Healthcare professionals' knowledge, skills, and role in offering and facilitating memory making during end-of-life care in the adult intensive care unit

Family's experience of memory making in adult intensive care and its use in early bereavement: A descriptive qualitative study

AIM AND OBJECTIVES

To explore the family's experience being offered memory making during end-of-life care in the adult intensive care unit and its use in early bereavement.

BACKGROUND

Family members of individuals who develop a critical illness requiring emergency hospitalisation are unlikely to be prepared for a possible death. This places them at increased risk of poorer bereavement experiences. One potential intervention is memory making, which is an act that provides tangible objects such as a handprint, footprint, lock of hair, or teddy bear, that allows connections with and provides meaningful memories about a person. Families in the adult acute population reportedly have positive reactions regarding the objects, but it is unknown the object's effects on early bereavement experiences.

DESIGN

Descriptive qualitative study utilising inductive reflexive thematic analysis. Reporting adheres to the COREQ checklist.

METHODS

Between May 2019-December 2020, a purposeful, convenience sample of 21 participants from a tertiary referral, adult intensive care unit in Australia were recruited to explore their experiences being offered memory making during end-of-life care and the objects use in early bereavement. Interviews were conducted using a semi-structured format and occurred at the participants' location of choice.

RESULTS

Data analysis generated three themes: guidance during end of life by healthcare professionals that recognises the autonomy of the family; object used as a trigger to access memories; and storage and preservation of the object as an indication of its sentimental value and use in early bereavement CONCLUSION: Memory making objects such as handprints, locks of hair, or teddy bears received in the adult intensive care unit were valued and utilised during early bereavement by most recipients.

RELEVANCE TO CLINICAL PRACTICE

Findings inform practice evidence gaps regarding the family's experiences of memory making received as a bereavement intervention in the adult acute population.

PATIENT OR PUBLIC CONTRIBUTION

Participants contributed through sharing their first-hand experiences of receiving memory making in the adult intensive care unit.

Factors associated with the decision to offer memory making in end-of-life: A survey of healthcare professionals in adult intensive care

AIM

Report experiences and behaviour influences with healthcare professionals' decision to and experiences of offering memory making during end-of-life care in the adult acute population.

BACKGROUND

Little is known about healthcare professionals' experiences offering memory making during adult acute end-of-life care.

DESIGN

Survey.

METHODS

Registered nurses, medical practitioners and social workers employed at a single tertiary referral adult intensive care, where memory making had been implemented nearly two years prior were invited to participate between June and August 2017. Reporting adheres to the STROBE checklist.

RESULTS

Ninety-six valid surveys (75% response rate: 75 registered nurses, 19 medical practitioners, and 2 social workers) were analysed with 67 participants reporting experience offering memory making. Highest overall agreement scores included believing families value memory making and the offer of memory making being beneficial. Enablers were described as organisational supports, personal qualities and good interpersonal relationships. Barriers identified included the intensive care environment, workload, inexperience offering/facilitating memory making, being afraid to offer, lack of resources and legality concerns. Compared with non-experienced participants, experienced participants reported higher level of confidence and comfort offering memory making, pride in their ability, ability to spend time supporting families and had observed colleagues offering memory making. Experienced participants were less likely to be afraid to offer, be limited by the family's behaviours, report lack of resources or be time limited to offer memory making.

CONCLUSION

Findings identify elements needed for the development and support for offering memory making to assist bereaved families in adult acute care including role modelling, support to reduce negative emotions, workload assistance and leadership/organisational support.

RELEVANCE TO CLINICAL PRACTICE

Discoveries have important implications in addressing evidence gaps regarding behaviour influences linked to the decision to offer memory making. Findings inform development and sustainability to integrate memory making as routine end-of-life care intervention in adult acute care.