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Yu H. Improving pressure ulcer care in intensive care units: Evaluating the impact of bundled care and silver nanoparticle dressings. World J Clin Cases 2024; 12:3873-3881. [PMID: 38994315 PMCID: PMC11235428 DOI: 10.12998/wjcc.v12.i19.3873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/28/2024] [Accepted: 05/11/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Pressure ulcer (PU) are prevalent among critically ill trauma patients, posing substantial risks. Bundled care strategies and silver nanoparticle dressings offer potential solutions, yet their combined effectiveness and impact on patient satisfaction remain insufficiently investigated. AIM To assess the impact of bundled care along with silver nanoparticle dressing on PUs management and family satisfaction in critically ill trauma patients. METHODS A total of 98 critically ill trauma patients with PUs in intensive care unit (ICU) were included in this study. Patients were randomly assigned to either the control group (conventional care with silver nanoparticle dressing, n = 49) or the intervention group (bundled care with silver nanoparticle dressing, n = 49). The PU Scale for Healing (PUSH) tool was used to monitor changes in status of pressure injuries over time. Assessments were conducted at various time points: Baseline (day 0) and subsequent assessments on day 3, day 6, day 9, and day 12. Family satisfaction was assessed using the Family Satisfaction ICU 24 questionnaire. RESULTS No significant differences in baseline characteristics were observed between the two groups. In the intervention group, there were significant reductions in total PUSH scores over the assessment period. Specifically, surface area, exudate, and tissue type parameters all showed significant improvements compared to the control group. Family satisfaction with care and decision-making was notably higher in the intervention group. Overall family satisfaction was significantly better in the intervention group. CONCLUSION Bundled care in combination with silver nanoparticle dressings effectively alleviated PUs and enhances family satisfaction in critically ill trauma patients. This approach holds promise for improving PUs management in the ICU, benefiting both patients and their families.
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Affiliation(s)
- Hong Yu
- Department of Intensive Care Unit, The First People's Hospital of Ziyang, Ziyang 641300, Sichuan Province, China
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Tabah A, Ramanan M, Bailey RL, Chavan S, Baker S, Huckson S, Pilcher D, Litton E. Family visitation policies, facilities, and support in Australia and New Zealand intensive care units: A multicentre, registry-linked survey. Aust Crit Care 2022; 35:375-382. [PMID: 34353725 DOI: 10.1016/j.aucc.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The objective of this study was to describe family visitation policies, facilities, and support in Australia and New Zealand (ANZ) intensive care units (ICUs). METHODS A survey was distributed to all Australian and New Zealand ICUs reporting to the Australian and New Zealand Intensive Care Society Centre for Outcomes and Resources Evaluation Critical Care Resources (CCR) Registry in 2018. Data were obtained from the survey and from data reported to the CCR Registry. For this study, open visiting (OV) was defined as allowing visitors for more than 14 h per day. SETTING AND PARTICIPANTS This study included all Australian and New Zealand ICUs reporting to CCR in 2018. MAIN OUTCOME MEASURES The main outcome measures were family access to the ICU and visiting hours, characteristics of the ICU waiting area, and information provided to and collected from the relatives. FINDINGS Fifty-six percent (95/170) of ICUs contributing to CCR responded, representing 44% of ANZ ICUs and a range of rural, metropolitan, tertiary, and private ICUs. Visiting hours ranged from 1.5 to 24 h per day, with 68 (72%) respondent ICUs reporting an OV policy, of which 64 (67%) ICUs were open to visitors 24 h a day. A waiting room was part of the ICU for 77 (81%) respondent ICUs, 74 (78%) reported a separate dedicated room for family meetings, and 83 (87%) reported available social worker services. Most ICUs reported facilities for sleeping within or near the hospital. An information booklet was provided by 64 (67%) ICUs. Only six (6%) ICUs required personal protective equipment for all visitors, and 76 (80%) required personal protective equipment for patients with airborne precautions. CONCLUSIONS In 2018, the majority of ANZ ICUs reported liberal visiting policies, with substantial facilities and family support.
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Affiliation(s)
- Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, 4020, Redcliffe, Queensland, Australia; Faculty of Medicine, University of Queensland, 4029, Brisbane, Queensland, Australia.
| | - Mahesh Ramanan
- Faculty of Medicine, University of Queensland, 4029, Brisbane, Queensland, Australia; Intensive Care Units, Caboolture and Prince Charles Hospitals, Queensland, Australia; The George Institute for Global Health, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia.
| | - Rachel L Bailey
- Intensive Care Outreach, Caboolture Hospital, Caboolture, Queensland, Australia.
| | - Shaila Chavan
- ANZICS Centre for Outcome and Resource Evaluation, Camberwell, Victoria, Australia.
| | - Stuart Baker
- Intensive Care Unit, Redcliffe Hospital, 4020, Redcliffe, Queensland, Australia; Faculty of Medicine, University of Queensland, 4029, Brisbane, Queensland, Australia.
| | - Sue Huckson
- ANZICS Centre for Outcome and Resource Evaluation, Camberwell, Victoria, Australia.
| | - David Pilcher
- ANZICS Centre for Outcome and Resource Evaluation, Camberwell, Victoria, Australia; Department of Intensive Care, The Alfred Hospital, Prahran, Victoria, Australia; The Australian and New Zealand Intensive Care - Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Edward Litton
- ANZICS Centre for Outcome and Resource Evaluation, Camberwell, Victoria, Australia; Intensive Care Unit, St John of God Hospital, Perth, Western Australia, Australia; School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
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Chiang MC, Huang CC, Hu TH, Chou WC, Chuang LP, Tang ST. Factors associated with bereaved family surrogates' satisfaction with end-of-life care in intensive care units. Intensive Crit Care Nurs 2022; 71:103243. [PMID: 35396097 DOI: 10.1016/j.iccn.2022.103243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Family satisfaction with end-of-life care in the intensive care unit constitutes an important outcome for evaluating end-of-life care quality. Research on this topic focuses on linking end-of-life care processes to family-surrogate satisfaction with the patient's end-of-life care but has seldom examined patient- and family-surrogate-based factors. We aimed to comprehensively and simultaneously examine factors facilitating or deterring family satisfaction with end-of-life care in the intensive care unit from patient- and family-surrogate perspectives. METHODS For this secondary-analysis study, 278 Taiwanese family surrogates were surveyed one-month post-patient death using the Family Satisfaction in the Intensive Care Unit questionnaire (FS-ICU), which measures care and decision-making. Associations between family satisfaction with end-of-life care and patient and family characteristics, patient disease severity, and length of intensive care stay were examined by multivariate, multilevel linear regression models. RESULTS Female family surrogates were more satisfied with patients' end-of-life care than male family surrogates when patients had a higher APACHE II but a lower SOFA score. Adult-child surrogates had lower FS-ICU Care scores than other family surrogates. Higher satisfaction with ICU decision-making was associated with patients' higher APACHE II but lower SOFA scores, longer stay and family socio-demographics, including being unmarried, educational attainment above junior high school and reported financial sufficiency to make ends meet. CONCLUSION Patient disease severity and family-surrogate characteristics are significantly associated with surrogates' satisfaction with patients' end-of-life care in the intensive care unit. Specific interventions should be tailored to the needs of high-risk family surrogates to increase their satisfaction with this care.
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Affiliation(s)
- Ming Chu Chiang
- Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Taiwan, ROC
| | - Chung-Chi Huang
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan, ROC; Department of Respiratory Therapy, Chang Gung University, Tao-Yuan, Taiwan, ROC
| | - Tsung-Hui Hu
- Department of Internal Medicine, Division of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan, ROC
| | - Wen-Chi Chou
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan, ROC; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan, ROC
| | - Li-Pang Chuang
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan, ROC
| | - Siew Tzuh Tang
- Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Taiwan, ROC; Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan, ROC; School of Nursing, Medical College, Chang Gung University, Tao-Yuan, Taiwan, ROC.
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Garg SK. Patients' Family Satisfaction in Intensive Care Unit: A Leap Forward. Indian J Crit Care Med 2022; 26:161-163. [PMID: 35712749 PMCID: PMC8857726 DOI: 10.5005/jp-journals-10071-24120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Garg SK. Patients' Family Satisfaction in Intensive Care Unit: A Leap Forward. Indian J Crit Care Med 2022;26(2):161-163.
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Affiliation(s)
- Sunil Kumar Garg
- Department of Critical Care, NMC Healthcare, Dubai, United Arab Emirates
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Padilla Fortunatti C, De Santis JP, Munro CL. Family Satisfaction in the Adult Intensive Care Unit: A Concept Analysis. ANS Adv Nurs Sci 2021; 44:291-305. [PMID: 33624988 DOI: 10.1097/ans.0000000000000360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Admission of patients to an intensive care unit is often a stressful event for family members. In the context of patient- and family-centered care, family satisfaction is recognized as a quality indicator of intensive care unit care. However, family satisfaction has not been consistently used or conceptualized in the literature. A modified version of Walker and Avant's method for concept analysis was utilized to examine the concept of family satisfaction in the adult intensive care unit. Antecedents, attributes, consequences, and empirical referents of family satisfaction are presented and implications for practice, research, and policy.
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Affiliation(s)
- Cristobal Padilla Fortunatti
- University of Miami, School of Nursing & Health Studies, Coral Gables, Florida (Ms Padilla Fortunatti and Drs De Santis and Munro); and Department of the Adult and the Senescent, Pontificia Universidad Católica de Chile, School of Nursing, Santiago, Chile (Ms Padilla Fortunatti)
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Brandao Barreto B, Luz M, do Amaral Lopes SAV, Rosa RG, Gusmao-Flores D. Exploring family members' and health care professionals' perceptions on ICU diaries: a systematic review and qualitative data synthesis. Intensive Care Med 2021; 47:737-749. [PMID: 34117901 DOI: 10.1007/s00134-021-06443-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Although the intensive care unit (ICU) diary has been proposed as a tool for preventing psychiatric symptoms in survivors of critical illness, relatives and health care providers may benefit from it too. This study aims to summarize the current qualitative evidence on families' and health care professionals' experiences of writing in and reading the ICU diaries. METHODS We searched MEDLINE, OVID, Embase, and EBSCOhost from inception to February 2021, and included all the studies that presented any qualitative finding regarding relatives' and health care providers' experiences of writing in and reading an ICU diary. We used modified Critical Appraisal Skills Programme (CASP) and Confidence in the Evidence from Reviews of Qualitative Research (CERQual) for quality assessment. A thematic synthesis approach was used to analyze and synthesize the qualitative data. RESULTS Twenty-eight studies were analyzed (15 including family members and 13 including health care professionals). For family members, the ICU diary is an important source of medical information, provides a way for them to register their presence at patient's bedside and express their feelings, and contributes to humanizing the ICU staff. This impression is shared by relatives of patients who did not survive critical illness. Health care providers believe the diary is beneficial for themselves and others; however, they are concerned with possible negative impressions from patients and family that could lead to judicial problems. They also remark on several obstacles they face when constructing the diaries (workload, creativity, and environment for writing), which can make it a distressful process. CONCLUSION This qualitative synthesis shows that family members and health care professionals consider the ICU diary a valuable intervention. It also brings evidence to challenges faced during diary writing, which should be carefully approached in order to reduce the stress associated with this process.
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Affiliation(s)
- Bruna Brandao Barreto
- Intensive Care Unit of the Hospital da Mulher, Rua Barão de Cotegipe, 1153, Roma, Salvador, BA, 40411-900, Brazil. .,Programa de Pós Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
| | - Mariana Luz
- Intensive Care Unit of the Hospital da Mulher, Rua Barão de Cotegipe, 1153, Roma, Salvador, BA, 40411-900, Brazil.,Programa de Pós Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Selma Alves Valente do Amaral Lopes
- Department of Paediatrics, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Neonatal Intensive Care Unit, Hospital Martagão Gesteira, Salvador, Bahia, Brazil
| | - Regis Goulart Rosa
- Intensive Care Unit, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Dimitri Gusmao-Flores
- Intensive Care Unit of the Hospital da Mulher, Rua Barão de Cotegipe, 1153, Roma, Salvador, BA, 40411-900, Brazil.,Departamento de Medicina Interna E Apoio Diagnóstico, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Programa de Pós Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Intensive Care Unit, Hospital da Cidade, Salvador, Bahia, Brazil
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Burlakov N, Rozani V, Bluvstein I, Kagan I. The Association Between Quality and Safety Climate of a Hospital Ward, Family Members' Empowerment, and Satisfaction With Provided Care. J Nurs Scholarsh 2021; 53:727-736. [PMID: 34048128 DOI: 10.1111/jnu.12682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study was designed to examine the perceptions of ward quality and safety held by family members and nurses, and investigate its impact on family members' empowerment, and satisfaction with patient hospitalization. DESIGN A cross-sectional study on two study groups was conducted at a large public hospital in Israel. The first group comprised 86 family members of patients hospitalized for more than 72 hours in acute critical condition in intensive care units (ICU) or general wards (GW). The second group included 101 registered nurses who treated the patients in the ICU or GW. METHODS Data were collected by a validated self-administered structured questionnaire. All participants voluntarily signed an informed consent and answered questions related to their demographic characteristics, perceptions, and attitudes toward quality and safety climate, empowerment, and satisfaction with the patients' hospitalization. Pearson correlations coefficient, t-test for independent samples, and a multiple regression model were performed to analyze the data. FINDINGS The mean age of family members was 51.4 ± 14.1 years and of nurses was 40.9 ± 9.9 years. A significant positive association was found between ward quality and safety climate and empowerment of the family member (r = .716; p < .001); empowerment of the family member and family members' satisfaction with the patients' hospitalization (r = .695; p < .001); and ward safety and quality climate and family members' satisfaction with the patients' hospitalization (r = .763; p <.001). Family members ranked ward quality and safety climate (M = 4.20 ± 0.60 vs. M = 3.61 ± 0.40), and their satisfaction with the patients' hospitalization (M = 4.49 ± 0.69 vs. M = 4.07± 0.54), which were significantly (p < .001) higher than the nurses' estimate. The significant predictors for family members' satisfaction with patients' hospitalization were commitment to quality leadership (b = .210; p = .027); implementing a quality improvement (b = .547; p < .001); and hand-off communication (b = .299; p = .001). CONCLUSIONS Positive relationships between quality and safety climate, empowerment, and satisfaction with patients' hospitalization suggest that by improving the ward quality and safety climate, and family empowerment, we may also improve family satisfaction. Although family members reported being satisfied with hospitalization in the ICU and GW, quality leadership and implementing a quality improvement among the nurses and hand-off communication between nurses and patients' families, will be targeted to improve family satisfaction with the patients' hospitalization. CLINICAL RELEVANCE Nurses who provide care for patients in a critical condition should maintain high levels of safety and quality care in order to improve the patients' family empowerment and satisfaction. Specifically, their efforts should target a commitment to quality leadership, implementing quality improvement, and hand-off communication.
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Affiliation(s)
- Nataly Burlakov
- Senior Nurse, Intensive Care Unit, Bnei Zion Medical Center, Haifa, Israel
| | - Violetta Rozani
- Lecture, Department of Nursing, The Stanley Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Irit Bluvstein
- Teacher, Department of Nursing, The Stanley Steyer School of Health Professions; School of Psychological Sciences and the Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel
| | - Ilya Kagan
- Senior Lecturer, Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Analyzing clinical and system drivers of satisfaction in the intensive care unit as a component of high quality care. Heart Lung 2020; 50:277-283. [PMID: 33383546 DOI: 10.1016/j.hrtlng.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 12/06/2020] [Accepted: 12/22/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Quality improvement in the intensive care unit has transitioned from focusing on mortality to improving care and reducing morbidity. OBJECTIVE This study prospectively investigated clinical and system drivers of family satisfaction in a large quaternary hospital ICU. METHODS A validated tool was distributed to family members and a registry chart analysis was conducted. The aims were to assess associations with high or low family satisfaction to evaluate unit-level satisfaction. Candidate predictors were selected from univariate logistic regressions and finalized in a multivariate model by a stepwise selection approach. RESULTS Overall, 75% (n = 188) of respondents (n = 250) indicated high satisfaction. Respondents with higher satisfaction had a Plan of the Day posted (OR = 3.3, 95% CI: 1.63, 6.89, p = 0.001), and did not live with the patient (OR =0.5, 95% CI: 0.25, 0.96, p = 0.044). CONCLUSION This study indicates that communication and transparency of plans contributes to family satisfaction with ICU care.
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Puppala M, Ezeana CF, Alvarado MVY, Goode KN, Danforth RL, Wong SS, Vassallo ML, Wong ST. A multifaceted study of hospital variables and interventions to improve inpatient satisfaction in a multi-hospital system. Medicine (Baltimore) 2020; 99:e23669. [PMID: 33371105 PMCID: PMC7748194 DOI: 10.1097/md.0000000000023669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022] Open
Abstract
Knowing the areas of service, actions, and parameters that can influence patient perception about a service provided can help hospital executives and healthcare workers to devise improvement plans, leading to higher patient satisfaction. To identify inpatient satisfaction determinants, assess their relationships with hospital variables, and improve patient satisfaction through interventions. We studied the inpatient population of an eight-hospital tertiary medical center in 2015. The satisfaction determinants were based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey answers and included clinical and organizational variables. Interventions began at the end of 2016 included bedside care coordination rounds (BCCR), medications best practices alert (BPA), connect transitions post-discharge calls (CONNECT Transitions) and a framework for provider-patient interactions called AIDET (Acknowledge, Introduce, Duration, Explain, and Thank). Substantial impact upon patient satisfaction was observed after the introduction of these interventions. Three groups were identified: 1. high satisfaction, which correlated with race, surgery, and cancer care; 2. low satisfaction, correlated with elderly, emergency room, intensive care unit, chronic obstructive pulmonary disease, and vascular diseases; and 3. neutral, correlated with hospital-acquired complications, several diagnostic procedures, and medical care delay. Significant improvements in the 3 groups were achieved with interventions that optimize care provider interactions with patients and their families. Based on the HCAHPS-based analysis, we implemented new measures and programs for addressing coordination of care, improving patient safety, reducing the length of stay, and ultimately improving patient satisfaction.
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Affiliation(s)
| | | | | | | | | | - Solomon S.Y. Wong
- Department of Systems Medicine and Bioengineering
- Present address: Baylor University School of Law, Waco, TX
| | - Mark L. Vassallo
- Department of Quality Operations, Houston Methodist Hospital, Houston, Texas
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Trust MD, Lara S, Hecht J, Teixeira PG, Coopwood B, Aydelotte J, Cardenas TCP, Guerra E, Ali S, Brown CVR. A Prospective Study of Family Satisfaction Changes After Tracheostomy Placement in Trauma Patients. Am Surg 2020; 87:961-964. [PMID: 33295184 DOI: 10.1177/0003134820954831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tracheostomy is a commonly performed procedure in surgical intensive care units. Although the indications and benefits of this procedure are well known, little has been studied in the adult surgical/trauma population about patient family satisfaction after tracheostomy placement. MATERIALS AND METHODS We performed a prospective study at our academic level I trauma center from 2015-2016 in patients who underwent elective tracheostomy. Family members were asked to complete an eight-point questionnaire using a forced Likert scale of graded responses. Questionnaires were administered prior to tracheostomy and again at 24-and 72-hour post-tracheostomy placement. Responses were compared using univariate analysis. RESULTS A total of 26 family members completed all 3 surveys. Family members believed loved ones appeared more comfortable, were more interactive, and were better progressing clinically. After 72 hours, family members felt less anxiety. There was no difference in perceptions of patient distress, ability to provide support, or their worry about scars, or comfort in visiting them. DISCUSSION Family members believed tracheostomies provided greater patient comfort, increased interactive abilities, better progress in their care, and experienced less anxiety after placement. Family satisfaction may therefore be an additional benefit in support of earlier tracheostomy.
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Affiliation(s)
- Marc D Trust
- Dell Medical School, The University of Texas, Austin, USA
| | - Sabino Lara
- Dell Medical School, The University of Texas, Austin, USA
| | - Jonathan Hecht
- Dell Medical School, The University of Texas, Austin, USA
| | | | - Ben Coopwood
- Dell Medical School, The University of Texas, Austin, USA
| | | | | | - Erin Guerra
- Dell Medical School, The University of Texas, Austin, USA
| | - Sadia Ali
- Dell Medical School, The University of Texas, Austin, USA
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Abstract
OBJECTIVE Investigate clinical and system drivers of family satisfaction in the PICU. DESIGN Mixed methods qualitative and quantitative (observational) study. Qualitative interviews with families were performed as a pilot to inform modality of survey distribution based on family preferences. A validated pediatric satisfaction survey deployed to family members for 7 months with a corresponding chart review and administrative data collection. SETTING PICU in a tertiary children's hospital. PATIENTS Two hundred six families of patients admitted to the PICU more than 48 hours. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Families preferred surveys distributed electronically on a tablet in the PICU setting. The Pediatric Family Satisfaction-ICU survey was used to assess comfort with medical decision-making and communication with the care team. Capture rate of all eligible patients was 69.5% and response rate was 90.8%. Overall, 64.7% of respondents were highly satisfied, whereas over one third were not highly satisfied; families of Hispanic ethnicity (odds ratio of lower satisfaction of families with Hispanic ethnicity: 2.09; 95% CI, 1.01-4.33; p = 0.047) and high social stressors (odds ratio of higher satisfaction among high stressed subgroup: 0.49; 95% CI, 0.24-0.99; p = 0.047) reported statistically significant lower satisfaction. Additional free-text responses were identified in 21% of respondents, with the majority of comments indicating wishes for improvements clustered around communication with the medical team or sleeping environment of families and patients. CONCLUSIONS High capture rates of family satisfaction in the PICU can be obtained with a PICU-specific survey, limiting barriers to completion by including family preferences, and distributing in the PICU setting. Less than two-third of PICU families are highly satisfied; patients of Hispanic ethnicity and those with high social stressors predict low satisfaction, whereas illness severity, age, and PICU length of stay did not have statistical significance. Local improvement teams can use this approach to drive enhanced satisfaction.
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Tajarernmuang P, Chittawatanarat K, Dodek P, Heyland DK, Chanayat P, Inchai J, Pothirat C, Liwsrisakun C, Bumroongkit C, Deesomchok A, Theerakittikul T, Limsukon A. Validity and Reliability of a Thai Version of Family Satisfaction with Care in the Intensive Care Unit Survey. Indian J Crit Care Med 2020; 24:946-954. [PMID: 33281320 PMCID: PMC7689133 DOI: 10.5005/jp-journals-10071-23559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To examine reliability and validity of a Thai version of the Family Satisfaction with Intensive Care Unit (FS-ICU 24) questionnaire and use this survey in intensive care units (ICUs) in Thailand. Materials and methods The standard English FS-ICU questionnaire was translated into the Thai language using translation and culture adaptation guidelines. After reliability and validity testing, we consecutively surveyed the satisfaction of family members of ICU patients over 1 year. Adult family members of patients admitted to medical or surgical ICUs for 48 hours or more who had visited the patients at least once during the ICU stay were included. Results In all, 315 (95%) of 332 surveys were returned from family members. Cronbach's α of the Thai FS-ICU 24 questionnaire was 0.95. Factor analysis demonstrated good construct validity. The mean (±SD) of total satisfaction score, overall ICU care subscale, and decision-making subscale were 81.5 ± 14.3, 81.0 ± 15.6, and 82.0 ± 14.0. Items with the lowest scores were the waiting room atmosphere and the frequency of doctors communicating with family members about the patient's condition. The mean total satisfaction score tended to be higher in family members of survivors than in family members of nonsurvivors (81.9 ± 13.8 vs 77.7 ± 16.2, p value = 0.059). The overall satisfaction scores between medial ICU and surgical ICU were not significantly different. Conclusion The Thai version of FS-ICU questionnaire was found to have acceptable reliability and validity in a Thai population and can be used to drive improvements in ICU care. Trial registration www.clinicaltrials.in.th, TCR20160603002 How to cite this article Tajarernmuang P, Chittawatanarat K, Dodek P, Heyland DK, Chanayat P, Inchai J, et al. Validity and Reliability of a Thai Version of Family Satisfaction with Care in the Intensive Care Unit Survey. Indian J Crit Care Med 2020;24(10):946–954.
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Affiliation(s)
| | | | - Peter Dodek
- Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada; Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Daren K Heyland
- Clinical Evaluation Research Unit, Queen's University; Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | - Panida Chanayat
- Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Juthamas Inchai
- Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | | | | | - Atikun Limsukon
- Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
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13
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Family ratings of ICU care. Is there concordance within families? J Crit Care 2019; 55:108-115. [PMID: 31715527 DOI: 10.1016/j.jcrc.2019.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/09/2019] [Accepted: 10/23/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE To examine heterogeneity of quality-of-care ratings within families and to examine possible predictors of concordance. MATERIALS AND METHODS We examined two aspects of agreement within families: response similarity and the amount of exact concordance in responses in a cohort of Danish ICU family members participating in a questionnaire survey (the European Quality Questionnaire: euroQ2). RESULTS Two hundred seventy-four family respondents representing 122 patients were included in the study. Identical ratings between family members occurred in 28%-59% of families, depending upon the specific survey item. In a smaller sample of 28 families whose patients died, between 39% and 86% gave identical responses to items rating end-of-life care. There was more response variance within than between families, yielding low estimates of intrafamily correlation. Statistics correcting for chance agreement also suggested modest within-family agreement. CONCLUSIONS The finding that variance is higher within than between families suggests the value of including multiple participants within a family in order to capture varying points of view.
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14
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Weber U, Johnson J, Anderson N, Knies AK, Nhundu B, Bautista C, Huang KB, Hamza M, White J, Coppola A, Akgün KM, Greer DM, Marcolini EG, Gilmore EJ, Petersen NH, Timario N, Poskus K, Sheth KN, Hwang DY. Dedicated Afternoon Rounds for ICU Patients' Families and Family Satisfaction With Care. Crit Care Med 2019; 46:602-611. [PMID: 29300237 DOI: 10.1097/ccm.0000000000002963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU. DESIGN Pre- and postimplementation (pre-I and post-I) design. SETTING Single academic neuroscience ICU. PATIENTS Patients in the neuroscience ICU admitted for longer than 72 hours or made comfort measures only at any point during neuroscience ICU admission. INTERVENTION The on-service attending intensivist and a neuroscience ICU nursing leader made bedside visits to families to address concerns during regularly scheduled, advertised times two afternoons each week. MEASUREMENTS AND MAIN RESULTS One family member per patient during the pre-I and post-I periods was recruited to complete the Family Satisfaction in the ICU 24 instrument. Post-I respondents indicated whether they had participated in the afternoon rounds. For primary outcome, the mean pre-I and post-I composite Family Satisfaction in the ICU 24 scores (on a 100-point scale) were compared. A total of 146 pre-I (March 2013 to October 2014; capture rate, 51.6%) and 141 post-I surveys (October 2014 to December 2015; 47.2%) were collected. There was no difference in mean Family Satisfaction in the ICU 24 score between groups (pre-I, 89.2 ± 11.2; post-I, 87.4 ± 14.2; p = 0.6). In a secondary analysis, there was also no difference in mean Family Satisfaction in the ICU 24 score between the pre-I respondents and the 39.0% of post-I respondents who participated in family rounds. The mean Family Satisfaction in the ICU 24 score of the post-I respondents who reported no participation trended lower than the mean pre-I score, with fewer respondents in this group reporting complete satisfaction with emotional support (75% vs. 54%; p = 0.002), coordination of care (82% vs. 68%; p = 0.03), and frequency of communication by physicians (60% vs. 43%; p = 0.03). CONCLUSIONS Dedicated afternoon rounds for families twice a week may not necessarily improve an ICU's overall family satisfaction. Increased dissatisfaction among families who do not or cannot participate is possible.
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Affiliation(s)
- Urs Weber
- Yale School of Medicine, New Haven, CT
| | | | | | | | | | | | | | | | | | | | - Kathleen M Akgün
- Department of Internal Medicine, Pulmonary, Critical Care and Sleep Medicine Section, VA Connecticut Healthcare System and Yale University School of Medicine, West Haven, CT
| | - David M Greer
- Yale-New Haven Hospital, New Haven, CT.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT
| | - Evie G Marcolini
- Yale-New Haven Hospital, New Haven, CT.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT
| | - Emily J Gilmore
- Yale-New Haven Hospital, New Haven, CT.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven, CT
| | - Nils H Petersen
- Yale-New Haven Hospital, New Haven, CT.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven, CT
| | | | | | - Kevin N Sheth
- Yale-New Haven Hospital, New Haven, CT.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven, CT
| | - David Y Hwang
- Yale-New Haven Hospital, New Haven, CT.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven, CT
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15
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Thimmapur RM, Raj P, Raju B, Kanmani TR, Reddy NK. Caregivers satisfaction with intensive care unit services in tertiary care hospital. Int J Crit Illn Inj Sci 2019; 8:184-187. [PMID: 30662863 PMCID: PMC6311964 DOI: 10.4103/ijciis.ijciis_25_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Caregivers play a vital role in intensive care unit (ICU) because critically ill patients cannot make their own decisions due to their illness. Measuring family satisfaction on quality of ICU care is essential. Hence, the current paper aimed to measure the family caregiver satisfaction in ICU care in tertiary care hospital. Methods The study adopted descriptive research design conducted from July 2016 to January 2017 at ICU in Emergency and Trauma Care center. A total number of 60 consented caregivers were recruited. An Internationally validated Family satisfaction survey questionnaire (FS) was used. Continuous variables of the data were described by mean standard deviation and categorical variables by frequency (%). Normality of the continuous variables was checked by Shapiro-Wilk test. Kruskal-Wallis test was used to compare the average FS score between the groups. Results Results showed that caregiver age was ranged between 25 and 66 years with mean age 40 (±19). Among the caregivers, 75% were male and 25% were female of which 75% were married and remaining were unmarried. Around half of the caregivers (48.3) were educated up to primary or secondary and 26.7% had higher secondary education level. About 46.7% involved in manual laborers and 36.7% were working in the private sector. Family members had taken primary caregiving role without prior experience (81.7%) at ICU. Almost 95% of the caregivers were highly satisfied with ICU care and only 5% were not satisfied. Conclusion Majority of caregivers are satisfied with ICU care. However, adequate measures need to be taken to ensure the complete satisfaction among caregivers at ICU.
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Affiliation(s)
| | - Prabhu Raj
- Department of Neurosurgery, NIMHANS, Bengaluru, Karnataka, India
| | - Birudu Raju
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - T R Kanmani
- Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
| | - N Krishna Reddy
- Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
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16
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Jannes C, Miedaner F, Langhammer K, Enke C, Göpel W, Kribs A, Nitzsche A, Riedel R, Woopen C, Kuntz L, Roth B. Increased parental satisfaction by unrestricted visiting hours and developmentally supportive care in NICUs - results of a German multicenter study. J Matern Fetal Neonatal Med 2018; 33:1874-1880. [PMID: 32216530 DOI: 10.1080/14767058.2018.1532499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This study aims to provide insights into the impact of organizational family-centered care characteristics at German neonatal intensive care units (NICUs) on the satisfaction of parents of very low birthweight (VLBW) infants.Materials and methods: Using multilevel modeling, this study analyzed whether organizational characteristics of NICUs fostering parent-infant interaction (by way of the existence of a recreation room, possibility of rooming in, existence of unrestricted visiting hours for parents, existence of parental classes, and the connection to parent associations as well as the existence of standards on developmentally supportive care) increase the satisfaction of parents after the infants' high-intensive care phase within the NICU.Results: Nine hundred and twenty-three VLBW infants from 66 NICUs in Germany born between May and October 2013 were enrolled in this multicenter study. We retrieved 1493 questionnaires completed by 1277 parents. The existence of unrestricted visiting hours (adjusted odds ratio (AOR): 1.967; 95% CI [1.118, 3.459]) and standardized procedures for developmentally supportive care (AOR: 1.775; 95% CI [1.166, 2.704]) were positively associated with parental satisfaction.Conclusions: Fostering the parent-infant interaction through the provision of developmentally supportive care and unrestricted visiting hours for parents whose infants are hospitalized within an NICU significantly contributes to the satisfaction of parents.
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Affiliation(s)
- Christiane Jannes
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne; and Research Unit Ethics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Felix Miedaner
- Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany
| | - Kristina Langhammer
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University Clinic Cologne, Cologne, Germany
| | - Christian Enke
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne; and Research Unit Ethics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Wolfgang Göpel
- Department of Pediatrics, University of Lübeck, Lübeck, Germany
| | - Angela Kribs
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University Clinic Cologne, Cologne, Germany
| | - Anika Nitzsche
- Faculty of Human Sciences and Faculty of Medicine, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany
| | - Rainer Riedel
- Institute for Medical Economics and Health Services Research, Rheinische Fachhochschule Cologne, Cologne, Germany
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne; and Research Unit Ethics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Ludwig Kuntz
- Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany
| | - Bernhard Roth
- Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany.,Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University Clinic Cologne, Cologne, Germany
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17
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Ågård AS, Hofhuis JGM, Koopmans M, Gerritsen RT, Spronk PE, Engelberg RA, Randall Curtis J, Zijlstra JG, Jensen HI. Identifying improvement opportunities for patient- and family-centered care in the ICU: Using qualitative methods to understand family perspectives. J Crit Care 2018; 49:33-37. [PMID: 30359923 DOI: 10.1016/j.jcrc.2018.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/19/2018] [Accepted: 10/11/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE The purposes of the study were to provide richer context for families' quantitative assessments of the quality of ICU care, and to describe further quality areas of importance for family members. MATERIALS AND METHODS Free-text comments from 1077 family members of 920 patients focusing on family evaluation of ICU quality of care were analyzed using content analysis. Twenty-one Danish and Dutch ICUs participated from October 2014 to June 2015. RESULTS Four themes emerged as important to families: information, clinician skills, ICU environment, and discharge from the ICU. Families highlighted the importance of receiving information that was accessible, understandable and honest. They indicated that quality care was ensured by having clinicians who were both technically and interpersonally competent. The ICU environment and the circumstances of the transfer out of the ICU were described as contributing to quality of care. The comments identified room for improvement within all themes. CONCLUSIONS The study highlights the importance of including both technical and emotional care for patients and families and the consequent need to focus on clinicians' mastery of interpersonal skills.
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Affiliation(s)
- Anne Sophie Ågård
- Department of Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Århus N, Denmark; Department of Science in Nursing, Institute of Public Health, Aarhus University, Building 1260, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - José G M Hofhuis
- Department of Intensive Care Medicine Gelre Hospitals Apeldoorn, Apeldoorn, the Netherlands.
| | - Matty Koopmans
- Center of Intensive Care, Medisch Centrum Leeuwarden, PO Box 888, 8901 BR Leeuwarden, the Netherlands.
| | - Rik T Gerritsen
- Center of Intensive Care, Medisch Centrum Leeuwarden, PO Box 888, 8901 BR Leeuwarden, the Netherlands.
| | - Peter E Spronk
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| | - Ruth A Engelberg
- Division of Pulmonary, Critical Care and Sleep Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359762, Seattle, WA 98104, USA; Cambia Palliative Care Center of Excellence, University of Washington, Seattle, USA.
| | - J Randall Curtis
- Division of Pulmonary, Critical Care and Sleep Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359762, Seattle, WA 98104, USA; Cambia Palliative Care Center of Excellence, University of Washington, Seattle, USA.
| | - Jan G Zijlstra
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands.
| | - Hanne Irene Jensen
- Department of Anaesthesiology and Intensive Care, Vejle and Middelfart Hospitals, Beriderbakken 4, 7100 Vejle, Denmark; Institute of Regional Health Research, University of Southern Denmark, J.B.Winsløwsvej 19, 5000 Odense, Denmark.
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18
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Development and initial validation of the Swedish Family Satisfaction Intensive Care Questionnaire (SFS-ICQ). Intensive Crit Care Nurs 2018; 50:118-124. [PMID: 29935980 DOI: 10.1016/j.iccn.2018.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/27/2018] [Accepted: 05/02/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Measuring patients satisfaction is an important part of continuous quality improvement in health care. In intensive care, family satisfaction is often used as a proxy for patient experience. At present, no suitable instrument to measure this has been fully validated in Sweden. The purpose of this study was to develop and validate a questionnaire intended to evaluate families' satisfaction of quality of care in Swedish intensive care units. METHODS Based on literature and the modification of pertinent items in two existing North American questionnaires, a Swedish questionnaire was developed. Content validity was assessed by experts, and the cognitive method Think Aloud was used with twelve family members of intensive care patients in two different intensive care units. Data was analysed using qualitative content analysis. FINDINGS Seven items in the questionnaire were identified as problematic, causing eight problems concerning questioning of content and 23 concerning misunderstanding. Six of these items were changed in order to be understood the way they were intended, and one item was removed. CONCLUSION A family satisfaction questionnaire applicable in Swedish intensive care units has been developed and validated for respondents' understanding of the questions being asked. However, further psychometric testing should be performed when more data are available.
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19
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Clark K, Milner KA, Beck M, Mason V. Measuring Family Satisfaction With Care Delivered in the Intensive Care Unit. Crit Care Nurse 2018; 36:e8-e14. [PMID: 27908955 DOI: 10.4037/ccn2016276] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families' needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families' satisfaction with care in this setting. OBJECTIVE To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit. To assess the feasibility of the selected tool for measuring family satisfaction and to make recommendations that are based on the results. METHOD A descriptive survey design using the Family Satisfaction in the Intensive Care Unit 24-item questionnaire to measure satisfaction with care and decision-making. RESULTS Forty family members completed the survey. Overall, the mean score for families' satisfaction with care was 72.24% (SD, 14.87%) and the mean score for families' satisfaction with decision-making was 72.03% (SD, 16.61%). Families reported that nurses put them at ease and provided understandable explanations. Collaboration, inclusion of families in clinical discussions, and timely information regarding changes in the patient's condition were the most common points brought up in free-text responses from family members. Written communication, including directions and expectations, would have improved the families' experience. CONCLUSION Although patients' family members reported being satisfied with their experience in the intensive care unit, there is room for improvement. Effective communication among the health care team, patients' families, and patients will be targeted for quality improvement initiatives.
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Affiliation(s)
- Kathleen Clark
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts.,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing.,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing.,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts
| | - Kerry A Milner
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts. .,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing. .,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing. .,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts.
| | - Marlene Beck
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts.,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing.,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing.,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts
| | - Virginia Mason
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts.,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing.,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing.,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts
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20
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Mahrous MS. Relating family satisfaction to the care provided in intensive care units: quality outcomes in Saudi accredited hospitals. Rev Bras Ter Intensiva 2017; 29:188-194. [PMID: 28591370 PMCID: PMC5496753 DOI: 10.5935/0103-507x.20170018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/14/2017] [Indexed: 11/20/2022] Open
Abstract
Objectives This study aims to identify the satisfaction levels of the family members of
patients in intensive care units. Methods This is a cross-sectional analytical study. General intensive care units
offer a variety of services to clinical and surgical patients. For the
purpose of this study, a trained interviewer communicated with the families
of patients, either before or after visiting hours. Results The study included 208 participants: 119 (57.2%) males and 89 (42.8%)
females. Seventy-three (35.1%) of the patients attended a private hospital,
and 135 (64.9%) attended a public hospital in the city of Al Madinah Al-
Munawarah. All of the participants were either family members or friends of
patients admitted to the intensive care units at the hospitals. The
responses of both groups yielded low scores on the satisfaction index.
However, a relatively high score was noted in response to questions 2, 6,
and 10, which concerned the care that was extended by the hospital staff to
their patients, the courteous attitude of intensive care unit staff members
towards patients, and patients' satisfaction with the medical care provided,
respectively. A very low score was obtained for item 11, which was related
to the possibility for improvements to the medical care that the patients
received. Overall, greater satisfaction with the services offered by the
public intensive care units was reported compared to the satisfaction with
the services offered by the private intensive care units. Conclusion An overall low score on the satisfaction index was obtained, and further
studies are recommended to assess the current situation and improve the
satisfaction and quality of care provided by intensive care units.
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21
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Sedation versus no sedation: Are there differences in relatives' satisfaction with the Intensive Care Unit? A survey study based on data from a randomised controlled trial. Intensive Crit Care Nurs 2017; 39:59-66. [PMID: 27887881 DOI: 10.1016/j.iccn.2016.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 08/17/2016] [Accepted: 08/20/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Currently there is a trend towards less or no use of sedation of mechanically ventilated patients. Still, little is known about how different sedation strategies affect relatives' satisfaction with the Intensive Care Unit (ICU). AIM To explore if there was a difference in relatives' personal reactions and the degree of satisfaction with information, communication, surroundings, care and treatment in the ICU between relatives of patients who receive no sedation compared with relatives of patients receiving sedation during mechanical ventilation in the ICU. METHOD A survey study using a questionnaire with 39 questions was distributed to relatives of mechanically ventilated patients, who had been randomised to either sedation with daily wake up or no sedation. RESULTS Forty-nine questionnaires were sent out and 36 relatives answered. The response rate was 73%. We found no differences in relatives' personal reactions or in the degree of satisfaction with information, communication, care and treatment in the ICU between relatives of patients in the two groups. Relatives of patients treated with no sedation felt more bothered by disturbances in the surroundings compared with relatives of patients who were sedated (p=0.03). CONCLUSION Treating the patient during mechanical ventilation with no sedation does not affect relatives' satisfaction adversely.
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22
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Mistraletti G, Umbrello M, Mantovani ES, Moroni B, Formenti P, Spanu P, Anania S, Andrighi E, Di Carlo A, Martinetti F, Vecchi I, Palo A, Pinna C, Russo R, Francesconi S, Valdambrini F, Ferretti E, Radeschi G, Bosco E, Malacarne P, Iapichino G. A family information brochure and dedicated website to improve the ICU experience for patients' relatives: an Italian multicenter before-and-after study. Intensive Care Med 2016; 43:69-79. [PMID: 27830281 DOI: 10.1007/s00134-016-4592-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Good communication between ICU staff and patients' relatives may reduce the occurrence of post-traumatic stress disorder, anxiety or depression, and dissatisfaction with clinicians. An information brochure and website to meet relatives' needs were designed to explain in technical yet simple terms what happens during and after an ICU stay, to legitimize emotions such as fear, apprehension, and suffering, and to improve cooperation with relatives without increasing staff workload. The main outcomes were improved understanding of prognosis and procedures, and decrease of relatives' anxiety, depression, and stress symptoms. METHODS In this prospective multicenter before-and-after study, a self-administered questionnaire was used to investigate relatives' understanding of prognosis, treatments, and organ dysfunction, families' satisfaction, and symptoms of anxiety, depression, and post-traumatic stress. RESULTS A total of 551 relatives received questionnaires in nine Italian ICUs; 332 (60%) responded, 144 before and 179 after implementation of the brochure and website. Of the 179 relatives who responded after, 131 (73%) stated they had read the brochure and 34 (19%) reported viewing the website. The intervention was associated with increased correct understanding of the prognosis (from 69 to 84%, p = 0.04) and the therapeutic procedures (from 17 to 28%, p = 0.03). Multivariable analysis, together with non-modifiable factors (relative's gender, education level, relationship to patient, and patient status at ICU discharge), showed the intervention to be significantly associated with a lower incidence of post-traumatic stress symptoms (Poisson coefficient = -0.29, 95% CI -0.52/-0.07). The intervention had no effect on the prevalence of symptoms of anxiety and depression. CONCLUSION An information brochure and website designed to meet relatives' needs improved family members' comprehension and reduced their prevalence of stress symptoms.
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Affiliation(s)
- Giovanni Mistraletti
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, A.O. San Paolo-Polo Universitario, Via A. Di Rudinì 8, 20142, Milan, Italy. .,U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy.
| | - Michele Umbrello
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Elena Silvia Mantovani
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Benedetta Moroni
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, A.O. San Paolo-Polo Universitario, Via A. Di Rudinì 8, 20142, Milan, Italy
| | - Paolo Formenti
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Paolo Spanu
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Stefania Anania
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Elisa Andrighi
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Alessandra Di Carlo
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Federica Martinetti
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Irene Vecchi
- U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
| | - Alessandra Palo
- U.O. Anestesia e Rianimazione 1, I.R.C.C.S. San Matteo, Pavia, Italy
| | - Cristina Pinna
- U.O. Anestesia e Rianimazione, Dipartimento di Area Critica, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Riccarda Russo
- U.O.C. Rianimazione e Terapia Intensiva, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Francesconi
- U.O.C. Anestesia e Rianimazione, A. O. Ospedale Civile di Desio, Desio, Milan, Italy
| | - Federico Valdambrini
- U.O. Anestesia e Rianimazione, A.O. Ospedale Civile di Legnano, Legnano, Milan, Italy
| | - Enrica Ferretti
- S.C. Anestesia Rianimazione B DEA, Ospedale San Giovanni Bosco, Turin, Italy
| | - Giulio Radeschi
- U.O. Anestesia e Rianimazione, A.O. U. San Luigi Gonzaga di Orbassano, Orbassano, Turin, Italy
| | - Edda Bosco
- U.O. Anestesia e Rianimazione, A.O. Cardinal Massaia, Asti, Italy
| | - Paolo Malacarne
- U.O. Anestesia e Rianimazione-P.S, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Gaetano Iapichino
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, A.O. San Paolo-Polo Universitario, Via A. Di Rudinì 8, 20142, Milan, Italy.,U.O. Anestesia e Rianimazione, Dipartimento Emergenza-Urgenza, A.O. San Paolo-Polo Universitario, Milan, Italy
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Köse I, Zincircioğlu Ç, Öztürk YK, Çakmak M, Güldoğan EA, Demir HF, Şenoglu N, Erbay RH, Gonullu M. Factors Affecting Anxiety and Depression Symptoms in Relatives of Intensive Care Unit Patients. J Intensive Care Med 2016; 31:611-7. [DOI: 10.1177/0885066615595791] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 06/23/2015] [Indexed: 11/16/2022]
Abstract
Aim: To determine the incidences of anxiety and depression in relatives of patients admitted to an intensive care unit (ICU) and to investigate the relationships between psychological symptoms and demographic features of the patients and their relatives. Methodology: Relatives of 78 ICU patients were enrolled in the study. Sociodemographic features of patients and their relatives were recorded. The Turkish version of the Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Results: Twenty-eight (35.9%) cases with anxiety and 56 (71.8%) cases with depression were identified. The mean anxiety and depression scores were 9.49 ± 4.183 and 9.40 ± 4.286, respectively. Anxiety ( P = .028) and concomitant anxiety with depression ( P = .035) were more frequent among family members of young patients. The relationship to the patient, especially being a spouse, was significantly associated with symptoms (anxiety, P = .009; depression, P = .019; and both, P = .005). Conclusion: Spouses and family members of relatively young patients had higher rates of anxiety and depression. In contrast to the literature, depression was more common than anxiety among the relatives of ICU patients. Further research is needed on the impact of cultural and regional differences on anxiety and depression rates in family members of ICU patients.
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Affiliation(s)
- Işıl Köse
- Department of Anesthesiology and Reanimation, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Çiler Zincircioğlu
- Department of Anesthesiology and Reanimation, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Yasemin Kılıç Öztürk
- Department of Family Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Meltem Çakmak
- Department of Anesthesiology and Reanimation, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | | | - Hafize Fisun Demir
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
| | - Nimet Şenoglu
- Department of Anesthesiology and Reanimation, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Rıza Hakan Erbay
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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24
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Venkataraman R, Ranganathan L, Rajnibala V, Abraham BK, Rajagopalan S, Ramakrishnan N. Critical care: Are we customer friendly? Indian J Crit Care Med 2015; 19:507-12. [PMID: 26430335 PMCID: PMC4578193 DOI: 10.4103/0972-5229.164796] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: Assessing and enhancing family satisfaction are imperative for the provision of comprehensive intensive care. There is a paucity of Indian data exploring family's perception of Intensive Care Unit (ICU) patients. We wanted to explore family satisfaction and whether it differed in families of patients admitted under intensivists and nonintensivists in our semi-open ICU. Methodology: We surveyed family members of 200 consecutive patients, between March and September 2009 who were in ICU for >3 days. An internationally validated family satisfaction survey was adapted and was administered to a family member, on day 4 of the patient's stay. The survey consisted of 15 questions in five categories - patient care, medical counseling, staff interaction, visiting hours, and facilities and was set to a Likert scale of 1–4. Mean, median, and proportions were computed to describe answers for each question and category. Results: A total of 515 patients were admitted during the study period, of which 200 patients stayed in the ICU >3 days. One family member each of the 200 patients completed the survey with 100% response rate. Families reported the greatest satisfaction with patient care (94.5%) and least satisfaction with visiting hours (60.5%). Chi-square tests performed for each of the five categories revealed no significant difference between satisfaction scores of intensivists and nonintensivists' patients. Conclusion: Family members of ICU patients were satisfied with current care and communication, irrespective of whether they were admitted under intensivists or nonintensivists. Family members preferred open visiting hours policy than a time limited one.
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Affiliation(s)
- Ramesh Venkataraman
- Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Lakshmi Ranganathan
- Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - V Rajnibala
- Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Babu K Abraham
- Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
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25
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Debaty G, Ageron FX, Minguet L, Courtiol G, Escallier C, Henniche A, Maignan M, Briot R, Carpentier F, Savary D, Labarere J, Danel V. More than half the families of mobile intensive care unit patients experience inadequate communication with physicians. Intensive Care Med 2015; 41:1291-8. [DOI: 10.1007/s00134-015-3890-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
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26
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Azoulay E, Chaize M, Kentish-Barnes N. Involvement of ICU families in decisions: fine-tuning the partnership. Ann Intensive Care 2014; 4:37. [PMID: 25593753 PMCID: PMC4273688 DOI: 10.1186/s13613-014-0037-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/06/2014] [Indexed: 11/10/2022] Open
Abstract
Families of patients are not simple visitors to the ICU. They have just been separated from a loved one, often someone they live with, either abruptly or, in nearly half the cases, because a chronic condition has suddenly worsened. They must cope with a serious illness of a loved one, while having to adapt to the unfamiliar and intimidating ICU environment. In many cases, the outcome of the critical illness is uncertain, a situation that causes considerable distress to the relatives. As shown by our research group and others, families exhibit symptoms of anxiety (70%) and depression (35%) in the first few days after admission, as well as symptoms of stress (33%) and difficulty understanding the information delivered by the healthcare staff (50%). Furthermore, relatives of patients who die in the ICU are at risk for psychiatric syndromes such as generalized anxiety, panic attacks, depression, and posttraumatic stress syndrome. In this setting of psychological distress, families are asked to consider sharing in healthcare decisions about their loved one in the ICU. This article aims to foster the debate about the shared decision-making process. We have three objectives: to transcend the overly simplistic position that opposes paternalism and autonomy, to build a view founded only on an evaluation of actual practice and experience in the field, and to keep the focus squarely on the patient. Families want information and communication time from the staff. Nurses and physicians need to understand that families can share in decisions only if the entire ICU staff actively promotes family involvement and, of course, if the family wants to participate in all or part of the decision-making process.
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Affiliation(s)
- Elie Azoulay
- Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA team, Biostatistics and clinical epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | - Marine Chaize
- Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA team, Biostatistics and clinical epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | - Nancy Kentish-Barnes
- Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA team, Biostatistics and clinical epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
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27
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Hartog CS, Jensen HI. Family-centered ICU care may be good for everyone. Intensive Care Med 2014; 39:1650-2. [PMID: 23797786 DOI: 10.1007/s00134-013-2996-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 06/05/2013] [Indexed: 12/01/2022]
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28
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Levy MM, De Backer D. Re-visiting visiting hours. Intensive Care Med 2013; 39:2223-5. [PMID: 24085018 DOI: 10.1007/s00134-013-3119-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
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