Family Satisfaction Research Articles

Are you really satisfied in life? Developing a scale on life satisfaction

Purpose This study attempted to measure life satisfaction and developed a scale to measure its dimensions with the required psychometric properties (validity and reliability). In today’s scenario, organizations are focusing on life satisfaction by helping employees to maintain their work-life balance. Therefore, this paper aims to develop a robust scale of life satisfaction. Design/methodology/approach The methodology consists of three broad stages: item generation, scale development, and validity. Using the sample of 198 working executives, this study used the exploratory factor analysis (EFA) and concluded the four dimensions of life satisfaction: work satisfaction, family satisfaction, societal satisfaction and self-satisfaction. Findings The results provide academicians and practitioners with new insight and dimensions of life satisfaction. The result of this study shows that life satisfaction has societal satisfaction, family satisfaction, job satisfaction and self-satisfaction dimensions. Practical implications This study will provide practitioners with new dimensions to measure life satisfaction. They can help employees achieve life satisfaction across four different factors. This will enable more employee satisfaction, an increase in retention rate and an increase in employee performance. Furthermore, this study provides implications from a policy perspective to design the business policy by considering life satisfaction as an important part of formulating and implementing human resource policies. Originality/value This study is unique in terms of exploring the dimensions of life satisfaction in a structured manner and establishing the psychometric properties as construct, content, and criterion validity along with reliability. This scale can be further used in future research to measure the life satisfaction construct.

Analysis of the Emergency Rescue Nursing Intervention Effect and Rescue Success Rate for Patients with Traumatic Hemorrhagic Shock

Objective: To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts. Methods: A total of 80 patients with traumatic hemorrhagic shock were selected as samples, with the timeframe from July 2022 to July 2023. The patients were randomly divided into two groups using a random number table method. Group A received emergency rescue nursing, while Group B received routine nursing care. The success rate of rescue, rescue indicators, complication rates, and family satisfaction with nursing care were compared between the two groups. Results: The rescue success rate in Group A was higher than in Group B (P < 0.05); the total blood loss in Group A was less, and the rescue time, full transportation time, and hospitalization time were shorter than in Group B (P < 0.05); the complication rate of patients with traumatic hemorrhagic shock in Group A was lower than in Group B (P < 0.05); the family satisfaction with emergency nursing care in Group A was higher than in Group B (P < 0.05). Conclusion: Emergency rescue interventions for patients with traumatic hemorrhagic shock can reduce blood loss, shorten rescue times, and improve the success rate of shock rescue, providing a safe and effective approach.

The power of partnership: Strategies for pan-Canadian spread and scale of paramedics providing palliative care.

Paramedics and Palliative Care is an example of a promising practice ("pilot") that underwent successful spread and scale across Canada. Through the support of two pan-Canadian health organizations and concurrent evolution of the profession of paramedicine, this innovation has become integrated into practice. Evaluation of the innovation sites showed positive impact in all elements of the quintuple aim, and data from the expansion sites mirrors this success. Paramedic comfort and confidence is improved. Patient and family satisfaction is high. Quality indicators such as time spent at home, and home deaths, improved after program launch. There are time and cost savings with the program in place. The framework that enabled this spread and scale is presented and elaborated, to support further uptake of this innovation and provide a blueprint for successful expansion of other promising practices to support healthcare improvement across Canada.

Family satisfaction with care provided to patients deceased in intensive care unit

Background & Objective: Patient’s family satisfaction is a crucial but often overlooked indicator of the quality of the intensive care unit (ICU). The goal was to assess how satisfied patients’ families were with the treatment they received for terminally ill patients, where we worked with them to create a care plan. Methods: The study was conducted in ICU at Pakistan Kidney and Liver Institute and Research Center (PKLI & RC), Lahore, Pakistan which is a quaternary care center between December 1st 2022 and April 30th 2023. We used the Family Satisfaction in the Intensive Care Unit 24 (FS-ICU 24) questionnaire to interview the next of kin of patients who passed away in our ICU. Results: Of the 330 patients admitted to the intensive care unit (ICU) between December 1, 2022, and April 30, 2023, 42 patients (12.7%) passed away. Mean age was 46.8 ± 14.5 years, with 28 men (66.7%) and 14 females (33.3%). Mean length of ICU stay was 5.57 ± 5.84 day. On a scale of 1-5 (1 = very Dissatisfied; 5 = fully satisfied) the overall family’s satisfaction score was 4.21 ± 0.52 with ICU consultants received a high satisfaction rating for informing families about their patients’ conditions and involving them in the decision-making process. Conclusion: The study showed involving family members in the care plan and helping them prepare for death not only helps them deal better but also makes them feel satisfied with the treatment they received in the intensive care unit, It makes them appreciate that they were able to participate in the decision-making process. doi: https://doi.org/10.12669/pjms.40.10.8697 How to cite this: Sharieff S, Sajjal A, Idrees A, Rafai WA. Family satisfaction with care provided to patients deceased in intensive care unit. Pak J Med Sci. 2024;40(10):2441-2446. doi: https://doi.org/10.12669/pjms.40.10.8697 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Examining the Relation Between Telehealth Experiences in Early Intervention and Rurality Among Families of Young Children With Developmental Disabilities

The Individuals with Disabilities Education Act (IDEA, 2004) governs the Early Intervention (EI) system for families of children aged zero to three with developmental delays and disabilities. As a result of the COVID-19 pandemic, many states offer telehealth as a way for families to receive their EI services. Given the limited EI providers in rural areas, it seems that telehealth may especially help rural families to access EI services. However, little research has been done in relation to family use and satisfaction with telehealth in relation to rurality. To this end, we conducted a statewide survey of 256 families of children in EI about their use of EI services via telehealth. There was a negative correlation between family satisfaction with telehealth and rurality, with rural families being more dissatisfied with telehealth. Implications for practice and research are discussed.

Impact of Shared Decision-Making on Family Satisfaction With Intensive Care Services: 'Share With Care' has a New Meaning in ICU.

Background: Physician's clinical inputs and informed bystander opinions are essential for successful intensive care unit (ICU) patient outcomes. There is insufficient data regarding the impact of shared decision-making on treatment outcomes and family satisfaction in Indian ICU settings. We aimed to determine the effect of shared decision-making factors on family satisfaction with ICU services. Patients and Methods: Family bystanders of 336 ICU patients with a stay >72 hours were conveniently surveyed across 13 months prospectively using Family Satisfaction in the Intensive Care Unit 24 Revised (FS-ICU 24R) questionnaire. We analyzed the responses to determine shared decision-making factors impacting family satisfaction. Results: Univariate analysis of ten variables of FS-ICU 24R questionnaire decision-making subscale revealed that consistency of information (OR 8.71, P < 0.001), honesty of information (OR 7.04, P < 0.001), and frequency of communication with doctors (OR 6.25, P < 0.001) were associated with highest odds of family involvement and satisfaction. Multivariable logistic regression showed that consistency of information (adjusted OR 3.85, P < 0.001) and frequent doctor communication (adjusted OR 2.22, P = 0.02) were independent predictors associated with family satisfaction. The number of decision-makers (P = 0.463) or family's prior ICU experience (P = 0.430) was not associated with family satisfaction. Conclusion: A consistent and honest effort to cater to the family's information needs and frequent physician-bystander interaction is essential for family's satisfaction with ICU services. This even outweighs other decision-making factors such as number of decision-makers and their prior ICU experience. Incorporating shared decision-making in counseling should be a continuing practice.Trial registry name: Clinical Trials Registry - India.Registration number: CTRI/2022/09/045571.

Parent–Child Relationship, Resilience Beliefs, Relationship Quality and Stress During the Pandemic in American Families: A Moderated Mediation Analysis

ABSTRACTThe study aims to investigate factors within the double ABC‐X model to explain parents' stress during the first wave of the COVID‐19 pandemic, with a focus on adaptive resources (i.e., parent–child relationship and relationship quality) and the moderating effect of appraisal (i.e., family resilience beliefs). Drawing on a sample of 1386 American parents, this study examines the moderated mediation effects to test the conditional indirect influence of a moderating variable (i.e., family resilience beliefs) on the relationship between a predictor (i.e., stressor pile‐up) and an outcome variable (i.e., stress) through potential mediators (i.e., family satisfaction and relationship quality). The results indicate that the relationship between stressor pile‐up and parent stress was mediated by both parent–child relationship and relationship quality. In addition, the direct association between the parent–child relationship and parent stress was moderated by family resilience beliefs. However, the moderation effects of family resilience beliefs on relationship quality and stress were not supported. Family resilience beliefs moderated the indirect effect of stressor pile‐up on parent stress through the parent–child relationship, but not through relationship quality. The study emphasized the contribution of stressors and adaptive resources in understanding parental adaptation and the role of the family system in maintaining well‐being during unprecedentedly challenging times.

Time Usage and Satisfaction Based on Occupational Area Between Weekdays and Weekends of Family Caregivers and Non-family Caregivers of Dementia Patients.

The number of people with dementia and the burden on families to care for them are increasing. As a result, families are affected in their use of time to carry out daily activities. This study compared family caregivers of dementia patients (dementia family) and non-family caregivers of dementia patients (non-dementia family), reflecting their characteristics on weekdays and weekends. There were 92 participants each in the groups dementia family and non-dementia family. Each group was divided into 121 people on weekdays and 71 people on weekends. Time usage was measured by occupational area. The variables assessed were "lack of time," "tiredness," "life satisfaction," and "leisure satisfaction." Variables including "house chores sharing" and "role division" were also assessed. The time usage of the Korea National Statistical Office's 2019 "time use survey" was reclassified based on the occupational areas of the Occupational Therapy Practice Framework-Fourth Edition, and time usage and satisfaction were analyzed. Frequency analysis and independent t-test were used for statistical processing. On weekdays, the dementia family showed less time usage in the "leisure" area for men and "social participation" area for women than the non-dementia family. On weekends, dementia family showed less time usage in the "activities of daily living" (ADLs) area than the non-dementia family and women in dementia family showed less time usage in "ADLs" area compared to women in the non-dementia family. Satisfaction was found to be higher in terms of "lack of time" and "tiredness" on weekdays and "tiredness" on weekends in dementia family than in the non-dementia family. Time usage and satisfaction of dementia family and non-dementia family showed differences during weekdays and weekends. These results suggest that for family caregivers of dementia patients, it is necessary to improve the efficient use of time and satisfaction during weekdays and holidays.

Family-Led Coaching of Patients During Weaning From Sedation and Mechanical Ventilation in the ICU.

ICU patients are weaned from sedation and mechanical ventilation through spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs). Weaning can be distressing for patients and their families. Family-led coaching could reassure patients and reduce stress for families by engaging them in patient care. This study developed and piloted a family-led coaching tool to support patients undergoing SATs/SBTs. Patient and family member dyads were recruited from 2 medical-surgical ICUs in Calgary, Canada (February 3-August 1, 2023). Surveys were administered to collect family (1) demographics, (2) anxiety and satisfaction with ICU care, (3) feedback on the tool, and (4) attitudes about family presence during SATs/SBTs (also collected from clinicians). Tool feasibility was determined by calculating the proportions of (1) eligible patients who were recommended for participation in the study by clinicians and (2) families approached who consented to participate in the study. One thousand one hundred fifty patients were admitted to the study ICUs during the study period of which 819 received mechanical ventilation, and 42 were recommended by bedside clinicians for participation in the study. Twenty-five dyads were approached, 21 dyads consented to participate, and one withdrew consent before data collection. Of the enrolled families, 12 (60%) reported the coaching tool to be useful, and 5 (25%) recommended minor suggestions such as "shortening" the tool. Fourteen (70%) families reported positive experiences (through open-ended feedback) with being present for the SAT/SBT. State-Trait Anxiety Inventory (Y1) scores (scale range 20-80 points) significantly decreased in families from the first (pre coaching) to the second (post coaching) measures (mean decrease 8.2 points, SD 10.3, P = .001). All clinicians indicated they were comfortable with family presence and/or coaching during SATs/SBTs. Family-led coaching of patients during SATs/SBTs appears to be feasible, favorably perceived by families and clinicians, and potentially associated with lower family anxiety.

Cognitive processing, resilience, and family functioning as contributors to posttraumatic growth in family caregivers of patients with Alzheimer’s disease

Objectives The present study examined the existence of posttraumatic growth (PTG) and its association with cognitive processing, resilience, and family functioning in family caregivers of patients with Alzheimer’s disease (AD). Method Family caregivers (N = 114) were surveyed using measures of cognitive processing, resilience, family functioning, and PTG. Data were analyzed using descriptive statistics, Pearson correlations, and multiple regression analyses. Results The average PTG score in the sample was 48.6 (SD = 18.7; range 14–105). Race, education level, severity of the patient’s AD, cognitive processing, resilience, and family functioning explained 25.8% of the variance in PTG (F [9, 95] = 5.025, p < 0.001). Race was significantly correlated with PTG; specifically, non-White caregivers reported higher PTG than White caregivers (p < 0.05). When controlling for race and education level, mild AD, intrusive rumination, and family satisfaction were significant predictors of PTG (p < 0.05). However, deliberate rumination, resilience, and family communication were not significant predictors PTG (p > 0.05). Conclusion These findings provide insight into factors that may influence the development of PTG in family caregivers of patients with AD. Results may inform intervention strategies to mitigate the negative consequences of caregiving and promote PTG in this caregiver population.

The Use of Remote Presence Robotic Tele-Presentation in Rural and Remote Canada: A Systematic Review.

Objective: One potential solution to limited health care in rural and remote regions is remote presence robotic tele-presentation to allow health care providers to care for patients in their home community via a robotic interface. We synthesized evidence regarding the use of remote presence robotic tele-presentation in rural and/or remote Canadian health settings. Methods: Medline, PubMed, and Embase were searched up to August 2023. Remote presence robotic tele-presentation refers to any robotic device used for the purpose of presenting and/or collecting patient information. Primary research was included if the patient was located in remote and/or rural Canada, featured remote presence robotic tele-presentation, and assessed patient, family, or clinician satisfaction, patient transport to nearby regional or urban center, health care costs, clinical outcomes, infrastructure outcomes, adverse events, or telementoring. Results: Six studies were included. Patients, nurses, and physicians all reported high levels of satisfaction when using the remote presence robotic tele-presentation. Fifty to sixty-three percent of patients were managed in their home community and did not require transfer to another center. Remote presence robotic sonography resulted in adequate imaging in 81% of first trimester ultrasound limited exams but was less useful for second trimester complete obstetric ultrasounds (20% adequate imaging). Two of eight laparoscopic colorectal surgeries had to be converted to open surgeries. Telerobotic ultrasound clinics resulted in a diagnosis in 70% of cases. Conclusions: Evidence suggests remote presence robotic tele-presentation is a safe and cost-effective approach to providing care in distant communities and can prevent some transfers and evacuations to tertiary hospitals.

LGGL-02 NURSING CONSIDERATIONS FOR PEDIATRIC PATIENTS WITH PONTINE GLIOMAS: A COMPARATIVE ANALYSIS BETWEEN THE NAIROBI HOSPITAL AND KENYA

Abstract INTRODUCTION Pontine gliomas, aggressive brain tumors predominantly affecting pediatric patients, pose limited treatment options and a grim prognosis, emphasizing the crucial role of nursing care for comprehensive patient and family support. This abstract explores nursing considerations for pediatric pontine glioma patients at The Nairobi Hospital, contrasting them with broader healthcare practices in Kenya. METHODS A thorough literature review focused on nursing practices for pediatric pontine glioma patients, utilizing peer-reviewed journals, healthcare guidelines, expert opinions, and textbooks. Key areas included vital observations, parental support strategies, patient and family empowerment initiatives, palliative care approaches, and nursing intervention impact on outcomes and family satisfaction. RESULTS The analysis highlighted nursing considerations at The Nairobi Hospital, where a patient-centered approach and proactive vital observations were evident. Nurses monitored health status pre-radiotherapy, adjusting care plans promptly. End-of-life care showcased comprehensive palliative support and bereavement guidance, contrasting varied national practices, underscoring the need for standardized protocols and enhanced training nationwide CONCLUSION Nursing care’s pivotal role in optimizing outcomes and quality of life for pediatric pontine glioma patients and families was emphasized. The study’s implications extend to healthcare policy, education, and practice, stressing collaborative efforts to improve standards and patient outcomes.

Heterogeneity in happiness: A latent profile analysis of single emerging adults.

Whether attending college, entering the workforce, or finding a romantic partner, single emerging adults navigate a pivotal stage of their lives. The present cross-sectional study sought to examine the heterogeneity in happiness of single emerging adults (N = 1,073) with a person-centered, group-differential approach. Using five predictors of life satisfaction (friendship satisfaction, family satisfaction, self-esteem, neuroticism, and extraversion) as indicators in latent profile analysis (LPA), we identified five distinct profiles (or groups) of young singles. The profiles, ordered from favorable to unfavorable indicator patterns, presented diverse shape and level differences that corresponded to varying happiness levels. Singles in Profile 1 with the most favorable indicator patterns (e.g., high friendship satisfaction, low neuroticism) were the happiest, while those in Profile 5 with the least favorable indicator patterns (e.g., low friendship satisfaction, high neuroticism) were the unhappiest. In the middle profiles, singles often offset disadvantages in one area (e.g., high neuroticism) with advantages in others (e.g., high friendship satisfaction) to achieve average to somewhat high levels of happiness. Importantly, friendship satisfaction emerged as a vital indicator, often distinguishing which singles were happy or not. Covariate analyses further validated the profiles and revealed additional profile differences (e.g., gender, anxiety, depression). Overall, our findings underscore the essential role of satisfying friendships in promoting the well-being of single emerging adults.

Association Between Nursing Home 5-Star Rating and Consumer Satisfaction

ObjectiveConsumers can currently access the Centers for Medicare and Medicaid Services 5-Star Quality Rating System when they choose a nursing home (NH). However, the system does not incorporate NH consumers’ opinions. Without having access to satisfaction or quality-of-life measures, consumers could make uninformed decisions. This study aims to investigate the association between 5-star ratings and family/resident satisfaction scores. DesignSecondary data analysis was used. Setting and ParticipantsA unique, NH-level dataset of Ohio NHs that contains star ratings, satisfaction scores, and NH characteristics was constructed (N = 701). Data were drawn from the 2018 star rating data, 2018 Ohio Nursing Home Family Satisfaction Survey, 2017 Ohio Nursing Home Resident Satisfaction Survey, 2017 Ohio Biennial Survey of Long-Term Care Facilities, and the Certification and Survey Provider Enhanced Reports. MethodsChi-square and logistic regression analyses were conducted controlling other NH characteristics. ResultsChi-square results showed consumer satisfaction and star ratings were correlated, but imperfectly related. Regression results found that NHs with higher family satisfaction score received significantly higher star ratings across all domains except the quality-measure star rating. For each 1% point increase in the family satisfaction score, the probability of being a 4 to 5 overall star NH increases by 1.1% point (P < .01), and being a 4 to 5 health inspection star NH increases by 1.2% points (P < .01). NHs with higher resident satisfaction score received significantly higher star ratings. For every 1% point increase in the resident satisfaction score, the probability of being a 4- to 5-star NH increases by 0.7% point (P < .05) across all star ratings. Conclusions and ImplicationsEarly studies found little relationship between 5-star ratings and consumer satisfaction scores. This study found consumer satisfaction is associated, although imperfectly, with star ratings. This highlights the need to publicly report NH consumer perspectives to help them make informed care decisions.

Exploring the factors contributing to parent stress symptoms during the COVID-19 pandemic in Europe: An ABC-X model approach.

The COVID-19 pandemic has had a significant impact on the mental health and well-being of families worldwide, with parents particularly at risk for stress and other psychological symptoms. In this study, we sought to understand the factors contributing to parent stress symptoms during the early stages of the pandemic in 23 European countries (N = 40,138) using the double ABC-X model. We examined whether the relationship between stressor pile-up and perceived stress was mediated by family satisfaction and relationship satisfaction and whether family resiliency beliefs impacted these mediated relationships. Our results showed a direct association between stressor pile-up and parent stress symptoms, but we did not find evidence for the mediating role of family satisfaction or relationship satisfaction in this relationship. We also found that family resiliency beliefs did not moderate the indirect effects of family satisfaction and relationship satisfaction on parent stress symptoms. These findings suggest that the ABC-X model may not fully capture the processes affecting parents' experience of stress during the pandemic and that alternative models such as the vulnerability-stress-adaptation model may be more relevant. Future research should also consider the potential negative impact of resiliency beliefs on mental health and other risk and protective factors such as self-compassion.

Do integrated stroke units affect patient and family experience of care transitions?

Purpose Patients and families identify discharge from hospital as highly challenging. Less is known about experiences of transition between acute services and inpatient rehabilitation. We aimed to understand the experiences of patients and families as they transition to inpatient rehabilitation services, before and after the opening of a new integrated stroke and rehabilitation unit (ISU). Materials and methods Adults were recruited 7 days after transfer to inpatient rehabilitation, in two 6-month periods before and after the opening of the ISU. Their experiences of care continuity were evaluated with a survey. Univariate analyses compared survey data pre- and post-ISU. A subset of participants completed semi-structured interviews that underwent thematic analysis. Results 150 patients were recruited (median age 60 years, range 20-92 years, 72 female). There were no differences between pre- and post-ISU survey scores for patient or family experiences (all p > 0.3). Interview analysis identified 3 major themes: “Whānaungatanga - the foundation of patient experience”, “In the dark and out of control”, and “A nice view…but I want to be able to do more.” Conclusions Implementation of an integrated stroke and rehabilitation unit maintained levels of patient and family satisfaction. Interviews identified important themes for services planning to improve patient experience.

Clinical Care Trajectory Assessment of Children With Congenital Diaphragmatic Hernia and Neurodevelopmental Impairment

BackgroundInterdisciplinary long-term health surveillance identifies opportunities to mitigate CDH-related multisystem morbidity, particularly in patients with neurodevelopmental impairment (NDI). However, no studies to date have assessed the impact of these morbidities on the patient/family. Our aim was to describe the clinical trajectory of patients with CDH and NDI (CDH-NDI), and to explore the lived experience and satisfaction of families with existing support resources. MethodsA multi-phase explanatory study (REB 2023–8964) was conducted. Phase 1: Review of clinical data for CDH-NDI patients attending a longitudinal follow-up clinic; Phase 2: Satisfaction assessment of CDH-NDI families with existing hospital resources. Standard statistical analyses were performed for Phases 1 and 2, respectively. ResultsOf 91 patients included, 27 had NDI, stratified into mild (n = 2), moderate (n = 7), and severe (n = 18) cohorts. Ventilation (16 vs. 8; p < 0.001), ICU (34 vs. 18; p < 0.001) and hospital (41 vs. 22; p < 0.001) days were significantly longer in the severe cohort. The severe cohort required significantly more unscheduled visits, particularly in the first four years of life (p < 0.05). Despite high family satisfaction with existing resources, team communication during ICU-ward transfers could be improved. Parents also desired to share experiences with other CDH families. ConclusionCDH children with NDI require increased support, particularly in the first four years of life. While clinic satisfaction is high, improvement of team communication and access to support resources remain high priorities for parents. Level of EvidenceLevel II (prospectively collected data, retrospective analysis).

Mitigating Alarm Fatigue and Improving the Bedside Experience by Reducing Nonactionable Alarms

To assess whether conditional bedside alarm triggers can reduce the frequency of non-actionable alarms without compromising patient safety and enhance nursing and family satisfaction. Single center, quality improvement initiative in an acute care cardiac unit (ACCU) and pediatric intensive care unit (PICU). Following the 4-week pre-intervention baseline period, bedside monitors were programmed with hierarchical time delay and conditional alarm triggers. Bedside alarms were tallied for 4 weeks each in the immediate post intervention period and 2-year follow-up. The primary outcome was alarms per monitored patient day. Nurses and families were surveyed pre- and post-intervention. A total of 1509 patients contributed to 2034, 1968, and 2043 monitored patient days which were evaluated in the baseline, follow-up, and 2-year follow-up periods, respectively. The median number of alarms per monitored patient day decreased by 75% in the PICU (p<0.001) and 82% in the ACCU (p<0.001) with sustained effect at 2-year follow-up. No increase of rapid response calls, emergent transfers, or code events occurred in either unit. Nursing surveys reported an improved capacity to respond to alarms and fewer perceived non-actionable alarms. Family surveys, however, did not demonstrate improved sleep quality. Implemented changes to bedside monitor alarms decreased total alarm frequency in both the acute care cardiac unit and pediatric intensive care unit, improving the care provider experience without compromising safety.

Multicomponent family support intervention in intensive care units: statistical analysis plan for the cluster-randomized controlled FICUS trial

The FICUS trial is a cluster-randomized superiority trial to determine the effectiveness of a nurse-led, interprofessional family support intervention (FSI) on the quality of care, family management and individual mental health of family members of critically ill patients, compared to usual care. This paper describes the statistical analysis plan of the FICUS trial. The primary outcome is quality of family care, assessed by the Family Satisfaction in ICU Questionnaire (FS-ICU-24R) at patient discharge from the ICU. Several secondary outcomes are additionally assessed 3, 6, and 12 months thereafter. Sixteen clusters (ICUs) were randomly assigned 1:1 to FSI or usual care using minimization (8 per treatment). The target sample size is 56 patients per cluster (896 in total). Recruitment has been completed in January 2024. The follow-up of the last participant will be completed in early 2025. The primary and secondary outcomes will be analyzed by linear mixed-effects models (LMM). The main model for the primary outcome will include a random intercept per cluster with treatment (FSI vs. usual care) as the only explanatory variable due to the relatively small number of clusters. In addition, covariate-adjusted analyses will be conducted, including two cluster-level characteristics used in the minimization as well as participant-level characteristics. Moreover, a number of subgroup analyses by cluster- and participant-level characteristics are pre-specified.Trial registration ClinicalTrials.gov NCT05280691. Registered on February 20, 2022.

Evaluation of simulation-based intervention for implicit bias mitigation: A response to systemic racism

BackgroundTraining health care professionals to mitigate implicit biases can reduce health inequities caused by racism. Implicit bias mitigation strategies (IBMS) have been shown to reduce biased behaviors. This study aimed to determine the impact of IBMS practice simulation on learners’ behaviors and family experience in one hospital unit. MethodsThis study used a quasi-experimental design in a large pediatric hospital. In total, 195 participants completed a simulation-based education intervention. Learners practiced IBMS with Simulated Participants. Participant perceptions were measured at four time points, and translational outcomes were collected using survey results and other outcomes. ResultsSituational judgment test results improved postintervention and at follow-up. Participants reported using IBMS skills at time points three and four. Internal and External Motivation Scale and family satisfaction scores remained unchanged. Family experience measures improved, showing decreases in security dispatch calls for perceived family escalation and in deny entries and behavioral contracts stratified by race. ConclusionsSimulation can shift perspectives and behaviors. More research is needed on the impact of simulation-based interventions on IBMS skill development and translational outcomes.