available. The aim of this study was to culturally adapt and validate theCritical Care Family Needs Inventory in a sample of Chilean relatives of intensive care patients. Methods The back-translated version of the inventory was culturally adapted following input from 12 intensive care and family experts. Then, it was evaluated by 10 relatives of recently transferred ICU patients and pre-tested in 10 relatives of patients that were in the intensive care unit. Psychometric properties were assessed through exploratory factor analysis and Cronbach's α in a sample of 251 relatives of critically ill patients. Results The Chilean-Spanish version of the Critical Care Family Needs Inventoryhad minimal semantic modifications and no items were deleted. A two factor solution explained the 31% of the total instrument variance. Reliability of the scale was good (α=0.93), as were both factors (α=0.87; α=0.93). Conclusion The Chilean-Spanish version of theCritical Care Family Needs Inventory was found valid and reliable for understanding the needs of relatives of patients in acute care settings.

The needs of the relatives in the adult intensive care unit: Cultural adaptation and psychometric properties of the Chilean-Spanish version of the Critical Care Family Needs Inventory

IntroductionThe admission of a patient to an intensive care unit is an extraordinary event for their family. Although the Critical Care Family Needs Inventory is the most commonly used questionnaire for understanding the needs of relatives of critically ill patients, no Spanish-language version is available. The aim of this study was to culturally adapt and validate theCritical Care Family Needs Inventory in a sample of Chilean relatives of intensive care patients. MethodsThe back-translated version of the inventory was culturally adapted following input from 12 intensive care and family experts. Then, it was evaluated by 10 relatives of recently transferred ICU patients and pre-tested in 10 relatives of patients that were in the intensive care unit. Psychometric properties were assessed through exploratory factor analysis and Cronbach’s α in a sample of 251 relatives of critically ill patients. ResultsThe Chilean-Spanish version of the Critical Care Family Needs Inventoryhad minimal semantic modifications and no items were deleted. A two factor solution explained the 31% of the total instrument variance. Reliability of the scale was good (α=0.93), as were both factors (α=0.87; α=0.93). ConclusionThe Chilean-Spanish version of theCritical Care Family Needs Inventory was found valid and reliable for understanding the needs of relatives of patients in acute care settings.

Quality of care in the intensive care unit from the perspective of patient\u2019s relatives: development and psychometric evaluation of the consumer quality index \u2018R-ICU\u2019

BackgroundThe quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient’s relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index ‘Relatives in Intensive Care Unit’ (CQI ‘R-ICU’). The CQI ‘R-ICU’ measures the perceived quality of care from the perspective of patients’ relatives, and identifies aspects of care that need improvement.MethodsThe CQI ‘R-ICU’ was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients’ relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis.ResultsTwelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire’s vocabulary. The response rate of patients’ relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: ‘Communication’ (α = .80) and ‘Participation’ (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients’ relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and involvement in decision-making on the medical treatment of the patient.ConclusionsThe CQI ‘R-ICU’ evaluates quality of care from the perspective of relatives of intensive care patients and provides practical information for quality assurance and improvement programs. The development and psychometric evaluation of the CQI ‘R-ICU’ led to a draft questionnaire, sufficient to justify further research into the reliability, validity, and the discriminative power of the questionnaire.

Sleep problems, anxıety, depressıon and fatıgue on famıly members of adult intensıve care unıt patıents.

The purpose of this study was to determine the levels of sleep problems, anxiety, depression and fatigue in family members of intensive care patients in Turkey and factors affecting these complaints. This cross-sectional study was carried out with 350 first-degree relatives of intensive care patients at a university and state hospital. Data were collected between 5 January and 30 May 2014 using a personal information form, the Visual Analogue Scale for Fatigue, the Hospital Anxiety and Depression Scale and the modified Post Sleep Inventory. Of the 350 family members, 76% reported moderate or more serious problems. Anxiety was reported by 81.4% of the family members, and depression by 94.2%. Family members in the study had fatigue, with average scores of 79.42. There were significant correlations between the Visual Analogue Scale for Fatigue and anxiety, depression and scores on the Modified Post-Sleep Inventory (P < 0.05). Family members of intensive care patients experienced symptoms of fatigue, anxiety, depression and sleep problems. The prevalence of symptoms of sleep problems, anxiety and depression and complaints of fatigue was significantly higher in the family members of intensive care patients in Turkey than reported in the literature.

Needs of American relatives of intensive care patients: Perceptions of relatives, physicians and nurses

This study investigated differences between the perceptions of American relatives, physicians and nurses concerning the needs of relatives visiting intensive care patients. This was a prospective descriptive study. Perceived needs were measured using the 45 item Critical Care Family Needs Inventory (CCFNI) with 101 relatives visiting as well as 28 physicians and 109 nurses working with the same group of patients. Data were collected using a convenience sample of patients, their relatives visiting, as well as the physicians and nurses working with the same patients in six adult intensive care units in a large American tertiary acute care medical centre with over a 900 bed capacity. There were significant correlations (p<0.05) between the relatives, physicians and nurses on eight of the 45 individual items on the CCFNI. Subscale (Information, Proximity, Assurance, Comfort and Support) scores for the needs perceived by relatives, physicians and nurses were calculated and there were significant differences in the three groups on Information (F=5.90, df=2, p=.0005), Support (F=4.12, df=2, p=.022) and Comfort (F=5.01, df=2, p=.010). Relatives and nurses made multiple comments on the surveys. This is important information for all health care workers to consider in setting visiting policies in adult ICUs and developing approaches such as family centred care.