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Wendlandt B, Edwards T, Hughes S, Gaynes BN, Carson SS, Hanson LC, Toles M. Novel Definitions of Wellness and Distress among Family Caregivers of Patients with Acute Cardiorespiratory Failure: A Qualitative Study. Ann Am Thorac Soc 2024; 21:782-793. [PMID: 38285875 PMCID: PMC11109912 DOI: 10.1513/annalsats.202310-904oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/24/2024] [Indexed: 01/31/2024] Open
Abstract
Rationale: Family caregivers of patients with acute cardiorespiratory failure are at high risk for distress, which is typically defined as the presence of psychological symptoms such as anxiety, depression, or posttraumatic stress. Interventions to reduce caregiver distress and increase wellness have been largely ineffective to date. An incomplete understanding of caregiver wellness and distress may hinder efforts at developing effective support interventions. Objectives: To allow family caregivers to define their experiences of wellness and distress 6 months after patient intensive care unit (ICU) admission and to identify moderators that influence wellness and distress. Methods: Primary family caregivers of adult patients admitted to the medical ICU with acute cardiorespiratory failure were invited to participate in a semistructured interview 6 months after ICU admission as part of a larger prospective cohort study. Interview guides were used to assess caregiver perceptions of their own well-being, record caregiver descriptions of their experiences of family caregiving, and identify key stress events and moderators that influenced well-being during and after the ICU admission. This study was guided by the Chronic Traumatic Stress Framework conceptual model, and data were analyzed using the five-step framework approach. Results: Among 21 interviewees, the mean age was 58 years, 67% were female, and 76% were White. Nearly half of patients (47%) had died before the caregiver interview. At the time of the interview, 9 caregivers endorsed an overall sense of distress, 10 endorsed a sense of wellness, and 2 endorsed a mix of both. Caregivers defined their experiences of wellness and distress as multidimensional and composed of four main elements: 1) positive versus negative physical and psychological outcomes, 2) high versus low capacity for self-care, 3) thriving versus struggling in the caregiving role, and 4) a sense of normalcy versus ongoing life disruption. Postdischarge support from family, friends, and the community at large played a key role in moderating caregiver outcomes. Conclusions: Caregiver wellness and distress are multidimensional and extend beyond the absence or presence of psychological outcomes. Future intervention research should incorporate novel outcome measures that include elements of self-efficacy, preparedness, and adaptation and optimize postdischarge support for family caregivers.
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Affiliation(s)
- Blair Wendlandt
- Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine
| | | | | | - Bradley N. Gaynes
- Department of Psychiatry, UNC School of Medicine
- Department of Epidemiology, Gillings School of Global Public Health, and
| | - Shannon S. Carson
- Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine
| | - Laura C. Hanson
- Division of Geriatric Medicine and Palliative Care Program, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Tracy MF, Hagstrom S, Mathiason M, Wente S, Lindquist R. Emotional, mental health and physical symptom experience of patients hospitalized with COVID-19 up to 3 months post-hospitalization: A longitudinal study. J Clin Nurs 2024; 33:591-605. [PMID: 37698148 DOI: 10.1111/jocn.16880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/20/2023] [Accepted: 08/02/2023] [Indexed: 09/13/2023]
Abstract
AIMS AND OBJECTIVES To explore emotional, mental health and physical symptoms up to 3 months after discharge for adults hospitalized with COVID-19. BACKGROUND 10%-30% of adults with COVID-19 experience physical and psychological symptoms 3 months or more following infection. Knowing symptoms can help direct early intervention. DESIGN A longitudinal descriptive design to study COVID-related symptoms 2 weeks, 6 weeks and 3 months after hospitalization. METHODS Sixty-six patients were recruited from a hospital system in Midwestern US (October 2020-May 2021). Participants self-reported demographics, hospital and post discharge symptoms, PROMIS measures (depression, anxiety, fatigue, cognitive function, satisfaction social roles, sleep disturbance) and Impact of Event Scale-Revised (IES-R). Hospital length of stay, comorbidities, lowest oxygen saturation, respiratory support and resources used were collected. Descriptive and nonparametric statistics described the sample and identified correlations between variables. The STROBE checklist was used. RESULTS Data from 1 (T1) and 3 months (T2) post discharge were analysed (N = 52). A majority were female, white and married; 96% experienced ≥1 COVID-related symptoms at T1; 85% at T2. Fatigue was most prevalent, followed by shortness of breath, muscle weakness and foggy thinking. More physical symptoms during hospitalization correlated positively with number of symptoms at T1 and T2; a majority stated these impacted their normal routine 'somewhat' or 'a lot'. T1 depression highly correlated with all T2 PROMIS and IES-R scores and number of physical symptoms. More symptoms at T1 were associated with worse fatigue, lower cognitive function and lower satisfaction with social roles at T2. CONCLUSION This study adds to the growing knowledge of mental, physical and emotional symptoms and relationships between these early after hospitalization with COVID-19. RELEVANCE TO CLINICAL PRACTICE Findings can help identify holistic nursing interventions to improve health and mitigate symptoms for people with long COVID. PATIENT OR PUBLIC CONTRIBUTION Patients contributed via study participation.
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Affiliation(s)
- Mary Fran Tracy
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | | | | | - Sarah Wente
- M Health Fairview, Minneapolis, Minnesota, USA
| | - Ruth Lindquist
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
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Denke C, Voigt B, Krampe H, Spies C, Rose M. [Psychosocial Care in the Intensive Care Unit]. Anasthesiol Intensivmed Notfallmed Schmerzther 2023; 58:666-674. [PMID: 38056446 DOI: 10.1055/a-2081-3521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
The improvement of intensive care treatment options leads to an increasing number of patients being treated in this setting. For the majority of those affected and their relatives, this treatment is associated with tremendous stress, but also subsequent physical, psychological and cognitive impairments, the post-intensive care syndrome. The aim of psychosocial support in the intensive care unit is to stabilise and minimise the acute stress. This is done through care services oriented towards trauma therapy interventions and emergency psychology. Equally central are the needs of the patient's relatives and ways to stabilise and relieve them. The third pillar of psychosocial work in the intensive care unit is the support of the treatment team. Finally, an outlook is given for the specialised aftercare of these complex patients in PICS outpatient clinics.
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Ahmad SR, Rhudy L, Fogelson LA, LeMahieu AM, Barwise AK, Gajic O, Karnatovskaia LV. Humanizing the Intensive Care Unit: Perspectives of Patients and Families on the Get to Know Me Board. J Patient Exp 2023; 10:23743735231201228. [PMID: 37736130 PMCID: PMC10510354 DOI: 10.1177/23743735231201228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
In this qualitative study, we explored perspectives of patients in the intensive care unit (ICU) and their families on the Get to Know Me board (GTKMB). Of the 46 patients approached, 38 consented to participate. Of the 66 family members approached, 60 consented to participate. Most patients (26, 89%) and family members (52, 99%) expressed that GTKMB was important in recognizing patient's humanity. Most patients (20, 68%) and families (39, 74%) said that it helped to build a better relationship with the provider team. 60% of patients and families commented that the GTKMB was used as a platform by providers to interact with them. Up to 45 (85%) of the family members supported specific contents of the GTKMB. In structured interviews (11 patients, 7 family members), participants additionally commented on ways providers used the GTKMB to communicate, support patient's personhood, and on caveats in interacting with GTKMB. Critically ill patients and families found the GTKMB helpful in preserving personhood of patient, fostering communication, and building relationships with clinicians.
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Affiliation(s)
- Sumera R. Ahmad
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Lori Rhudy
- Department of Graduate Nursing, Winona State University, Rochester, MN, USA
| | | | | | - Amelia K. Barwise
- Department of Bioethics Research Program, Mayo Clinic, Rochester, MN, USA
| | - Ognjen Gajic
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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Johnson KR, Temeyer JP, Schulte PJ, Nydahl P, Philbrick KL, Karnatovskaia LV. Aloud real- time reading of intensive care unit diaries: A feasibility study. Intensive Crit Care Nurs 2023; 76:103400. [PMID: 36706496 DOI: 10.1016/j.iccn.2023.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/10/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Memories of frightening/delusional intensive care unit experiences are a major risk factor for subsequent psychiatric morbidity of critical illness survivors; factual memories are protective. Systematically providing factual information during initial memory consolidation could mitigate the emotional character of the formed memories. We explored feasibility and obtained stakeholder feedback of a novel approach to intensive care unit diaries whereby entries were read aloud to the patients right after they were written to facilitate systematic real time orientation and formation of factual memories. RESEARCH METHODOLOGY Prospective interventional pilot study involving reading diary entries aloud. We have also interviewed involved stakeholders for feedback and collected exploratory data on psychiatric symptoms from patients right after the intensive care stay. SETTING Various intensive care units in a single academic center. MAIN OUTCOME MEASURES Feasibility was defined as intervention delivery on ≥80% of days following patient recruitment. Content analysis was performed on stakeholder interview responses. Questionnaire data were compared for patients who received real-time reading to the historical cohort who did not. RESULTS Overall, 57% (17 of 30) of patients achieved the set feasibility threshold. Following protocol adjustment, we achieved 86% feasibility in the last subset of patients. Patients reported the intervention as comforting and appreciated the reorientation aspect. Nurses overwhelmingly liked the idea; most common concern was not knowing what to write. Some therapists were unsure whether reading entries aloud might overwhelm the patients. There were no significant differences in psychiatric symptoms when compared to the historic cohort. CONCLUSION We encountered several implementation obstacles; once these were addressed, we achieved set feasibility target for the last group of patients. Reading diary entries aloud was welcomed by stakeholders. Designing a trial to assess efficacy of the intervention on psychiatric outcomes appears warranted. IMPLICATIONS FOR CLINICAL PRACTICE There is no recommendation to change current practice as benefits of the intervention are unproven.
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Affiliation(s)
- Kimberly R Johnson
- Department of Pulmonary and Critical Care, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Joseph P Temeyer
- Department of Nursing, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Phillip J Schulte
- Department of Biostatistics, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Peter Nydahl
- Department of Anesthesia and Critical Care, Arnold-Heller-Str. 3, University Hospital Schleswig-Holstein, Kiel 24105, Germany
| | - Kemuel L Philbrick
- Department of Psychiatry and Psychology, 200 First St SW, Mayo Clinic, Rochester, MN 55905, USA
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The patient experience of a medical emergency team review: A convergent mixed-methods study. Aust Crit Care 2023; 36:254-261. [PMID: 35177341 DOI: 10.1016/j.aucc.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS The aim of this study was to explore clinician-patient engagement during, and patient experience of, medical emergency team (MET) reviews. DESIGN This study involved a convergent mixed-methods design. METHODS This three-phase study was conducted at two hospitals of one Australian health service. Reviews by the MET were observed for clinician-patient engagement behaviours; medical records were audited to confirm patient demographics and clinical characteristics; and patients who received a MET review were interviewed. Quantitative data were analysed using descriptive statistics, and thematic analysis of qualitative interview data was conducted. RESULTS In total, 26 MET reviews were observed for 22 patients (median age = 81.5 years and 68.2% females). Between 8 and 13 clinicians and other staff members were present during each review, with a total of 209 clinicians present during the 26 reviews. Clinicians were not observed to speak directly or indirectly to the patient about their care in 38.5% (n = 10/26) of the MET reviews, and 58.3% (n = 56/96) of interventions were performed without explanation. Four themes were identified from the interviews: An unexpected event; A lack of understanding; In good hands, and What happens next? CONCLUSION Clinician-patient engagement was infrequent during and after MET reviews. Patients experienced surprise from the sudden arrival of clinicians in their room and had poor levels of understanding about the review. However, most patients felt supported and safe. MET reviews are frequent safety-critical events, and this study identified the patient experience of these events. Clinicians should be aware that patients expressed they were surprised and shocked by the review and that an explanation of what was being done by the clinical team was rarely offered. These findings can be used to inform strategies to improve their patient-engagement behaviours and patient-centred care.
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Joebges S, Mouton-Dorey C, Ricou B, Biller-Andorno N. Coercion in intensive care, an insufficiently explored issue-a scoping review of qualitative narratives of patient's experiences. J Intensive Care Soc 2023; 24:96-103. [PMID: 36874283 PMCID: PMC9975803 DOI: 10.1177/17511437221091051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose The use of coercion, in a clinical context as imposing a measure against a patient's opposition or declared will, can occur in various forms in intensive care units (ICU). One prime example of a formal coercive measure in the ICU is the use of restraints, which are applied for patients' own safety. Through a database search, we sought to evaluate patient experiences related to coercive measures. Results For this scoping review, clinical databases were searched for qualitative studies. A total of nine were identified that fulfilled the inclusion and the CASP criteria. Common themes emerging from the studies on patient experiences included communication issues, delirium, and emotional reactions. Statements from patients revealed feelings of compromised autonomy and dignity that came with a loss of control. Physical restraints were only one concrete manifestation of formal coercion as perceived by patients in the ICU setting. Conclusion There are few qualitative studies focusing on patient experiences of formal coercive measures in the ICU. In addition to the experience of restricted physical movement, the perception of loss of control, loss of dignity, and loss of autonomy suggests that restraining measures are just one element in a setting that may be perceived as informal coercion.
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Affiliation(s)
- Susanne Joebges
- Clinic for Anesthesiology, Surgical Intensive Care Medicine and Postoperative Pain Therapy, Dortmund, Germany.,Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zürich, Switzerland
| | - Corine Mouton-Dorey
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zürich, Switzerland
| | - Bara Ricou
- Department of Anaesthesiology, Pharmacology and Surgery Intensive Care, University of Geneva, Geneva, Switzerland
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zürich, Switzerland
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Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement. J Cardiovasc Dev Dis 2022; 9:jcdd9110365. [PMID: 36354764 PMCID: PMC9694228 DOI: 10.3390/jcdd9110365] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Neurological complications such as acute ischemic stroke or postoperative delirium are frequent after cardiac surgery or percutaneous valve replacement. This study aimed to identify corresponding risk factors. (2) Methods: 297 patients with percutaneous valve replacement or cardiac surgery were postoperatively screened for neurological complications such as delirium, stroke, seizures and hallucinations twice daily for three days. Pre- and perioperative risk factors were evaluated in a multivariate model. (3) Results: Neurological complications occurred in 43.8% (n = 130) as composed of delirium (43.43%, n = 129), stroke (2.7%, n = 8), seizures (1.35%, n = 4) and real hallucinations (3.36%, n = 10). Multiple logistic regression revealed an association of neurological complications with lower Montreal Cognitive Assessment scores (Exp(B) 2.042; 95% CI, 1.183−3.525, p = 0.010), older age (Exp(B) 1.071; 95% CI, 1.036−1.107, p < 0.001), red blood cell transfusions until postoperative day 3 (Exp(B) 1.157; 95% CI, 1.030−1.300, p = 0.014), history of heart failure (Exp(B) 1.985; 95% CI, 1.130−3.487, p = 0.017) and increased CRP levels (Exp(B) 1.004; 95% CI, 1.000−1.008, p = 0.037). (4) Conclusions: Postoperative delirium remains a frequent complication after cardiac surgery, while stroke and seizures occur rarely. A preoperative risk profile including older age, history of heart failure and cognitive impairment was identified for a complicated postoperative course. However, the impact of an intense inflammatory response must not be neglected.
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Jöbges S. Kommunikation mit Patientinnen auf der Intensivstation. Med Klin Intensivmed Notfmed 2022; 117:595-599. [DOI: 10.1007/s00063-022-00957-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
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Chu YR, Liu CJ, Chu CC, Kung PT, Chou WY, Tsai WC. Stress on caregivers providing prolonged mechanical ventilation patient care in different facilities: A cross-sectional study. PLoS One 2022; 17:e0268884. [PMID: 35613142 PMCID: PMC9132287 DOI: 10.1371/journal.pone.0268884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Taiwan has implemented an integrated prospective payment program (IPP) for prolonged mechanical ventilation (PMV) patients that consists of four stages of care: intensive care unit (ICU), respiratory care center (RCC), respiratory care ward (RCW), and respiratory home care (RHC). We aimed to investigate the life impact on family caregivers of PMV patients opting for a payment program and compared different care units. Method A total of 610 questionnaires were recalled. Statistical analyses were conducted by using the chi-square test and multivariate logistic regression model. Results The results indicated no associations between caregivers’ stress levels and opting for a payment program. Participants in the non-IPP group spent less time with friends and family owing to caregiver responsibilities. The results of the family domain show that the RHC group (OR = 2.54) had worsened family relationships compared with the ICU group; however, there was less psychological stress in the RCC (OR = 0.54) and RCW (OR = 0.16) groups than in the ICU group. In the social domain, RHC interviewees experienced reduced friend and family interactivity (OR = 2.18) and community or religious activities (OR = 2.06) than the ICU group. The RCW group felt that leisure and work time had less effect (OR = 0.37 and 0.41) than the ICU group. Furthermore, RCW interviewees (OR = 0.43) were less influenced by the reduced family income than the ICU group in the economic domain. Conclusions RHC family caregivers had the highest level of stress, whereas family caregivers in the RCW group had the lowest level of stress.
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Affiliation(s)
- Yeong-Ruey Chu
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chin-Jung Liu
- Department of Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan
- School of Nursing, China Medical University, Taichung, Taiwan
| | - Chia-Chen Chu
- Department of Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Wen-Yu Chou
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- * E-mail:
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Denke C, Eitner B, Falk K, Spies C. Self-healing Environment. Anasthesiol Intensivmed Notfallmed Schmerzther 2022; 57:10-13. [PMID: 35021236 DOI: 10.1055/a-1644-8605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Stantz A, Emilio J, Ahmad S, Gajic O, Garrison G, Boswell C, Al Zahidy M. An Individualized Recovery Task Checklist Which Served as an Educational Instrument in a Critically Ill and Intubated COVID-19 Patient. J Prim Care Community Health 2022; 13:21501319221116249. [PMID: 35920044 PMCID: PMC9358336 DOI: 10.1177/21501319221116249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This case involves a patient with severe COVID-19 pneumonia and massive pulmonary
embolism requiring mechanical ventilation. His clinical course was complicated
by delirium likely triggered by his critical illness and failed initial
extubation, isolation from family, and escalating fear and desperation. In
hopeful preparation for subsequent successful extubation, a unique approach was
taken to decrease the risk of panic, delirium, and decompensation leading to
reintubation. As a means of orienting him to his treatment pathway and to
provide encouragement for continued recovery, an impromptu patient-directed
checklist was constructed. The recovery checklist, written in simplified
language, outlined the stages of severe illness that the patient had overcome
after his emergent intubation. The list also outlined the tasks he needed to
complete prior to hospital discharge. Unexpectedly, the checklist received a
great deal of engagement from both the patient and medical team and played an
important role in this patient’s successful recovery and rehabilitation.
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Affiliation(s)
| | - Joel Emilio
- Western State University College of Law, Irvine, CA, USA
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Abstract
Vicarious trauma, secondary trauma, and workplace violence are the common forms of psychological trauma associated with nurses. Additional areas of nurses' trauma have not been adequately described, defined, or conceptually organized in the literature. In this article, a new middle-range theory of nurses' psychological trauma is presented with a novel discourse of nurse-specific traumas, theoretical statements, and outcomes of psychological traumas that are unique to nurses and the professional worlds in which they live. A middle-range theory is forwarded so that future scholars may test this theory and derive implications for practice, education, policy, and research.
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Affiliation(s)
- Karen J Foli
- School of Nursing, Purdue University, West Lafayette, Indiana
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Henao Castaño ÁM, Villamil Buitrago AV, Marín Ramírez S, Cogollo Hernandez CA. Características del síndrome post cuidado intensivo: revisión de alcance. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2021. [DOI: 10.11144/javeriana.ie23.csci] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Objetivo: identificar la evidencia disponible de las características del síndrome post unidad de cuidado intensivo en el paciente que egresa de la unidad de cuidado intensivo. Método: revisión de alcance con la metodología del Joanna Briggs Institut, en cinco bases de datos con la estrategia de búsqueda ([PostIntensive AND Care AND Syndrome] [Nursing AND Care AND PICS]). Se incluyeron estudios primarios publicados entre los años 2010 y 2020, disponibles en texto completo. Resultados: después del análisis de los 48 estudios primarios se extrajeron seis categorías temáticas así: aspecto cognitivo en el síndrome post UCI, osteomusculares, psicoemocionales, estrategias de prevención con modelos de sobrevivientes de UCI, síndrome post unidad cuidado intensivo en la familia y herramientas de evaluación. Conclusiones: mejorar la calidad de atención de los pacientes que presentan este síndrome, prevenir la aparición y aumentar la calidad de vida prestada a los sobrevivientes de UCI y sus familias. La evidencia reporta que entre los cuidadores se pueden desencadenar distintos trastornos que disminuyen su calidad de vida. La enfermería juega un papel crucial en la prevención de la aparición del síndrome mediante estrategias en la UCI e interdisciplinares; los planes de egreso y seguimiento a los pacientes pueden lograr que estos se rehabiliten más rápido y eviten discapacidades o secuelas a largo plazo.
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Shin JW, Happ MB, Tate JA. VidaTalk™ patient communication application "opened up" communication between nonvocal ICU patients and their family. Intensive Crit Care Nurs 2021; 66:103075. [PMID: 34127362 PMCID: PMC10833611 DOI: 10.1016/j.iccn.2021.103075] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 04/05/2021] [Accepted: 04/11/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To explore family members' perceptions of an electronic communication application, VidaTalk™, their communication experience, and emotional reactions to communication with mechanically ventilated patients in the intensive care units. RESEARCH METHODOLOGY/DESIGN Qualitative phase of a mixed-methods study nested within a randomised controlled trial. Family members in the intervention group received the VidaTalk™ app as a communication aid during their intensive care stay. Seven family members participated in 18 semi-structured email interviews after discharge between May and December 2018. Interviews were analysed using qualitative content analysis. SETTING Families were recruited in multiple intensive care units located in one university hospital. MAIN OUTCOME MEASURES Communication experience with the VidaTalk™ and emotions while communicating with the patient. Basic qualitative description and constant comparative techniques were used to code and analyse the text using ATLAS_ti (Version 7.5.18). FINDINGS The VidaTalk™ opened up family-patient communication by allowing clear communication and expanding communication content. Family members felt happy and thankful to communicate with the patient. They also expressed feelings of relief and less frustration and less stress while communicating with the patient. On the other hand, the patient's ability to express their worries or anxiety sometimes made families feel sad or distressed. CONCLUSION The VidaTalk™ was helpful for family-patient communication. The VidaTalk™ may help families reduce psychological distress. However, expanded communication with critically ill patients may cause other negative feelings.
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Affiliation(s)
- Ji Won Shin
- Betty Irene Moore School of Nursing, University of California - Davis, Betty Irene Moore Hall, 2570 48th St., Sacramento, CA 95817, USA; College of Nursing, The Ohio State University, Newton Hall #352, 1585 Neil Ave., Columbus, OH 43210, USA.
| | - Mary Beth Happ
- College of Nursing, The Ohio State University, Newton Hall #352, 1585 Neil Ave., Columbus, OH 43210, USA.
| | - Judith A Tate
- College of Nursing, The Ohio State University, Newton Hall #352, 1585 Neil Ave., Columbus, OH 43210, USA.
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Krampe H, Denke C, Gülden J, Mauersberger VM, Ehlen L, Schönthaler E, Wunderlich MM, Lütz A, Balzer F, Weiss B, Spies CD. Perceived Severity of Stressors in the Intensive Care Unit: A Systematic Review and Semi-Quantitative Analysis of the Literature on the Perspectives of Patients, Health Care Providers and Relatives. J Clin Med 2021; 10:jcm10173928. [PMID: 34501376 PMCID: PMC8432195 DOI: 10.3390/jcm10173928] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to synthesize quantitative research that identified ranking lists of the most severe stressors of patients in the intensive care unit, as perceived by patients, relatives, and health care professionals (HCP). We conducted a systematic literature search in PubMed, MEDLINE, EMBASE, PsycInfo, CINAHL, and Cochrane Library from 1989 to 15 May 2020. Data were analyzed with descriptive and semi-quantitative methods to yield summarizing ranking lists of the most severe stressors. We synthesized the results of 42 prospective cross-sectional observational studies from different international regions. All investigations had assessed patient ratings. Thirteen studies also measured HCP ratings, and four studies included ratings of relatives. Data indicated that patients rate the severity of stressors lower than HCPs and relatives do. Out of all ranking lists, we extracted 137 stressor items that were most frequently ranked among the most severe stressors. After allocation to four domains, a group of clinical ICU experts sorted these stressors with good to excellent agreement according to their stress levels. Our results may contribute to improve HCPs' and relatives' understanding of patients' perceptions of stressors in the ICU. The synthesized stressor rankings can be used for the development of new assessment instruments of stressors.
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Affiliation(s)
- Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
| | - Claudia Denke
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
| | - Jakob Gülden
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
| | - Vivian-Marie Mauersberger
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
| | - Lukas Ehlen
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
| | | | - Maximilian Markus Wunderlich
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (M.M.W.); (F.B.)
| | - Alawi Lütz
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
- Department of Healthcare Management, Technische Universität Berlin, 10623 Berlin, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (M.M.W.); (F.B.)
| | - Björn Weiss
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
| | - Claudia D. Spies
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (H.K.); (C.D.); (J.G.); (V.-M.M.); (L.E.); (A.L.); (B.W.)
- Correspondence: ; Tel.: +49-30-450-551-102
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Cuzco C, Delgado-Hito P, Marín Pérez R, Núñez Delgado A, Romero-García M, Martínez-Momblan MA, Martínez Estalella G, Carmona Delgado I, Nicolas JM, Castro P. Patients' experience while transitioning from the intensive care unit to a ward. Nurs Crit Care 2021; 27:419-428. [PMID: 34402141 DOI: 10.1111/nicc.12697] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/05/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Intensive care unit (ICU) patients can experience emotional distress and post-traumatic stress disorder when they leave the ICU, also referred to as post-intensive care syndrome. A deeper understanding of what patients go through and what they need while they are transitioning from the ICU to the general ward may provide input on how to strengthen patient-centred care and, ultimately, contribute to a positive experience. AIM To describe the patients' experience while transitioning from the ICU to a general ward. DESIGN A descriptive qualitative study. METHOD Data were gathered through in-depth interviews and analysed using a qualitative content analysis. The qualitative study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. FINDINGS Forty-eight interviews were conducted. Impact on emotional well-being emerged as a main theme, comprising four categories with six subcategories. CONCLUSION Transition from the ICU can be a shock for the patient, leading to the emergence of a need for information, and an impact on emotional well-being that has to be planned for carefully and addressed prior to, during, and following transition from the ICU to the general ward. RELEVANCE TO CLINICAL PRACTICE It is essential that nurses understand patients' experiences during transfer, identifying needs and concerns to be able to develop and implement new practices such as ICU Liaison Nurse or Nurse Outreach for the follow-up of these patients, the inclusion of a consultant mental health nurse, and the application of patient empowerment during ICU discharge.
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Affiliation(s)
- Cecilia Cuzco
- Medical Intensive Care Unit, Hospital Clinic, Barcelona, Spain.,Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Delgado-Hito
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,International Research Project: Proyecto HU-CI, Madrid, Spain
| | - Raquel Marín Pérez
- Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Hospital Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Marta Romero-García
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,International Research Project: Proyecto HU-CI, Madrid, Spain
| | - María Antonia Martínez-Momblan
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Gemma Martínez Estalella
- Medical Intensive Care Unit, Hospital Clinic, Barcelona, Spain.,Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - José María Nicolas
- Medical Intensive Care Unit, Hospital Clinic, Barcelona, Spain.,Biomedical Research Institute August Pi Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clinic, Barcelona, Spain.,Biomedical Research Institute August Pi Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
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18
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Abdul Halain A, Tang LY, Chong MC, Ibrahim NA, Abdullah KL. Psychological distress among the family members of Intensive Care Unit (ICU) patients: A scoping review. J Clin Nurs 2021; 31:497-507. [PMID: 34254377 DOI: 10.1111/jocn.15962] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To map research-based psychological distress among the family members with patients in the intensive care unit (ICU). BACKGROUND Having a loved one in the ICU is a stressful experience, which may cause psychological distress for family members. Depression, anxiety and stress are the common forms of psychological distress associated with ICU patient's family members. Directly or indirectly, psychological distress may have behavioural or physiological impacts on the family members and ICU patient's recovery. DESIGN The study was based on the five-stage methodological framework by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) and were guided by the PRISMA-ScR Checklist. METHODS A comprehensive and systematic search was performed in five electronic databases, namely the Scopus, Web of Sciences, CINAHL® Complete @EBSCOhost, ScienceDirect and MEDLINE. Reference lists from the screened full-text articles were reviewed. RESULTS From a total of 1252 literature screened, 22 studies published between 2010-2019 were included in the review. From those articles, four key themes were identified: (a) Prevalence of psychological distress; (b) Factors affecting family members; (c) Symptoms of psychological distress; and (d) Impact of psychological distress. CONCLUSIONS Family members with a critically ill patient in ICU show high levels of anxiety, depression and stress. They had moderate to major symptoms of psychological distress that negatively impacted both the patient and family members. RELEVANCE TO CLINICAL PRACTICE The review contributed further insights on psychological distress among ICU patient's family members and proposed psychological interventions that could positively impact the family well-being and improve the patients' recovery.
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Affiliation(s)
- Azura Abdul Halain
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Li Yoong Tang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Noor Airini Ibrahim
- Department of Anaesthesiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing School of Medical and Life Science, Sunway University, Selangor, Malaysia
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19
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Felten-Barentsz KM, van de Wetering-van Dongen VA, Vloet L, Koenders N, Nijhuis-van der Sanden MWG, Hoogeboom TJ. Family participation during physical activity in the intensive care unit: A longitudinal qualitative study. J Crit Care 2021; 65:42-48. [PMID: 34082254 DOI: 10.1016/j.jcrc.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Family-centered care has been implemented in the ICU to meet relatives' needs concerning information, support, participation and shared decision making. This study explores the needs, beliefs, feelings and behaviors of relatives of patients admitted to the ICU regarding participation during physical activity. METHODS Longitudinal qualitative study design following a grounded theory approach. Relatives were interviewed at 4, 8 and 12 days after the patient's ICU-admission. Data were analyzed using constant comparison. RESULTS Twenty-five interviews were conducted in ten relatives. Relatives believed that physical activity in the ICU improves recovery. Participating in physical activity decreased their feelings of powerlessness and uselessness. Relatives mentioned that they would be stimulated to participate if they were invited, guided and informed by healthcare providers. The perceived reticence of healthcare providers, patient's health-changing capacity and the inability to communicate led to a more passive attitude towards participation. CONCLUSIONS The conceptual model shows how family participation during physical activity changes from a passive role, with negative beliefs and feelings of uselessness and powerlessness, to a more proactive participatory role. Relatives felt more useful and like they were part of the team. Providing relatives with additional information might be a viable strategy to help and stimulate participation.
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Affiliation(s)
- Karin M Felten-Barentsz
- Department of Rehabilitation - Physical Therapy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, the Netherlands.
| | - Veerle A van de Wetering-van Dongen
- Department of Rehabilitation - Physical Therapy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lilian Vloet
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Niek Koenders
- Department of Rehabilitation - Physical Therapy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Department of Rehabilitation - Physical Therapy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Thomas J Hoogeboom
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
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20
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Kusi-Appiah E, Karanikola M, Pant U, Meghani S, Kennedy M, Papathanassoglou E. Tools for assessment of acute psychological distress in critical illness: A scoping review. Aust Crit Care 2021; 34:460-472. [PMID: 33648818 DOI: 10.1016/j.aucc.2020.12.003] [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: 08/08/2020] [Revised: 11/23/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Patients' experience of psychological distress in the intensive care unit (ICU) is associated with adverse effects, reduced satisfaction, and delayed physical and psychological recovery. There are no specific guidelines for the assessment and management of acute psychological distress during hospitalisation in the ICU. We reviewed existing tools for the assessment of acute psychological distress in ICU patients, examined evidence on their metric properties, and identified potential gaps and methodological considerations. METHOD A scoping review based on literature searches (Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, PsycINFO, Scopus, Health and Psychosocial Instruments, Dissertations and Theses Global, and Google Scholar) and predefined eligibility criteria was conducted as per current scoping review guidelines. FINDINGS Overall, 14 assessment tools were identified having been developed in diverse ICU settings. The identified tools assess mainly anxiety and depressive symptoms and ICU stressors, and investigators have reported various validity and reliability metrics. It was unclear whether available tools can be used in specific groups, such as noncommunicative patients and patients with delirium, brain trauma, stroke, sedation, and cognitive impairments. CONCLUSION Available tools have methodological limitations worth considering in future investigations. Given the high prevalence of psychiatric morbidity in ICU survivors, rigorously exploring the metric integrity of available tools used for anxiety, depressive, and psychological distress symptom assessment in the vulnerable ICU population is a practice and research priority. RELEVANCE TO CLINICAL PRACTICE These results have implications for the selection and implementation of psychological distress assessment methods as a means for promoting meaningful patient-centred clinical outcomes and humanising ICU care experiences.
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Affiliation(s)
- Elizabeth Kusi-Appiah
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
| | - Maria Karanikola
- Cyprus University of Technology, Department of Nursing, 15 Vragadinou str-Limassol, 3041, Cyprus.
| | - Usha Pant
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
| | - Shaista Meghani
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
| | - Megan Kennedy
- John W. Scott Health Sciences Librarian, University of Alberta Library, 2K3.28 Walter C. Mackenzie Health Sciences Centre, Edmonton, AB, T6G 2R7, Canada.
| | - Elizabeth Papathanassoglou
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
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21
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Schlosser M, Adao K, Derkyi A, Fitzgerald-Monroe A, Ebenezer L, Eckes E. Communication Challenges in High-Containment Clinical Environments. Am J Nurs 2021; 121:40-45. [PMID: 33470614 DOI: 10.1097/01.naj.0000733424.64237.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The authors describe the personal protective equipment (PPE) clinicians require when involved in the care of patients with potential or confirmed exposure to highly infectious pathogens, such as the Ebola virus, multidrug-resistant organisms, or severe acute respiratory syndrome coronavirus 2, the cause of COVID-19. They discuss the communication challenges that arise with the various PPE required when caring for patients in high-containment clinical environments and how they and their colleagues in the National Institutes of Health's Special Clinical Studies Unit developed, field-tested, refined, and ultimately implemented policies and procedures that enabled clinicians to communicate effectively with other staff, patients, and external partners, such as governmental agencies, other specialized units, and nonprofit organizations.
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Affiliation(s)
- Meghan Schlosser
- Meghan Schlosser is a travel nurse with American Mobile Nursing, Fostoria, OH. Kimberly Adao is a clinical manager at the National Institutes of Health (NIH) Clinical Center (CC), Bethesda, MD, where Anitra Fitzgerald-Monroe and Leighann Ebenezer are senior clinical research nurses, and Ellen Eckes is a nurse consultant. Alberta Derkyi is an NP at the National Institute of Environmental Health Sciences, NIH CC. Contact author: Ellen Eckes, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise
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22
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Xu T, Wang Y, Wang R, Lamb KV, Ren D, Dai G, Wang L, Yue P. Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study. Scand J Caring Sci 2020; 35:1226-1239. [PMID: 33615516 DOI: 10.1111/scs.12941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients. AIM To describe the caring ability of nurses and its potential predictors in China. METHODS From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted. RESULTS Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho' norm, an international scoring standard of nurse's caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance. CONCLUSIONS Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.
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Affiliation(s)
- Tianmeng Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Yongli Wang
- Yuetan Community Health Service Center, Fuxing Hospital of Capital Medical University, Beijing, China
| | - Rongjin Wang
- School of Nursing, Capital Medical University, Beijing, China
| | - Karen V Lamb
- College of Nursing, Rush University, Chicago, IL, USA
| | - Dianxu Ren
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Guizhi Dai
- Community Health Care Service Center of Dongcheng District, Beijing, China
| | - Li Wang
- Fangzhuang Community Health Care Service Center of Fengtai District, Beijing, China
| | - Peng Yue
- School of Nursing, Capital Medical University, Beijing, China
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23
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Jones AC, Hilton R, Ely B, Gororo L, Danesh V, Sevin CM, Jackson JC, Boehm LM. Facilitating Posttraumatic Growth After Critical Illness. Am J Crit Care 2020; 29:e108-e115. [PMID: 32929457 PMCID: PMC7646602 DOI: 10.4037/ajcc2020149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The theory of posttraumatic growth arose from accounts of various trauma survivors experiencing not only distress but also growth and change. An intensive care unit admission is an unplanned, sudden, and traumatic experience, and many survivors have posttraumatic stress that can lead to posttraumatic stress disorder. Survivors leave the intensive care unit with new functional impairments that drive depression, and they frequently experience anxiety. Amidst the stress of understanding the trauma of an intensive care unit admission, survivors can grow in their world views, relationships, and sense of self. Understanding posttraumatic growth in intensive care unit survivors will inform health care providers on how to help survivors understand their new difficulties after an intensive care unit stay and facilitate growth. This article is a conceptual review of posttraumatic growth, identifiers of posttraumatic growth, and how the tenets of the posttraumatic growth theory apply to intensive care unit survivors. Health care professionals, specifically nurses, can incorporate practices into their care during and after the intensive care unit stay that encourage understanding and positive accommodation of new difficulties brought on by the intensive care unit hospitalization to support survivor growth. Opportunities for research include incorporating posttraumatic growth assessments into post-intensive care unit clinics, self-help materials, and various programs or therapies. Outcomes associated with posttraumatic growth are listed to suggest directions for research questions concerning posttraumatic growth in intensive care unit survivors.
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Affiliation(s)
- Abigail C Jones
- Abigail C. Jones is a research assistant, School of Nursing, Vanderbilt University and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee
| | - Rachel Hilton
- Rachel Hilton is a research assistant, School of Nursing, Vanderbilt University
| | - Blair Ely
- Blair Ely is a research assistant, Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
| | - Lovemore Gororo
- Lovemore Gororo is an intensive care unit survivor and former patient at Vanderbilt University Hospital, Nashville, Tennessee
| | - Valerie Danesh
- Valerie Danesh is an assistant professor, School of Nursing, University of Texas at Austin, Austin, Texas, and a research scientist, Center for Applied Health Research, Baylor Scott & White Health, Dallas, Texas
| | - Carla M Sevin
- Carla M. Sevin is an assistant professor, Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
| | - James C Jackson
- James C. Jackson is a professor of medicine, Division of Allergy, Pulmonary, and Critical Care Medicine and Center for Health Services Research, Department of Medicine, Vanderbilt University School of Medicine; a professor, Geriatric Research, Education and Clinical Center Service and Clinical Research Center of Excellence, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System; and a professor, Department of Psychiatry, Vanderbilt Medical Center
| | - Leanne M Boehm
- Leanne M. Boehm is an assistant professor, School of Nursing, Vanderbilt University, and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
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Tan Y, Gajic O, Schulte PJ, Clark MM, Philbrick KL, Karnatovskaia LV. Feasibility of a Behavioral Intervention to Reduce Psychological Distress in Mechanically Ventilated Patients. Int J Clin Exp Hypn 2020; 68:419-432. [PMID: 32730136 DOI: 10.1080/00207144.2020.1795663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Many survivors of acute respiratory failure suffer from mood disorders following discharge from the hospital. We investigated the feasibility of intensivists delivering psychological support based on positive suggestion (PSBPS) to 20 intubated patients to reduce their psychological distress. Thirteen patients completed follow-up surveys. Of those, 9 remembered the intensive care unit physician talking to them, and 7 described it as comforting. Five patients (38%) met criteria for anxiety, depression, and acute stress. In comparison to historical controls, intervention may be associated with lower estimated odds of anxiety. PSBPS can be performed with patients in parallel with medical treatment to potentially reduce psychological morbidity and to humanize critical care. A larger randomized study is warranted to assess the efficacy of PSBPS.
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Affiliation(s)
- Yanni Tan
- National University Hospital , Singapore
| | - Ognjen Gajic
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic , Rochester, Minnesota, USA
| | - Phillip J Schulte
- Division of Biomedical Statistics and Informatics, Mayo Clinic , Rochester, Minnesota, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, Minnesota, USA
| | - Kemuel L Philbrick
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, Minnesota, USA
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25
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Doing time in an Australian ICU; the experience and environment from the perspective of patients and family members. Aust Crit Care 2020; 34:254-262. [PMID: 32943306 DOI: 10.1016/j.aucc.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 06/11/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The intensive care environment and experiences during admission can negatively impact patient and family outcomes and can complicate recovery both in hospital and after discharge. While their perspectives based on intimate experiences of the environment could help inform design improvements, patients and their families are typically not involved in design processes. Rather than designing the environment around the needs of the patients, emphasis has traditionally been placed on clinical and economic efficiencies. OBJECTIVE The main objective was to inform design of an optimised intensive care bedspace by developing an understanding of how patients and their families experience the intensive care environment and its impact on recovery. METHODS A qualitative descriptive study was conducted with data collected in interviews with 17 intensive care patients and seven family members at a large cardiothoracic specialist hospital, analysed using a framework approach. RESULTS Participants described the intensive care as a noisy, bright, confronting and scary environment that prevented sleep and was suboptimal for recovery. Bedspaces were described as small and cluttered, with limited access to natural light or cognitive stimulation. The limited ability to personalise the environment and maintain connections with family and the outside world was considered especially problematic. CONCLUSIONS Intensive care patients described features of the current environment they considered problematic and potentially hindering their recovery. The perspective of patients and their families can be utilised by researchers and developers to improve the design and function of the intensive care environment. This can potentially improve patient outcomes and help deliver more personalised and effective care to this vulnerable patient population and their families.
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Reinberger M, Bouchard R, Muhl E, Nau C, Hüppe M. [Stressors for patients in the intensive care unit : An analysis taking controllability into consideration]. Anaesthesist 2020; 69:555-564. [PMID: 32488535 DOI: 10.1007/s00101-020-00798-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Studies on stress factors for patients in intensive care units (ICU) have so far concentrated on whether certain stressors have occurred or how stressful they were. There are no studies on stress for patients in ICUs that measured both the perception of stress and the chances perceived to control it; however, loss of control can result in long-term psychopathological consequences, such as depression or posttraumatic stress disorder. Therefore, a questionnaire was developed to evaluate the influence of controllability on perception of stress. The aim of this study was to answer the following questions: which situations were experienced as stressful by patients in ICUs, whether patients perceived them as being controllable and whether the experience of stress depended on the controllability? Furthermore, it was examined which stressful situations are specific to ICUs. MATERIAL AND METHODS The questionnaire included 18 potentially stressful situations for ICU patients. These situations were assessed with respect to the occurrence, frequency and duration, the impact of stress and the perception of control. In addition, anxiety was assessed using STAI-X1. A total of 198 ICU patients and 100 patients hospitalized in a general surgery ward were interviewed. RESULTS Patients in ICUs remembered significantly more stressful situations than those on the normal ward (M ± SD = 10.2 ± 2.7 vs. 6.6 ± 2.0; d = 1.48; p < 0.001) and perceived them as more stressful (mean stress: M ± SD = 3.6 ± 1.5 vs. 2.2 ± 1.3; d = 1.01; p < 0.001). The most stressful situations for ICU patients were fixation of the arms (M ± SD = 7.47 ± 3.27), mechanical ventilation (M ± SD = 7.36 ± 3.29) and endotracheal suctioning (M ± SD = 7.19 ± 2.99). Approximately one third of patients underwent these situations. Situations experienced by more than 90% of ICU patients were evaluated as being the least stressful experiences, including infusion (M ± SD = 2.7 ± 2.7), measuring heart activity (M ± SD = 2.3 ± 2.7), taking blood samples (M ± SD = 2.2 ± 2.7), and temperature control (M ± SD = 0.9 ± 1.7). Controllability experienced by ICU patients negatively correlated with anxiety (r = -0.20, p = 0.004) and mean sensation of stress (r = -0.36; p < 0.001). When comparing stress levels of ICU patients who perceived controllability in a given situation to those who did not, the greatest effects (Cohen's d > 1.4) were observed for the situations presence of a bed barrier (M ± SD = 0.1 ± 0.4 vs. 5.9 ± 2.8), lighting at night (M ± SD = 0.7 ± 1.7 vs. 5.7 ± 3.3), presence of a ventilation tube (M ± SD = 2.5 ± 2.1 vs. 6.7 ± 3.0) and repositioning of the patient (M ± SD = 2.5 ± 2.9 vs. 6.7 ± 2.9). CONCLUSION The experience of loss of control seems to negatively modify the impact of stressors. Thus, an increase in aspects of controllability could reduce the burden on patients during intensive care.
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Affiliation(s)
- M Reinberger
- Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - R Bouchard
- Klinik für Allgemeine Chirurgie, Universität zu Lübeck, Lübeck, Deutschland
| | - E Muhl
- Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - C Nau
- Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - M Hüppe
- Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
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Foli KJ, Reddick B, Zhang L, Krcelich K. Nurses' psychological trauma: "They leave me lying awake at night". Arch Psychiatr Nurs 2020; 34:86-95. [PMID: 32513472 DOI: 10.1016/j.apnu.2020.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe nurses' personal and professional psychological trauma. METHODS A content analysis of 372 responses surrounding personal and professional trauma was performed. RESULTS Five themes emerged. A new type of trauma was uncovered, heretofore undescribed in the literature: insufficient resource trauma caused by a lack of resources and staff needed to render quality, safe care. CONCLUSION Nurses' reports were vivid, frequently indicating they were still recovering from traumatic experiences. Professional sources of trauma were categorized as inherent in the role of the nurse and those that could be mitigated through organizational policy, adequate resources, and oversight.
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Affiliation(s)
- Karen J Foli
- Purdue University School of Nursing, West Lafayette, IN, United States of America.
| | - Blake Reddick
- Purdue University School of Nursing, West Lafayette, IN, United States of America
| | - Lingsong Zhang
- Department of Statistics, Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana, United States of America
| | - Kathryn Krcelich
- Purdue University School of Nursing, West Lafayette, IN, United States of America
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Webster KEF, Carlson E. Building therapeutic connections with the acutely ill through standardised patient simulation in nurse education an evaluation study. NURSE EDUCATION TODAY 2020; 84:104261. [PMID: 31722281 DOI: 10.1016/j.nedt.2019.104261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 09/30/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Phenomenological empathy and sense of coherence are two researched communication approaches used to improve therapeutic connections with patients in a variety of nurse related settings. The aim of this study is to evaluate students' feedback concerning how this event has enabled that understanding, development and refinement of skill-sets in PE and SoC when managing the acutely ill during simulation. METHODS 114 third year bachelor degree-nursing students were given the opportunity to complete an evaluation, developed for the specific purpose of this study. The evaluation contained six closed questions on a four point Likert-scale and three open questions, handed out upon completion of the standardised patient simulation of the acutely ill. Comments written in response to the open questions were analysed using manifest content analysis and closed questions using SPSS to produce descriptive frequencies. RESULTS 100 students completed the evaluation. Student nurses', regardless of previous experience or age, indicated the need for more education and practice in phenomenological empathy and sense of coherence to enhance their ability to build therapeutic connections with the acutely ill. CONCLUSIONS Teaching phenomenological empathy and sense of coherence, as an integral part of standardised patient simulation is necessary to motivate student nurses ability to build therapeutic relationships with the acutely ill to enhance person centred care.
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Chung C, McKenna L, Cooper SJ. Patients' experiences of acute deterioration: A scoping review. Int J Nurs Stud 2019; 101:103404. [PMID: 31670222 DOI: 10.1016/j.ijnurstu.2019.103404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 07/05/2019] [Accepted: 08/20/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Patient experience is recognised as a means of assessing healthcare delivery with organisations in many countries now gathering patient experience or satisfaction data. It is well documented that the benefits of improving a patients' experience include increased satisfaction, reduced length of stay, improved patient outcomes and reduction of costs. The experience of acute clinical deterioration is unique, extensive and complex as well as being a difficult experience for all involved. However, little is known about this experience from the patient's perspective. AIM To explore what is known about the experiences of acute deterioration from the perspective of the patient. DESIGN A scoping review of international, peer-reviewed research studies and grey literature published between the years of 2000 and 2018. This review was guided by the three-step search strategy recommended by the Joanna Briggs Institute (JBI). DATA SOURCES A range of databases were searched, including CINAHL, Medline, Health Source, Joanna Briggs Institute, PsycINFO, Embase via Ovid, Cochrane library, Ovid Emcare, Scopus as well as grey literature, reference lists and the search engine Google Scholar. REVIEW METHODS Joanna Briggs Institute (JBI) scoping review framework was utilised to identify patients' experiences of acute deterioration. Ten databases were searched, and 249 articles were retrieved. After screening the titles and abstracts, 102 articles were assessed in full text for eligibility, and finally 23 articles were further analysed and synthesised using inductive thematic analysis. RESULTS 19 qualitative studies, three quantitative and one mixed methods study met the inclusion criteria. Seven key themes emerged related to patients' experience of acute deterioration: (1) transformation of perception: memories of factual events; (2) psychological transformation: emotional distress and well-being; (3) physiological transformation: physical distress; (4) facing death; (5) the severity of acute deterioration: from the perspective of the patient; (6) relationship with healthcare professionals and the clinical environment; and (7) the value of relationships: the support of family and friends. CONCLUSIONS Participants had considerable recall of their experiences and hospital admissions. The themes highlight the important issues patients face during their own acute physiological deterioration. This review has highlighted that further research is needed to specifically explore the patients' experience of acute deterioration and the emergency management they receive, for example from a hospital's rapid response team (RRT) or medical emergency team (MET).
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Affiliation(s)
- Catherine Chung
- Nursing and Healthcare Professions, Federation University Australia, Northways Rd., Churchill, Victoria 3842, Australia.
| | - Lisa McKenna
- Nursing and Healthcare Professions, Federation University Australia, Northways Rd., Churchill, Victoria 3842, Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Simon J Cooper
- Nursing and Healthcare Professions, Federation University Australia, Northways Rd., Churchill, Victoria 3842, Australia
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Stevens NR, Ziadni MS, Lillis TA, Gerhart J, Baker C, Hobfoll SE. Perceived lack of training moderates relationship between healthcare providers' personality and sense of efficacy in trauma-informed care. ANXIETY STRESS AND COPING 2019; 32:679-693. [PMID: 31345075 DOI: 10.1080/10615806.2019.1645835] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background and Objectives: Medical patients often have trauma histories that are not routinely assessed, which can adversely affect health outcomes. Despite growing awareness of this issue, there is limited understanding of factors that influence provider competency in trauma-informed care (TIC). The study examined healthcare providers' personality traits in relation to their sense of TIC efficacy, taking into account perceived barriers to TIC and professional quality of life. Study Design: The study used cross-sectional survey methods to examine our central hypothesis that provider personality traits and perceived barriers to TIC would be associated with TIC-efficacy, and to explore interactions among study variables. Methods: Survey data were collected from 172 healthcare providers examining TIC knowledge, TIC-efficacy, perceived barriers to TIC, personality traits, and professional quality of life. Results: TIC-efficacy was positively correlated with "intellectence/openness" and inversely correlated with "neuroticism" and perceived lack of training as a barrier. "Intellectence/openness" interacted with perceived lack of training to predict TIC-efficacy, suggesting that providers with lower "intellectence/openness" report greater TIC-efficacy when lack of training is not perceived as a barrier. Conclusions: Provider personality traits and perceived barriers to TIC appear related to providers' TIC-efficacy. Implications for overcoming barriers to TIC through training and implementation are discussed.
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Affiliation(s)
- Natalie R Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center , Chicago , IL , USA
| | - Maisa S Ziadni
- Systems Neuroscience and Pain Lab, Stanford University , Palo Alto , CA , USA
| | - Teresa A Lillis
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center , Chicago , IL , USA
| | - James Gerhart
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center , Chicago , IL , USA
| | - Courtney Baker
- School of Science and Engineering, Tulane University , New Orleans , LA , USA
| | - Stevan E Hobfoll
- STAR Consultants - Stress, Anxiety-Resilience , Chicago , IL , USA
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Ganz FD, Yihye G, Beckman N. Family-Centered Communication and Acute Stress in Israeli Intensive Care Units. Am J Crit Care 2019; 28:274-280. [PMID: 31263010 DOI: 10.4037/ajcc2019562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Intensive care unit stays can be stressful for patients' family members. Family-centered communication has 6 components: fostering relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. Whether these communication components decrease family members' stress is unknown. OBJECTIVE To describe levels of family-centered communication and associations with acute stress while patients are in the intensive care unit. METHODS A convenience sample of 130 family members of patients in 2 intensive care units in a Jerusalem, Israel, tertiary medical center received a family-centered communication questionnaire, the Perceived Stress Scale, and a personal characteristics questionnaire. RESULTS Most respondents were women (n = 79, 60.8%), children of the patient (n = 67, 51.9%), and familiar with the patient's diagnosis (n = 111, 85.4%). Mean (SD) participant age was 45.7 (13.6) years. Most considered the patient medically stable (n = 75, 57.7%). Mean (SD) intensive care unit stay was 7.45 (5.8) days. Mean (SD) total and item scores for family-centered communication were 98.75 (18.21) and 3.80 (0.70), respectively; for the Perceived Stress Scale, 19.63 (5.92) and 1.96 (0.59), respectively. Relationship building (r = -0.31, P = .002), participation in care management (r = -0.32, P = .001), and emotional support (r = -0.29, P = .003), and were significantly related to stress. CONCLUSIONS Stress levels were mild to moderate and communication scores were moderate to high. Better nurse communication with family members was associated with decreased acute stress, irrespective of personal characteristics or perceptions of the patient's medical status.
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Affiliation(s)
- Freda DeKeyser Ganz
- Freda DeKeyser Ganz is a department chair at Hadassah-Hebrew University School of Nursing, Jerusalem, Israel. Gilat Yihye is a head nurse at Hadassah Medical Center, Jerusalem. Nicole Beckman is a nursing instructor at Hadassah-Hebrew University School of Nursing
| | - Gilat Yihye
- Freda DeKeyser Ganz is a department chair at Hadassah-Hebrew University School of Nursing, Jerusalem, Israel. Gilat Yihye is a head nurse at Hadassah Medical Center, Jerusalem. Nicole Beckman is a nursing instructor at Hadassah-Hebrew University School of Nursing
| | - Nicole Beckman
- Freda DeKeyser Ganz is a department chair at Hadassah-Hebrew University School of Nursing, Jerusalem, Israel. Gilat Yihye is a head nurse at Hadassah Medical Center, Jerusalem. Nicole Beckman is a nursing instructor at Hadassah-Hebrew University School of Nursing
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Redley B, Phiri LM, Heyns T, Wang W, Han C. Family needs during critical illness in the Emergency Department: A retrospective factor analysis of data from three countries. J Clin Nurs 2019; 28:2813-2823. [DOI: 10.1111/jocn.14857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/19/2019] [Accepted: 03/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Bernice Redley
- Centre for Quality and Patient Safety Research – Monash Health Partnership, School of Nursing and Midwifery Deakin University Burwood Victoria Australia
| | - Lesego M. Phiri
- Department of Nursing Science University of Pretoria Pretoria South Africa
| | - Tanya Heyns
- Department of Nursing Science Sefako Makgatho Health Sciences University Ga‐Rankuwa South Africa
| | - Wei Wang
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences Monash University Frankston Victoria Australia
- Peninsula Health Frankston Victoria Australia
| | - Chin‐Yen Han
- Department of Nursing Chang Gung University of Science and Technology and Linkou Chang Gung Memorial Hospital Taoyuan City Taiwan, Republic of China
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