A pre-post evaluation of the Adler/Sheiner Programme (ASP): a nursing informational programme to support families and nurses in an intensive care unit (ICU)

Caring to care: Nurturing ICU healthcare professionals' wellbeing for enhanced patient safety

Healthcare professionals working in the Intensive Care Unit (ICU) care for patients suffering from a critical illness and their relatives. Working within a team of people with different personalities, competencies, and specialties, with constraints and demands might contribute to a working environment that is prone to conflicts and disagreements. This highlights that the ICU is a stressful place that can threaten healthcare professionals' wellbeing. This article aims to address the concept of wellbeing by describing how the stressful ICU work-environment threatens the wellbeing of health professionals and discussing how this situation jeopardizes patient safety. To promote wellbeing, it is imperative to explore actionable interventions such as improve communication skills, educational sessions on stress management, or mindfulness. Promoting ICU healthcare professionals' wellbeing through evidence-based strategies will not only increase their personal resilience but might contribute to a safer and more efficient patient care.

Translations of the Practice Environment Scale of the Nursing Work Index: A systematic review

Since 2002, the Practice Environment Scale of the Nursing Work Index has been used worldwide to evaluate nurse work environments. High quality translations in different languages can help advance science and inform practice globally. The study purposes were to conduct a systematic review of published translations of the instrument and to assess their linguistic equivalence and psychometric performance. We conducted a comprehensive search, a quality assessment and synthesis of linguistic equivalence, reliability, and validity data. Studies published through July 2021 were identified in the CINAHL, LILACS, EMCare, and Scopus databases. Thirty-eight publications were selected, comprising 46 translations into 24 languages and 15 language variants, and 35 countries. Translations are in predominantly European, Southeast Asian, and Middle Eastern languages. Two-thirds of the translations reflected medium to high fulfillment of translation quality criteria. The GRADE ratings, reflecting satisfactory fulfillment of cross-cultural equivalence and psychometric properties, were predominantly high (n = 23), then low (n = 15), then moderate (n = 8). The identified translations will support the advancement of global science and the improvement of nurses' work environments.

Exploring the Mental Health Challenges of Emergency Medicine and Critical Care Professionals: A Comprehensive Review and Meta-Analysis

Burnout and depression are global problems affecting healthcare providers, especially those working in stressful departments such as emergency departments (EDs) and critical care units (CCUs). However, pooled data analysis comparing healthcare providers operating in the ED and CCU is yet to be conducted. Therefore, this meta-analysis was systematically conducted to investigate and compare the prevalence of burnout and depression among emergency medicine (EM) and critical care medicine (CCM) professionals. We systematically searched for articles related to our research topic using the database search method and manual search method, which involved reviewing the reference lists of articles from electronic databases for additional studies. After screening the literature from the databases using the eligibility criteria, a quality appraisal using the Newcastle-Ottawa scale was performed on the eligible studies. In addition, a meta-analysis using the Review Manager software was performed to investigate the prevalence rates of burnout and depression. A total of 10 studies with 1,353 EM and 1,250 CCM professionals were included for analysis in the present study. The pooled analysis did not establish any considerable differences between EM and CCM healthcare workers on the prevalence of high emotional exhaustion (EE) (odds ratio (OR) = 1.01; 95% confidence interval (CI) = 0.46-2.19; p = 0.98), high depersonalization (OR = 1.16; 95% CI = 0.61-2.21; p = 0.64), low personal accomplishment (PA) (OR = 0.87; 95% CI = 0.67 - 1.12; p = 0.28), and depression (OR = 1.20; 95% CI = 0.74-1.95; p = 0.45). Moreover, pooled data showed no considerable differences in EE scores (mean difference (MD) = -1.07; 95% CI = -4.24-2.09; p = 0.51) and depersonalization scores (MD = -0.31; 95% CI = -1.35-0.73; p = 0.56). However, EM healthcare workers seemed to have considerably lower PA scores than their CCM counterparts (MD = 0.12; 95% CI = 0.08-0.16; p < 0.00001). No considerable difference was recorded in the prevalence of burnout and depression between EM and CCM healthcare workers. However, our findings suggest that EM professionals have lower PA scores than CCM professionals; therefore, more attention should be paid to the mental health of EM professionals to improve their PA.

Family Intensive Care Unit Syndrome: An Integrative Review

BACKGROUND

Hospitalization in the Intensive Care Unit (ICU) brings about psychological and physical symptoms in patients' family members. Family Intensive Care Unit Syndrome (FICUS) is a term used to explain the psychological symptoms of the family of a patient in response to the patient's admission to the ICU. The purpose of this study was to define FICUS along with its symptoms and predictors.

MATERIALS AND METHODS

The Web of Science, PubMed, Scopus, Google Scholar, and SID databases were searched for literature published in 2005-2018 with the keywords "FICUS," "intensive care unit," "family," "caregivers," "anxiety," "depression," and "post-traumatic stress disorder" in their title and abstract. The strategy for conducting an integrative review provided by Whittemore and Knafl (2005) was used in this study.

RESULTS

Twenty articles were included in the final data analysis. Following the patient's admission to the ICU, family members experience multiple psychological symptoms such as FICUS. The most commonly reported symptoms were anxiety, depression, post-traumatic stress disorder (PTSD), complicated grief, sleep disorder, stress, and fatigue. The low education level, having a critically-ill spouse, adequate support, financial stability, preference for decision-making, understanding of the disease process, anxiety, depression, or previous acute stress were predictors of FICUS.

CONCLUSIONS

On the basis of the results, families also experience physical symptoms, so the FICUS is not limited to the occurrence of psychological symptoms. This study found that there is no universal definition for the term "FICUS" in the research literature. Thus, further research is needed to explore FICUS in the health field.

Workplace-Based Organizational Interventions Promoting Mental Health and Happiness among Healthcare Workers: A Realist Review

Mental illness, deemed globally to account for 32% of years lived with a disability, generates significant impacts on workplaces. In particular, healthcare workers experience high rates of mental ill health such as burnout, stress, and depression due to workplace conditions including excessive workloads, workplace violence and bullying, which also produces negative effects on patients as well as on the happiness and wellbeing of those who remain at work. This review was undertaken to synthesize the evidence on workplace-based interventions at the organizational level promoting mental health and wellbeing among healthcare workers, to identify what has been receiving attention in this area and why, especially considering how such positive effects are produced. A search of three premier health-related databases identified 1290 articles that discussed healthcare workers, workplace interventions, and mental health. Following further examination, 46 articles were ultimately selected as meeting the criteria specifying interventions at the organizational level and combined with similar studies included in a relevant Cochrane review. The 60 chosen articles were then analyzed following a realist framework analyzing context, mechanism, and outcome. Most of the studies included in the realist review were conducted in high-income countries, and the types of organizational-level interventions studied included skills and knowledge development, leadership development, communication and team building, stress management as well as workload and time management. Common themes from the realist review highlight the importance of employee engagement in the intervention development and implementation process. The literature review also supports the recognized need for more research on mental health and happiness in low- and middle-income countries, and for studies evaluating the longer-term effects of workplace mental health promotion.

Burnout prevalence in intensive care nurses in Argentina

PURPOSE

Burnout syndrome among intensive care professionals has been widely documented internationally. Few studies address the incidence and prevalence in Latin America. And there are no validated studies about the situation in Argentina. Our goal was to determine burnout prevalence among intensive care nurses in Argentina and related risk factors.

MATERIALS AND METHODS

Online self-administered survey evaluating demographic variables and the Maslach Burnout Inventory in 486 critical care nurses between June and September 2016.

RESULTS

A percentage of 84.4 of participants show moderate or high levels of burnout syndrome (95% CI 80.8 to 87.4). No significant association was found between burnout and gender, age, years of practice, academic degree, role or multiplicity of jobs. There was no statistical difference in burnout prevalence among different types of populations of care (neonatal, paediatric or adult care). Nurse to patient ratios of 1:3 or higher was found to be a statistically significant risk factor for emotional exhaustion and depersonalization sub-scales (P=.002 and .0039, respectively).

CONCLUSION

More than 80% of nurses caring for critically ill patients in Argentina show moderate or high levels of burnout syndrome and this is related to a high nurse:patient ratio (1:3 or higher).

Psychosocial needs of families of intensive care patients: Perceptions of nurses and families

Background:

Admission to an intensive care unit (ICU) is not only stressful to the patients but the patients' family members. Families are believed not to receive their required attention because their needs are incorrectly and inaccurately evaluated by the health care team. Therefore, the present study aimed to examine the perceptions of ICU nurses and families regarding the psychosocial needs of families of intensive care patients.

Materials and Methods:

This descriptive-analytical study was conducted on a randomly selected population of 80 nurses and 80 family members of ICU patients. Data were collected using a two-part questionnaire containing sociodemographic characteristics and the Critical Care Family Need Inventory (CCFNI).

Results:

The rank order of the five most important CCFNI item needs identified by families were as follows: “To feel that the hospital personnel care about the patient”, “to be assured that the best care possible is being given to the patient”, “to have questions answered honestly”, “to know specific facts concerning patient's progress”, and “to be called at home about changes in the patient's condition.” The top five CCFNI item needs identified by nurses were in the following order: “To be assured that the best care possible is being given to the patient”, “to be told about transfer plans while they are being made”, “to feel that the hospital personnel care about the patient”, “to have questions answered honestly”, and “to know specific facts concerning patient's progress.”

Conclusion:

The present study showed there are similarities and dissimilarities between nurses and family members in their perceived importance of some family needs in the ICU. It can thus be inferred from our results that the participating nurses misestimated the needs of family members, attested by their wrong estimation of the most need statements.

The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review

BACKGROUND

Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health.

PURPOSE

The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion fatigue and the available preventive strategies.

METHODS

A systematic literature review was conducted, using Embase, Medline OvidSP, Cinahl, Web-of-science, PsychINFO, PubMed publisher, Cochrane and Google Scholar for articles published between 1992 and June, 2014. Studies reporting the prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals were included, as well as related intervention studies.

RESULTS

Forty of the 1623 identified publications, which included 14,770 respondents, met the selection criteria. Two studies reported the prevalence of compassion fatigue as 7.3% and 40%; five studies described the prevalence of secondary traumatic stress ranging from 0% to 38.5%. The reported prevalence of burnout in the ICU varied from 0% to 70.1%. A wide range of intervention strategies emerged from the recent literature search, such as different intensivist work schedules, educational programs on coping with emotional distress, improving communication skills, and relaxation methods.

CONCLUSIONS

The true prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals remains open for discussion. A thorough exploration of emotional distress in relation to communication skills, ethical rounds, and mindfulness might provide an appropriate starting point for the development of further preventive strategies.