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Agreement between Family Members and the Physician's View in the ICU Environment: Personal Experience as a Factor Influencing Attitudes towards Corresponding Hypothetical Situations. Healthcare (Basel) 2023; 11:healthcare11030345. [PMID: 36766921 PMCID: PMC9914929 DOI: 10.3390/healthcare11030345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND It is not known whether intensive care unit (ICU) patients' family members realistically assess patients' health status. OBJECTIVES The aim was to investigate the agreement between family and intensivists' assessment concerning changes in patient health, focusing on family members' resilience and their perceptions of decision making. METHODS For each ICU patient, withdrawal criteria were assessed by intensivists while family members assessed the patient's health development and completed the Connor-Davidson Resilience Scale and the Self-Compassion Scale. Six months after ICU discharge, follow-up contact was established, and family members gave their responses to two hypothetical scenarios. RESULTS 162 ICU patients and 189 family members were recruited. Intensivists' decisions about whether a patient met the withdrawal criteria had 75,9% accuracy for prediction of survival. Families' assessments were statistically independent of intensivists' opinions, and resilience had a significant positive effect on the probability of agreement with intensivists. Six months after discharge, family members whose relatives were still alive were significantly more likely to consider that the family or patient themselves should be involved in decision-making. CONCLUSIONS Resilience is related to an enhanced probability of agreement of the family with intensivists' perceptions of patients' health progression. Family attitudes in hypothetical scenarios were found to be significantly affected by the patient's actual health progression.
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Cuzco C, Castro Rebollo P, Marín Pérez R, Núñez Delgado AI, Romero García M, Martínez Momblan MA, Estrada Reventós D, Martínez Estalella G, Delgado-Hito P. Mixed-method research protocol: Development and evaluation of a nursing intervention in patients discharged from the intensive care unit. Nurs Open 2021; 8:3666-3676. [PMID: 33955196 PMCID: PMC8510756 DOI: 10.1002/nop2.894] [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] [Received: 12/01/2020] [Revised: 01/28/2021] [Accepted: 03/29/2021] [Indexed: 11/06/2022] Open
Abstract
AIM (a) To understand patients' lived experience at intensive care unit (ICU) discharge and (b) to evaluate the impact of a nursing empowerment intervention (NEI) on patients' anxiety and depression levels at ICU discharge. DESIGN A mixed-methods approach will be applied. METHODS In the qualitative phase, the hermeneutic phenomenological method will be used. Participants will be patients from three university hospitals who will be selected by purposive sampling. Data will be gathered through in-depth interviews and analysed using content analysis. The qualitative data obtained will be employed to develop the nursing intervention. Subsequently, a multicenter, parallel-group, experimental pre-test/post-test design with a control group will be used to measure the effectiveness of the nursing empowerment intervention in the quantitative phase by means of the Hospital Anxiety and Depression Scale (HADS). Simple random probabilistic sampling will include 172 patients in this phase.
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Affiliation(s)
- Cecilia Cuzco
- Hospital Clinic, Barcelona, Spain.,Faculty of Medicine and Health Sciences, School of Nursing, Department of Fundamental and Medical-Surgical Nursing, Universitat de Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain
| | - Pedro Castro Rebollo
- Hospital Clinic, Barcelona, Spain.,Biomedical Research Institute August Pi Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain.,School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Marta Romero García
- Faculty of Medicine and Health Sciences, School of Nursing, Department of Fundamental and Medical-Surgical Nursing, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), l'Hospitalet de Llobregat, Spain
| | - M Antonia Martínez Momblan
- Faculty of Medicine and Health Sciences, School of Nursing, Department of Fundamental and Medical-Surgical Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Dolors Estrada Reventós
- Hospital Clinic, Barcelona, Spain.,Faculty of Medicine and Health Sciences, School of Nursing, Department of Fundamental and Medical-Surgical Nursing, Universitat de Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain
| | - Gemma Martínez Estalella
- Hospital Clinic, Barcelona, Spain.,Faculty of Medicine and Health Sciences, School of Nursing, Department of Fundamental and Medical-Surgical Nursing, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), l'Hospitalet de Llobregat, Spain
| | - Pilar Delgado-Hito
- Faculty of Medicine and Health Sciences, School of Nursing, Department of Fundamental and Medical-Surgical Nursing, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), l'Hospitalet de Llobregat, Spain
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Chen Y, Jones C, Dunse N. Coronavirus disease 2019 (COVID-19) and psychological distress in China: Does neighbourhood matter? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 759:144203. [PMID: 33333329 PMCID: PMC7832354 DOI: 10.1016/j.scitotenv.2020.144203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 05/02/2023]
Abstract
Using individual data (n = 937) obtained from an online questionnaire between 20th January and 13th February, the early stage of the outbreak of the Coronavirus Disease 2019 (COVID-19) in 2020, we explore the direct association between people's perceptions of Coronavirus Disease 2019 (COVID-19) and psychological distress. We further examine the moderating role of neighbourhood environment and this distress. We find that people living in infected communities tend to perceive higher level of psychological distress compared to people living in uninfected communities. People's expected duration of COVID-19 is associated with higher psychological distress and this is partially moderated by the perception of neighbourhood noise level and overall environment quality. Additional results quantify the evidence that a quiet and well maintained neighbourhood environment could reduce the negative influences of expectation of a long duration of COVID-19 on people's psychological distress.
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Affiliation(s)
- Yiyi Chen
- The Urban Institute, Heriot-Watt University, Edinburgh EH14 4AS, UK.
| | - Colin Jones
- The Urban Institute, Heriot-Watt University, Edinburgh EH14 4AS, UK.
| | - Neil Dunse
- The Urban Institute, Heriot-Watt University, Edinburgh EH14 4AS, UK.
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Zaga CJ, Pandian V, Brodsky MB, Wallace S, Cameron TS, Chao C, Orloff LA, Atkins NE, McGrath BA, Lazarus CL, Vogel AP, Brenner MJ. Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1320-1334. [PMID: 32525695 DOI: 10.1044/2020_ajslp-20-00089] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Purpose As the COVID-19 pandemic has unfolded, there has been growing recognition of risks to frontline health care workers. When caring for patients with tracheostomy, speech-language pathologists have significant exposure to mucosal surfaces, secretions, and aerosols that may harbor the SARS-CoV-2 virus. This tutorial provides guidance on practices for safely performing patient evaluation and procedures, thereby reducing risk of infection. Method Data were collated through review of literature, guidelines, and consensus statements relating to COVID-19 and similar high-consequent infections, with a focus on mitigating risk of transmission to health care workers. Particular emphasis was placed on speech-language pathologists, nurses, and other allied health professionals. A multinational interdisciplinary team then analyzed findings, arriving at recommendations through consensus via electronic communications and video conference. Results Reports of transmission of infection to health care workers in the current COVID-19 pandemic and previous outbreaks substantiate the need for safe practices. Many procedures routinely performed by speech-language pathologists have a significant risk of infection due to aerosol generation. COVID-19 testing can inform level of protective equipment, and meticulous hygiene can stem spread of nosocomial infection. Modifications to standard clinical practice in tracheostomy are often required. Personal protective equipment, including either powered air-purifying respirator or N95 mask, gloves, goggles, and gown, are needed when performing aerosol-generating procedures in patients with known or suspected COVID-19 infection. Conclusions Speech-language pathologists are often called on to assist in the care of patients with tracheostomy and known or suspected COVID-19 infection. Appropriate care of these patients is predicated on maintaining the health and safety of the health care team. Careful adherence to best practices can significantly reduce risk of infectious transmission.
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Affiliation(s)
- Charissa J Zaga
- Department of Speech Pathology, Austin Health, Melbourne, Victoria, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
| | - Vinciya Pandian
- Department of Nursing Faculty, Johns Hopkins University, Baltimore, MD
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD
| | - Martin B Brodsky
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Sarah Wallace
- Department of Speech Voice and Swallowing, Manchester University NHS Foundation Trust, United Kingdom
| | - Tanis S Cameron
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
| | - Caroline Chao
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
| | - Lisa Ann Orloff
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, CA
| | - Naomi E Atkins
- Department of Respiratory Medicine, Austin Health, Melbourne, Victoria, Australia
| | - Brendan A McGrath
- Anaesthetics & Intensive Care Medicine, Manchester University NHS Foundation Trust, United Kingdom
| | - Cathy L Lazarus
- Department of Otolaryngology-Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adam P Vogel
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Redenlab, Melbourne, Victoria, Australia
| | - Michael J Brenner
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor
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Zaga CJ, Berney S, Vogel AP. The Feasibility, Utility, and Safety of Communication Interventions With Mechanically Ventilated Intensive Care Unit Patients: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1335-1355. [PMID: 31296037 DOI: 10.1044/2019_ajslp-19-0001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aim of this study was to conduct a systematic review of the literature relating to the feasibility, utility, and safety of augmentative and alternative communication (AAC) interventions and tracheostomy-related communication interventions with mechanically ventilated adult patients in the intensive care unit (ICU). Method MEDLINE, Embase, and PsycINFO databases were searched for relevant articles. Studies were included if (a) they were performed in the ICU, (b) they involved participants > 18 years of age, (c) > 85% of participants were mechanically ventilated, and (d) they reported on content that related to the feasibility and/or utility and/or safety of AAC intervention and/or tracheostomy-related communication intervention. Studies were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The levels of evidence for included studies were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Results Forty-eight studies met the inclusion criteria. Different communication interventions relating to intubated and tracheostomized mechanically ventilated patients were reviewed, including (a) communication boards, (b) electrolarynx, (c) high-technology AAC devices, (d) tracheostomy tubes with communication-enabling features, (e) one-way valve in line with the ventilator, (f) ventilator-adjusted leak speech, (g) ventilator adjustments and one-way valve, and (h) multiple interventions. Forty-seven of 48 studies examined the feasibility and utility of the interventions. Sixteen studies examined the safety of the interventions. The included studies were composed of randomized controlled trials (n = 2), quasi-experimental studies (n = 7), cohort studies (n = 8), case-control (n = 1), case series (n = 23), and case reports (n = 7). The levels of evidence varied and ranged from high (n = 2), moderate (n = 7), low (n = 9), and very low (n = 30). Conclusions There is developing evidence that communication interventions with mechanically ventilated ICU patients are feasible, have utility, and are safe. Further research is warranted to guide speech pathologist-directed intervention to improve patient outcomes and the patient experience in the ICU.
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Affiliation(s)
- Charissa J Zaga
- Speech Pathology Department, Austin Health, Melbourne, Australia
- Centre for Neuroscience of Speech, The University of Melbourne, Australia
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Australia
| | - Sue Berney
- Department of Physiotherapy, Austin Health, Melbourne, Australia
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Australia
| | - Adam P Vogel
- Centre for Neuroscience of Speech, The University of Melbourne, Australia
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Tübingen Germany
- Redenlab, Melbourne, Australia
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Scholes J, Trapani J. What's in this issue? Nurs Crit Care 2017. [PMID: 28632978 DOI: 10.1111/nicc.12307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Julie Scholes
- Professor of Nursing, Editor of Nursing in Critical Care
| | - Josef Trapani
- Lecturer in Nursing, Intern in Nursing in Critical Care
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Coping as a Multifaceted Construct: Associations With Psychological Outcomes Among Family Members of Mechanical Ventilation Survivors. Crit Care Med 2017; 44:1710-7. [PMID: 27065467 DOI: 10.1097/ccm.0000000000001761] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To develop and evaluate a preliminary multifaceted model for coping among family members of patients who survive mechanical ventilation. DESIGN AND SETTING In this multicenter cross-sectional survey, we interviewed family members of mechanically ventilated patients at the time of transfer from the ICU to the hospital ward. We constructed a theoretic model of coping that included characteristics attributable to family members, family-clinician rapport, and patients. We then explored relationships between coping factors and symptoms of psychological distress (anxiety, depression, and posttraumatic stress). SUBJECTS Fifty-six family members of survivors of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS Psychological distress measured by the Hospital Anxiety and Depression Scale and Posttraumatic Stress Scale. Optimism measured using the Life Orientation Test scale, resiliency by Conner-Davidson Resilience Scale, and social support using the Patient Reported Outcomes Measurement Information System inventory. Family members had moderate levels of psychological distress with median total Hospital Anxiety and Depression Scale equal to 14 (interquartile range, 5-20) and Posttraumatic Stress Scale equal to 22 (interquartile range, 15-31). Among family member characteristics, greater optimism (p = 0.001, Hospital Anxiety and Depression Scale; p = 0.010, Posttraumatic Stress Scale), resilience (p = 0.012, Hospital Anxiety and Depression Scale), and social support (p = 0.013, Hospital Anxiety and Depression Scale) were protective against psychological distress. On the contrary, characteristics of family-clinician rapport such as communication quality and presence of conflict did not have any associations with psychological distress. CONCLUSION To our knowledge, this is the first study to explore coping as a multifaceted construct and its relationship with family psychological outcomes among survivors of mechanical ventilation. We found certain family characteristics of coping such as optimism, resilience, and social support to be associated with less psychological distress. Further research is warranted to identify potentially modifiable aspects of coping that might guide future interventions.
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Butler JM, Hirshberg EL, Hopkins RO, Wilson EL, Orme JF, Beesley SJ, Kuttler K, Brown SM. Preliminary Identification of Coping Profiles Relevant to Surrogate Decision Making in the ICU. PLoS One 2016; 11:e0166542. [PMID: 27835704 PMCID: PMC5105941 DOI: 10.1371/journal.pone.0166542] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/31/2016] [Indexed: 11/19/2022] Open
Abstract
Objective The Intensive Care Unit (ICU) is a stressful environment for families of critically ill patients and these individuals are at risk to develop persistent psychological morbidity. Our study objective was to identify individual differences in coping with stress and information presentation preferences of respondents exposed to a simulated ICU experience. Methods Participants were recruited from a university and two community populations. Participants completed questionnaires that measured demographic information and characteristics that may be relevant to an individual’s ICU experience. Quality of life was measured by the EQ-5D, personality dimensions were examined with the abbreviated Big Five inventory, coping with stress was assessed with Brief COPE. Shared decision making preferences were assessed by the Degner Control Preferences Scale (CPS) and information seeking style was assessed with the Miller Behavioral Style Scale (MBSS). Social support was examined using an abbreviated version of the Social Relationship Index. Participants also completed a vignette-based simulated ICU experience, in which they made a surrogate decision on behalf of a loved one in the ICU. Results Three hundred forty-three participants completed the study. Three distinct coping profiles were identified: adaptive copers, maladaptive copers, and disengaged copers. Profiles differed primarily on coping styles, personality, quality of their closest social relationship, and history of anxiety and depression. Responses to the simulated ICU decision making experience differed across profiles. Disengaged copers (15%) were more likely to elect to refuse dialysis on behalf of an adult sibling compared to adaptive copers (7%) or maladaptive copers (5%) (p = 0.03). Notably, the MBSS and the CPS did not differ by coping profile. Conclusion Distinct coping profiles are associated with differences in responses to a simulated ICU experience. Tailoring communication and support to specific coping profiles may represent an important pathway to improving ICU experience for patients and families.
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Affiliation(s)
- Jorie M. Butler
- Geriatric Research Education and Clinical Center (GRECC), George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States of America
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah, United States of America
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- * E-mail:
| | - Eliotte L. Hirshberg
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
- Department of Internal Medicine, Division of Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States of America
- Department of Pediatrics, Division of Critical Care, University of Utah, Salt Lake City, Utah, United States of America
| | - Ramona O. Hopkins
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
- Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
| | - Emily L. Wilson
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
| | - James F. Orme
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
- Department of Internal Medicine, Division of Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | - Sarah J. Beesley
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
- Department of Internal Medicine, Division of Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | - Kathryn Kuttler
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
- Homer Warner Center for Informatics Research, Murray, Utah, United States of America
| | - Samuel M. Brown
- Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, United States of America
- Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, United States of America
- Department of Internal Medicine, Division of Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States of America
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Anxiété, dépression et attentes des familles de patients hospitalisés aux urgences : état des lieux et comparaison familles-soignants dans un service tunisien. ANNALES FRANCAISES DE MEDECINE D URGENCE 2015. [DOI: 10.1007/s13341-015-0581-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Questionnaires on Family Satisfaction in the Adult ICU: A Systematic Review Including Psychometric Properties. Crit Care Med 2015; 43:1731-44. [PMID: 25821917 DOI: 10.1097/ccm.0000000000000980] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To perform a systematic review of the literature to determine which questionnaires are currently available to measure family satisfaction with care on the ICU and to provide an overview of their quality by evaluating their psychometric properties. DATA SOURCES We searched PubMed, Embase, The Cochrane Library, Web of Science, PsycINFO, and CINAHL from inception to October 30, 2013. STUDY SELECTION Experimental and observational research articles reporting on questionnaires on family satisfaction and/or needs in the ICU were included. Two reviewers determined eligibility. DATA EXTRACTION Design, application mode, language, and the number of studies of the tools were registered. With this information, the tools were globally categorized according to validity and reliability: level I (well-established quality), II (approaching well-established quality), III (promising quality), or IV (unconfirmed quality). The quality of the highest level (I) tools was assessed by further examination of the psychometric properties and sample size of the studies. DATA SYNTHESIS The search detected 3,655 references, from which 135 articles were included. We found 27 different tools that assessed overall or circumscribed aspects of family satisfaction with ICU care. Only four questionnaires were categorized as level I: the Critical Care Family Needs Inventory, the Society of Critical Care Medicine Family Needs Assessment, the Critical Care Family Satisfaction Survey, and the Family Satisfaction in the Intensive Care Unit. Studies on these questionnaires were of good sample size (n ≥ 100) and showed adequate data on face/content validity and internal consistency. Studies on the Critical Care Family Needs Inventory, the Family Satisfaction in the Intensive Care Unit also contained sufficient data on inter-rater/test-retest reliability, responsiveness, and feasibility. In general, data on measures of central tendency and sensitivity to change were scarce. CONCLUSIONS Of all the questionnaires found, the Critical Care Family Needs Inventory and the Family Satisfaction in the Intensive Care Unit were the most reliable and valid in relation to their psychometric properties. However, a universal "best questionnaire" is indefinable because it depends on the specific goal, context, and population used in the inquiry.
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Hajj M, Gulgulian T, Haydar L, Saab A, Dirany F, Badr LK. The satisfaction of families in the care of their loved ones in CCUs in Lebanon. Nurs Crit Care 2015; 22:203-211. [PMID: 26256561 DOI: 10.1111/nicc.12195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/07/2015] [Accepted: 05/28/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care. AIMS To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction. METHODS A cross-sectional descriptive design was conducted using the Critical Care Family Satisfaction Survey (CCFSS). The participants were 123 adult relatives or significant others of patients cared for in both adult and paediatric intensive care units for at least 3 days. RESULTS The CCFSS showed acceptable internal reliability and construct validity in a Lebanese population. In general, families were satisfied with the care their loved ones received in the CCUs, and the least satisfaction was in the area of 'comfort' and the highest was in 'assurance'. Younger family members with more education were less satisfied with care and Christian families expressed less satisfaction with informational needs compared with Muslim families. Families of children in the paediatric CCU expressed least satisfaction with care. Gender, residency, relationship to patient, unit, prior experience in a CCU and diagnosis had no effect on satisfaction scores. CONCLUSIONS Assessment of family satisfaction in different cultures is important as each culture has specific needs that are essential to decipher. IMPLICATIONS FOR PRACTICE Patient satisfaction leads to improved quality of care; thus, it behoves nurses to meet the needs of families from different cultures to help them cope and increase their satisfaction, which leads to improve patient outcomes.
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Affiliation(s)
- Madeleine Hajj
- Department of Nursing, Keserwan Medical Center, Jounieh, Lebanon
| | - Taline Gulgulian
- School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Lili Haydar
- PICU, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amali Saab
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatima Dirany
- American University of Beirut Medical Center, Beirut, Lebanon
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12
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Frivold G, Dale B, Slettebø Å. Family members’ experiences of being cared for by nurses and physicians in Norwegian intensive care units: A phenomenological hermeneutical study. Intensive Crit Care Nurs 2015; 31:232-40. [DOI: 10.1016/j.iccn.2015.01.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 11/13/2014] [Accepted: 01/29/2015] [Indexed: 10/23/2022]
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13
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Oh J, Sohn JH, Shin CS, Na SH, Yoon HJ, Kim JJ, Park S, Park JY. Mutual relationship between anxiety and pain in the intensive care unit and its effect on medications. J Crit Care 2015; 30:1043-8. [PMID: 26116140 DOI: 10.1016/j.jcrc.2015.05.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE Little is known about the relationship between anxiety and pain in intensive care unit (ICU) patients despite its importance. The aims of the present study are to examine the correlation between pain and anxiety during ICU care and to investigate its effects on the dose of opioids and anxiolytics administered. METHODS The study subjects were awake critically ill patients admitted to an ICU over a 2-month period. Trained psychiatrists evaluated the nondelirious, noncomatose patients daily for anxiety and pain using the Numeric Rating Scale for Pain (NRS-Pain), Faces Anxiety Scale (FAS), and Hamilton Anxiety Rating Scale. RESULTS Daily alterations of anxiety and pain were significantly correlated with one another among 123 patients. Both the FAS and the Hamilton Anxiety Rating Scale were positively correlated with the NRS-Pain (P < .001 for both). The NRS-Pain score (P = .016) and the FAS score (P = .007) both significantly correlated with the dose of anxiolytics. The dose of opioids was unaffected by the severity of pain or anxiety. CONCLUSIONS Pain and anxiety among critically ill patients in the ICU were closely correlated. Pain and anxiety influenced the dose of anxiolytics administered. Therefore, a precise evaluation and comprehensive approach to the management of pain and anxiety are important for treating ICU patients.
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Affiliation(s)
- Jooyoung Oh
- Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, South Korea; Department of Medical System Engineering (DMSE), Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Jeong-Hyun Sohn
- Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, South Korea
| | - Cheung Soo Shin
- Department of Anesthesiology, College of Medicine, Yonsei University, Seoul, South Korea
| | - Se Hee Na
- Department of Anesthesiology, College of Medicine, Yonsei University, Seoul, South Korea
| | - Hyung-Jun Yoon
- Department of Psychiatry, Glory Hospital, Incheon, South Korea
| | - Jae-Jin Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, South Korea
| | - Sunyoung Park
- Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, South Korea
| | - Jin Young Park
- Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, South Korea.
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Skogstad L, Hem E, Sandvik L, Ekeberg O. Nurse-led psychological intervention after physical traumas: a randomized controlled trial. J Clin Med Res 2015; 7:339-47. [PMID: 25780483 PMCID: PMC4356095 DOI: 10.14740/jocmr2082w] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Emergency room nurses were trained to provide a short-term psychological intervention in physically injured patients with Impact of Event Scale (IES) scores > 20. The aims were to study the effects of the psychological intervention relative to usual care (UC). METHODS In a randomized controlled trial, psychological distress, daily functioning and the personality traits optimism/pessimism were compared with patients who received the UC. The interventions were provided 1 - 3 months after discharge. RESULTS The IES scores were significantly reduced in both groups at 3 months (intervention: 41.1 - 28.6, P < 0.001 vs. UC: 35.4 - 26.2, P < 0.001), but not significantly different between groups. Baseline IES score was a significant predictor of IES scores at 3 (β = 0.4, P < 0.05) and 12 months (β = 0.3, P < 0.05), whereas overall daily functioning at 3 months predicted IES scores at 12 months (β = -0.5, P < 0.001). Patients receiving intervention became significantly more optimistic during the year, and had an increase in overall daily functioning from 3 to 12 months (P < 0.001). Patients declining intervention were more pessimistic and had lower daily functioning. Patients who talked with nurses with more training in psychological processing had a larger reduction in IES symptoms at 3 months (β = -0.3, P = 0.081). CONCLUSION The nurse-led intervention had a significant effect on optimism and overall daily functioning. Nurses may become a low-cost option to perform short-term psychological interventions with physically injured hospitalized patients.
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Affiliation(s)
- Laila Skogstad
- Department of Research and Development, Division of Critical Care, Oslo University Hospital, Ulleval, Oslo, Norway ; Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Erlend Hem
- Department of Behavioral Sciences in Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Leiv Sandvik
- Unit of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Oivind Ekeberg
- Department of Behavioral Sciences in Medicine, Faculty of Medicine, University of Oslo, Norway ; Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
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Pelazza BB, Simoni RCM, Freitas EGB, Silva BRD, Silva MJPD. Visita de Enfermagem e dúvidas manifestadas pela família em unidade de terapia intensiva. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objetivo : Conhecer as dúvidas dos familiares de pacientes internados na unidade de terapia intensiva, há mais de 24 horas, e manifestadas durante as visitas de enfermagem. Métodos : Estudo transversal prospectivo que incluiu 115 famíliares de pacientes internados há mais de 24 horas em unidade de terapia intensiva. O instrumento de pesquisa foi um questionário aplicado em três visitas de enfermagem. Resultados : A dúvida mais apresentada foi sobre o estado clínico e a diferença média entre as dúvidas da primeira e segunda visita foi estatisticamente significante (p=0,047). A média de dúvidas da primeira visita foi significante, quando comparada com a terceira (p<0,001). Conclusão : As dúvidas manifestadas por familiares foram sobre o estado de saúde, condições clínicas e sobre o cuidado realizado. O número médio de dúvidas foi menor na terceira visita de enfermagem.
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16
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Simoni RCM, Silva MJPD. [The impact of the visit of nursing on the necessities of the host families of ICU]. Rev Esc Enferm USP 2013; 46 Spec No:65-70. [PMID: 23250260 DOI: 10.1590/s0080-62342012000700010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/18/2012] [Indexed: 11/22/2022] Open
Abstract
Study of a quantitative approach that aimed to implement the Visiting Nurse ICU adult and check and meet the main needs for information and verbalized by host families. After approval of the CEP of the HU-USP was asked if the family would like to receive some information on the part of nursing. All family members wanted to receive information from nurses in three visits with each family. The themes of doubt among the most familiar were the patient's clinical state and discharged from the ICU. We found that the average number of questions decreased from the first to third visit. The Visiting Nurse attended the main needs of the host family information and answering your questions about the nursing care provided to patients. It was also observed that the doubts and anxieties of family members decreased during the day, emphasizing the need that contact of Nurses and Families.
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Affiliation(s)
- Rosemary Cristina Marques Simoni
- Mestranda da Escola de Enfermagem da Universida de Grupo de São Paulo, Enfermeira Assistencial da Unidade de Terapia Intensiva do Hospital Universitario da Universidade de São Paulo, SP, Brasil.
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