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Lisanti AJ, Dong F, Demianczyk A, Vogiatzi MG, Quinn R, Chittams J, Hoffman R, Medoff−Cooper B. Salivary Diurnal Cortisol Predicts Post-Traumatic Stress Symptoms in Parents of Infants With Congenital Heart Disease. Biol Res Nurs 2024; 26:341-349. [PMID: 38166230 PMCID: PMC11131345 DOI: 10.1177/10998004231224791] [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] [Indexed: 01/04/2024]
Abstract
BACKGROUND Parents of infants born with congenital heart disease (CHD) who require open heart surgery after birth are at risk for prolonged psychological distress. Even after their infants are discharged, parents may experience anxiety, depressive, and post-traumatic stress (PTS) symptoms; yet, it is unclear which parents are at greater risk for ongoing symptoms. The purpose of this study was to explore whether measures of the biomarker cortisol in parents during their infants' postoperative period were associated with subsequent psychological distress symptoms at three-month post discharge. METHODS This was a prospective, longitudinal exploratory study of 40 parents of infants with CHD after open heart surgery using consecutive enrollment. Parents provided diurnal saliva samples for two consecutive days in the postoperative period. Six predictors were summarized and generated including waking cortisol, bedtime cortisol, cortisol awaking response, area under curve with respect to the ground (AUCg), cortisol index, and cortisol slope. Self-report outcome measures on anxiety, depressive, and PTS symptoms were collected three-months post-discharge. Linear mixed models examined the associations between each predictor and each outcome while accounting for within-dyad variance using an unstructured covariance matrix. RESULTS Cortisol AUCg was a predictor of PTS at three-months post-discharge (β = .34, p = .03, Cohen's d = 2.05). No significant relationships were found with the other cortisol measures. CONCLUSIONS & IMPLICATIONS Findings suggest that cortisol area under curve may help to identify parents at risk for increased PTS in the months following their infants' hospitalization for cardiac surgery, serving as a foundation for future study in this area.
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Affiliation(s)
- Amy Jo Lisanti
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Research Institute, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Fanghong Dong
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Abigail Demianczyk
- Center for Pediatric Behavioral Health, Cleveland Clinic Children’s, Cleveland, OH, USA
| | - Maria G. Vogiatzi
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ryan Quinn
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Jesse Chittams
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Hoffman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara Medoff−Cooper
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Research Institute, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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Basso B, Fogolin S, Danielis M, Mattiussi E. The Experiences of Family Members of Patients Discharged from Intensive Care Unit: A Systematic Review of Qualitative Studies. NURSING REPORTS 2024; 14:1504-1516. [PMID: 38921723 PMCID: PMC11206407 DOI: 10.3390/nursrep14020113] [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: 05/04/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Improving the understanding of the post-discharge experiences of family members after their loved ones leave the Intensive Care Unit (ICU) is essential for developing effective follow-up strategies. These strategies are crucial for mitigating potential negative outcomes for both patients and their families. The aim of this study was to explore the lived experiences of family members after the discharge of their loved ones from the ICU. METHODS In September 2023, we conducted a systematic search of qualitative studies across the following databases: CINAHL, MEDLINE, Scopus and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS Eight articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) grappling with a weighty burden; (2) recognizing and confronting adversities along the way; (3) seeking support beyond one's own resources; and (4) addressing comprehensive care requirements. CONCLUSIONS Family members face significant psychological and physical challenges while caring for their loved ones recovering from an ICU stay. Adequate formal and informal help is imperative to provide support both during hospitalization and after discharge. A refined understanding of the distinct requirements and experiences of family members can serve as a strategic framework for informing educational interventions and follow-up programs during the transition from hospital settings to community-based care. This study was not registered.
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Affiliation(s)
- Benedetta Basso
- School of Nursing, Department of Medical Sciences, University of Udine, Viale Ungheria 20, 33100 Udine, Italy; (B.B.); (S.F.); (E.M.)
| | - Sebastiano Fogolin
- School of Nursing, Department of Medical Sciences, University of Udine, Viale Ungheria 20, 33100 Udine, Italy; (B.B.); (S.F.); (E.M.)
| | - Matteo Danielis
- Laboratory of Studies and Evidence Based Nursing, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Loredan 18, 35131 Padova, Italy
| | - Elisa Mattiussi
- School of Nursing, Department of Medical Sciences, University of Udine, Viale Ungheria 20, 33100 Udine, Italy; (B.B.); (S.F.); (E.M.)
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Uysal N, Vaizoğlu D. The Effect of Video Call with Family Members on Physiological Parameters of Critically Ill Patients in Intensive Care Unit: A Quasi-experimental Study. Indian J Crit Care Med 2023; 27:732-736. [PMID: 37908419 PMCID: PMC10613864 DOI: 10.5005/jp-journals-10071-24549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/08/2023] [Indexed: 11/02/2023] Open
Abstract
Aim and background There are not enough studies on the direct effect of virtual patient visits on patients' vital signs in intensive care. The aim of this study is to determine the effect of video calls made between conscious patients and their families on the patient's vital signs and to determine the level of satisfaction. Materials and methods The research was carried out quasi-experimentally. Study data were collected from 135 patients and their relatives. The data were collected from the vital signs monitoring form and the Glasgow Coma Scale (GCS). Satisfaction with the video call was measured with a score scale between 0 and 5. Video calls were conducted by an intensive care unit (ICU) nurse every day between 13:00 and 15:00 for 5 days. Physiological parameters were measured 30 minutes before, during, and 30 minutes after the video calls. Results The mean patient pulse rate (PR) value was 92.04 ± 12.87, respiratory rate (RR) value was 22.89 ± 3.63, and GCS total score was 14.01 ± 0.12 during the call. There was a statistically significant difference between these values measured during the video calls and the values measured before and after the interview (p < 0.00). The mean score of patient satisfaction with the video call was 4.80 ± 0.44; for relatives, the mean score was 4.87 ± 0.33. Conclusion This study revealed that video calls with family members affected PR, RR, and GCS of patients hospitalized in ICU. Clinical significance Video calls can be implemented in all ICUs where visits are restricted. This practice is well recognized by both families and patients. How to cite this article Uysal N, Vaizoğlu D. The Effect of Video Call with Family Members on Physiological Parameters of Critically Ill Patients in Intensive Care Unit: A Quasi-experimental Study. Indian J Crit Care Med 2023;27(10):732-736.
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Affiliation(s)
- Nurcan Uysal
- Department of Nursing, Usküdar University Faculty of Health Sciences, Istanbul, Turkey
| | - Doğancan Vaizoğlu
- Department of Nursing, Istinye University Faculty of Health Sciences, Istanbul, Turkey
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Yuan C, Xiao Y, Wang F, Wang Y, Wang Y, Lin F. The effect of video visitation on intensive care unit patients and family members outcomes during the COVID-19 pandemic: A randomised controlled trial. Intensive Crit Care Nurs 2023; 76:103394. [PMID: 36731263 PMCID: PMC9852363 DOI: 10.1016/j.iccn.2023.103394] [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: 09/13/2021] [Revised: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the effect of video visitation on intensive care patients' and family members' outcomes during the COVID-19 pandemic. DESIGN This is a randomised controlled trial. SETTING An adult intensive care unit in a tertiary hospital in Beijing, China. METHODS A total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital. RESULTS There were no statistically significant differences between the groups in patients' anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members' anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members' satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05). CONCLUSION Video visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members' satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients' and family members' outcomes. IMPLICATIONS FOR CLINICAL PRACTICE Video visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.
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Affiliation(s)
- Cui Yuan
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China,Corresponding authors
| | - Yanyan Xiao
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fang Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yi Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yaqing Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Frances Lin
- School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia,Corresponding authors
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Digby R, Manias E, Haines KJ, Orosz J, Ihle J, Bucknall TK. Family experiences and perceptions of intensive care unit care and communication during the COVID-19 pandemic. Aust Crit Care 2023; 36:350-360. [PMID: 35501199 PMCID: PMC8971060 DOI: 10.1016/j.aucc.2022.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In 2020, during the first wave of the COVID-19 pandemic in Melbourne, visitor access to acute hospitals including intensive care units (ICUs) was initially barred, followed by a limit of one person per patient for one hour per day. This study explores the care and communication experienced by family members of ICU patients during this time. METHODS This qualitative descriptive study was conducted at an Australian quaternary hospital. Semistructured phone interviews were conducted using an aide-memoire designed to understand participants' experiences as family of a patient during this time. Interviews were recorded, transcribed, and thematically analysed. FINDINGS Twenty family members of patients in the ICU participated. Three major themes were identified: 'impact of restricting visiting procedures', 'family experiences of communication', and 'care and support'. Inflexible visiting restrictions had a momentous impact on families. Participants objected to having to nominate only two people to visit during the admission and the short visiting time limit. Some family members suffered extreme stress and anxiety during their absence from the bedside. Additional challenges were experienced by rural families, visitors with disabilities, and the young children of patients who were excluded. Communication with clinicians varied. Telehealth was valued by some but not universally embraced. The relationship between staff members and families and involvement in decision-making were unaffected. CONCLUSION Families experienced significant psychological distress from being separated from their critically ill relatives. Patient care and involvement in decision-making appeared to be unchanged, but communication with staff felt to be lacking. Better alternatives to face-to-face communication must be sought to limit the impact of family separation on mental health. Families are a key link between the patient and clinicians and often play a major role in patient support and recovery after discharge. There is an urgent need to support them and facilitate meaningful engagement despite the obstacles.
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Affiliation(s)
- R Digby
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia; Alfred Health, 55 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - E Manias
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia.
| | - K J Haines
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
| | - J Orosz
- Department of Intensive Care, The Alfred Hospital, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
| | - J Ihle
- Department of Intensive Care, The Alfred Hospital, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
| | - T K Bucknall
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia; Alfred Health, 55 Commercial Rd, Melbourne, VIC, 3004, Australia.
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Yoo HJ, Shim J. The impact of family care visitation programme on patients and caregivers in the intensive care unit: A mixed methods study. J Clin Nurs 2023. [PMID: 36876455 DOI: 10.1111/jocn.16650] [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: 07/24/2022] [Revised: 01/12/2023] [Accepted: 01/26/2023] [Indexed: 03/07/2023]
Abstract
AIMS To track changes in the haemodynamic and respiratory indicators of patients and evaluate families' caring experiences via the visitation programme in the intensive care unit (ICU). BACKGROUND Although most people recognise the importance of family care visitation programme in the ICU, objective research results on the effect on patients and caregivers are still insufficient. DESIGN Mixed methods. METHODS In this a quasi-experimental investigation and qualitative study, after executing the programme with families of ICU patients in a general hospital in South Korea from June to July 2019, changes in haemodynamic and respiratory indicators for control (n = 28) and experimental groups (n = 28) were analysed; the experimental group families' experiences were analysed through in-depth interviews; the qualitative study's reporting rigour was checked against the COREQ guidelines and TREND checklist for a quasi-experimental study. Qualitative and quantitative data were examined using content analysis and repeated-measures analysis of variance, respectively. RESULTS There was a significant change in systolic and diastolic blood pressure in the haemodynamic indicator, and the respiratory indicator in both groups increased slightly over time and then gradually stabilised; there were no significant differences or interactions between groups regarding time of systolic blood pressure. The respiratory rate significantly decreased only in the experimental group. There was a significant increase in oxygen saturation over time, as well as interactions between time and group and between groups. Four themes were extracted from families' experiences. CONCLUSION The haemodynamic and respiratory indicators of the group using patient- and family-centred care (PFCC) showed a stable effect on critically ill patients, which increased families' satisfaction. In future, interventions should encourage family participation in the ICU for successful PFCC. RELEVANCE TO CLINICAL PRACTICE The findings provided evidence for the importance of PFCC through changes in objective haemodynamic and respiratory indicators.
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Affiliation(s)
- Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, South Korea
| | - JaeLan Shim
- College of Nursing, Dongguk University, Gyeongju, South Korea
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Ito Y, Tsubaki M, Kobayashi M, Yagome S, Sakaguchi Y. Effect size estimates of risk factors for post-intensive care syndrome-family: A systematic review and meta-analysis. Heart Lung 2023; 59:1-7. [PMID: 36642001 DOI: 10.1016/j.hrtlng.2023.01.005] [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: 11/02/2022] [Revised: 12/05/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Families of patients admitted to ICUs often experience post-intensive care syndrome-family, and previous studies have reported several possible risk factors. However, to date, no meta-analyses have been conducted on the numerous risk factors associated with the development of post-intensive care syndrome-family and how strongly these factors are in association with post-intensive care syndrome-family. OBJECTIVES To identify risk factors for post-intensive care syndrome-family and determine the effect size of individual risk factors. METHODS This systematic review used MEDLINE, CINAHL, PsycINFO, and EMBASE databases to search all studies through December 1, 2021, that reported risk factors for anxiety, depression, PTSD, and prolonged grief disorder in the families of adult patients in ICUs. A meta-analysis was conducted to calculate an overall estimate for key risk factors, and odds ratio and 95% confidence intervals were used as summary statistics using the random-effects model. RESULTS Of 2964 identified studies, 17 were included. Nine factors for anxiety, eight for depression, and three for PTSD were assessed using results from 13 studies. The risk factor with the largest effect size was "history of mental illness," which, along with "female sex," was a significant risk factor common to anxiety, depression, and PTSD. "Poor communication with ICU staff," "severely ill patient," and "patients' spouse" were common risk factors for anxiety and depression. CONCLUSIONS We identified several risk factors related to patient and family demographic characteristics. Further research is required to identify and validate modifiable risk factors for the psychosocial experiences of families of ICU patients.
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Affiliation(s)
- Yoshiyasu Ito
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan; Department of Nursing, Graduate School of Health Sciences, Kobe University, Kobe, Japan.
| | | | | | | | - Yukihiro Sakaguchi
- School of Human Welfare Studies, Kwansei Gakuin University, Nishinomiya, Japan
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Putowski Z, Rachfalska N, Majewska K, Megger K, Krzych Ł. Identification of risk factors for post-intensive care syndrome in family members (PICS-F) among adult patients: a systematic review. Anaesthesiol Intensive Ther 2023; 55:168-178. [PMID: 37728444 PMCID: PMC10496103 DOI: 10.5114/ait.2023.130831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/25/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION Relatives of critically ill patients who either die or survive the intensive care unit (ICU) may develop substantial mental health problems that are collectively defined as post-intensive care syndrome in family (PICS-F). MATERIAL AND METHODS By using a systematised search strategy we included studies that focused on PICS-F in relatives of adult ICU patients and reported the risk factors associated with its development. The search was conducted within PubMed, Embase, SCOPUS, clinicaltrials.gov, and Cochrane Library on the 23 August 2022. PRISMA 2020 guidelines were implemented for appropriate reporting. The objective was to document all possible risk factors associated with the development of PICS-F. RESULTS We included 51 papers covering 9302 relatives. The frequency of PICS-F varied between 2.5 and 69%. We identified 51 different risk factors of PICS-F, among which we distinguished patient-related ( n = 16), relative-related ( n = 27), and medical staff-related ( n = 8) risk factors. Among 21 studies of the highest quality, we identified the 33 variables associated with the development of PICS-F, of which younger age of a patient, death of a patient, depression in relatives during the ICU stay, history of mental disorders in relatives, being a female relative, being a spouse, and having low satisfaction with communication and care in the ICU were the most commonly reported risk factors. CONCLUSIONS PICS-F is a highly frequent phenomenon that can be exacerbated by several risk factors. Special attention should be paid to relatives of younger patients with worse prognosis and with the following relative-related risk factors: female sex, being a spouse, and history of mental health disorders. Finally, the medical staff play a role in preventing the PICS-F development, not only by maintenance of proper communication, but also by early identification of relatives prone to PICS-F.
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Affiliation(s)
- Zbigniew Putowski
- Centre for Intensive Care and Perioperative Medicine, Jagiellonian University, Kraków, Poland
| | - Natalia Rachfalska
- Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Karolina Majewska
- Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
| | | | - Łukasz Krzych
- Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
- Department of Cardiac Anaesthesia and Intensive Therapy, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
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Xu YX, Liu GY, Ji ZZ, Li YY, Wang YL, Wu XY, Liu JL, Ma DX, Zhong MK, Gao CB, Xu Q. Restraint stress induced anxiety and sleep in mice. Front Psychiatry 2023; 14:1090420. [PMID: 37124267 PMCID: PMC10130584 DOI: 10.3389/fpsyt.2023.1090420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
In humans and animals, exposure to changes in internal or external environments causes acute stress, which changes sleep and enhances neurochemical, neuroendocrine, and sympathetic activities. Repeated stress responses play an essential role in the pathogenesis of psychiatric diseases and sleep disorders. However, the underlying mechanism of sleep changes and anxiety disorders in response to acute stress is not well established. In the current study, the effects of restraint stress (RS) on anxiety and sleep-wake cycles in mice were investigated. We found that after RS, the mice showed anxiety-like behavior after RS manipulation and increased the amounts of both non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in the dark period. The increase in sleep time was mainly due to the increased number of episodes of NREM and REM sleep during the dark period. In addition, the mice showed an elevation of the EEG power spectrum of both NREM and REM sleep 2 h after RS manipulation. There was a significant reduction in the EEG power spectrum of both NREM and REM sleep during the darkperiod in the RS condition. The expression of the c-Fos protein was significantly increased in the parabrachial nucleus, bed nucleus of the stria terminalis, central amygdala, and paraventricular hypothalamus by RS manipulation. Altogether, the findings from the present study indicated that neural circuits from the parabrachial nucleus might regulate anxiety and sleep responses to acute stress, and suggest a potential therapeutic target for RS induced anxiety and sleep alterations.
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Affiliation(s)
- Yong-Xia Xu
- Department of Geriatric Endocrinology, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Guo-Ying Liu
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Zhang-Zhang Ji
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yue-Yun Li
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yan-Li Wang
- Department of Geriatric Endocrinology, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xue-Yan Wu
- Department of Human Anatomy, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Jun-Lin Liu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Dan-Xia Ma
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Ming-Kui Zhong
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
- *Correspondence: Ming-Kui Zhong,
| | - Chao-Bing Gao
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Chao-Bing Gao,
| | - Qi Xu
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
- Qi Xu,
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de Souza LM, Freitas KS, da Silva Filho AM, Teixeira JRB, Souza GSS, Fontoura EG, Coifman AHM, Portela PP. Prevalence and factors associated with symptoms of depression in family members of people hospitalized in the intensive care unit. Rev Bras Ter Intensiva 2022; 34:499-506. [PMID: 36888831 PMCID: PMC9986997 DOI: 10.5935/0103-507x.20220080-pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/01/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the prevalence and factors associated with depression in family members of people hospitalized in intensive care units. METHODS A cross-sectional study was conducted with 980 family members of patients admitted to the intensive care units of a large public hospital in the interior of Bahia. Depression was measured using the Patient Health Questionnaire-8. The multivariate model consisted of the following variables: sex and age of the patient, sex and age of the family member, education level, religion, living with the family member, previous mental illness and anxiety. RESULTS Depression had a prevalence of 43.5%. In the multivariate analysis, the model with the best representativeness indicated that factors associated with a higher prevalence of depression were being female (39%), age younger than 40 years (26%) and previous mental illness (38%). A higher education level was associated with a 19% lower prevalence of depression in family members. CONCLUSION The increase in the prevalence of depression was associated with female sex, age younger than 40 years and previous psychological problems. Such elements should be valued in actions aimed at family members of people hospitalized in intensive care.
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Affiliation(s)
- Luciana Maciel de Souza
- Postgraduate Program Professional Master’s in Nursing, Universidade
Estadual de Feira de Santana - Feira de Santana (BA), Brazil
| | - Kátia Santana Freitas
- Postgraduate Program Professional Master’s in Nursing, Universidade
Estadual de Feira de Santana - Feira de Santana (BA), Brazil
- Postgraduate Program in Collective Health, Universidade Estadual de
Feira de Santana - Feira de Santana (BA), Brazil
| | | | - Jules Ramon Brito Teixeira
- Postgraduate Program in Collective Health, Universidade Estadual de
Feira de Santana - Feira de Santana (BA), Brazil
| | - Geysimara Santos Silveira Souza
- Postgraduate Program Professional Master’s in Nursing, Universidade
Estadual de Feira de Santana - Feira de Santana (BA), Brazil
| | - Elaine Guedes Fontoura
- Postgraduate Program Professional Master’s in Nursing, Universidade
Estadual de Feira de Santana - Feira de Santana (BA), Brazil
| | | | - Pollyana Pereira Portela
- Postgraduate Program in Collective Health, Universidade Estadual de
Feira de Santana - Feira de Santana (BA), Brazil
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Abstract
OBJECTIVES Children with severe chronic illness are a prevalent, impactful, vulnerable group in PICUs, whose needs are insufficiently met by transitory care models and a narrow focus on acute care needs. Thus, we sought to provide a concise synthetic review of published literature relevant to them and a compilation of strategies to address their distinctive needs. DATA SOURCES English language articles were identified in MEDLINE using a variety of phrases related to children with chronic conditions, prolonged admissions, resource utilization, mortality, morbidity, continuity of care, palliative care, and other critical care topics. Bibliographies were also reviewed. STUDY SELECTION Original articles, review articles, and commentaries were considered. DATA EXTRACTION Data from relevant articles were reviewed, summarized, and integrated into a narrative synthetic review. DATA SYNTHESIS Children with serious chronic conditions are a heterogeneous group who are growing in numbers and complexity, partly due to successes of critical care. Because of their prevalence, prolonged stays, readmissions, and other resource use, they disproportionately impact PICUs. Often more than other patients, critical illness can substantially negatively affect these children and their families, physically and psychosocially. Critical care approaches narrowly focused on acute care and transitory/rotating care models exacerbate these problems and contribute to ineffective communication and information sharing, impaired relationships, subpar and untimely decision-making, patient/family dissatisfaction, and moral distress in providers. Strategies to mitigate these effects and address these patients' distinctive needs include improving continuity and communication, primary and secondary palliative care, and involvement of families. However, there are limited outcome data for most of these strategies and little consensus on which outcomes should be measured. CONCLUSIONS The future of pediatric critical care medicine is intertwined with that of children with serious chronic illness. More concerted efforts are needed to address their distinctive needs and study the effectiveness of strategies to do so.
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12
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Harris BR, Beesley SJ, Hopkins RO, Hirshberg EL, Wilson E, Butler J, Oniki TA, Kuttler KG, Orme JF, Brown SM. Heart rate variability and subsequent psychological distress among family members of intensive care unit patients. J Int Med Res 2021; 49:3000605211057829. [PMID: 34846178 PMCID: PMC8649465 DOI: 10.1177/03000605211057829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective To determine whether heart rate variability (HRV; a physiological measure of
acute stress) is associated with persistent psychological distress among
family members of adult intensive care unit (ICU) patients. Methods This prospective study investigated family members of patients admitted to a
study ICU. Participants’ variability in heart rate tracings were measured by
low frequency (LF)/high frequency (HF) ratio and detrended fluctuation
analysis (DFA). Questionnaires were completed 3 months after enrollment to
ascertain outcome rates of anxiety, depression, and post-traumatic stress
disorder (PTSD). Results Ninety-nine participants were enrolled (median LF/HF ratio, 0.92
[interquartile range, 0.64–1.38]). Of 92 participants who completed the
3-month follow-up, 29 (32%) had persistent anxiety. Logistic regression
showed that LF/HF ratio (odds ratio [OR] 0.85, 95% confidence interval [CI]
0.43, 1.53) was not associated with 3-month outcomes. In an exploratory
analysis, DFA α (OR 0.93, 95% CI 0.87, 0.99), α1 (OR 0.97, 95% CI
0.94, 0.99), and α2 (OR 0.94, 95% CI 0.88, 0.99) scaling
components were associated with PTSD development. Conclusion Almost one-third of family members experienced anxiety at three months after
enrollment. HRV, measured by LF/HF ratio, was not a predictor of psychologic
distress, however, exploratory analyses indicated that DFA may be associated
with PTSD outcomes.
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Affiliation(s)
- Benjamin Re Harris
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sarah J Beesley
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Pulmonary and Critical Care Medicine, 98078Intermountain Medical Center, 98078Intermountain Medical Center, Salt Lake City, UT, USA.,Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ramona O Hopkins
- Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Psychology Department and Neuroscience Center, 6756Brigham Young University, Brigham Young University, Provo, UT, USA
| | - Eliotte L Hirshberg
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Pulmonary and Critical Care Medicine, 98078Intermountain Medical Center, 98078Intermountain Medical Center, Salt Lake City, UT, USA.,Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Pediatric Critical Care, University of Utah, Salt Lake City, UT, USA
| | - Emily Wilson
- Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jorie Butler
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Geriatrics and Psychology, University of Utah and Salt Lake City Veterans Administration Hospital, Salt Lake City, UT, USA
| | - Thomas A Oniki
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Pulmonary and Critical Care Medicine, 98078Intermountain Medical Center, 98078Intermountain Medical Center, Salt Lake City, UT, USA.,Care Transformation Information Systems, 7061Intermountain Healthcare, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Kathryn G Kuttler
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Pulmonary and Critical Care Medicine, 98078Intermountain Medical Center, 98078Intermountain Medical Center, Salt Lake City, UT, USA.,Care Transformation Information Systems, 7061Intermountain Healthcare, Intermountain Healthcare, Salt Lake City, UT, USA
| | - James F Orme
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Pulmonary and Critical Care Medicine, 98078Intermountain Medical Center, 98078Intermountain Medical Center, Salt Lake City, UT, USA.,Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Samuel M Brown
- Center for Humanizing Critical Care, 7061Intermountain Healthcare, Intermountain Healthcare, Murray, UT, USA.,Pulmonary and Critical Care Medicine, 98078Intermountain Medical Center, 98078Intermountain Medical Center, Salt Lake City, UT, USA.,Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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13
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Kebapcı A, Türkmen E. The effect of structured virtual patient visits (sVPVs) on COVID-19 patients and relatives' anxiety levels in intensive care unit. J Clin Nurs 2021; 31:2900-2909. [PMID: 34837436 DOI: 10.1111/jocn.16117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 02/01/2023]
Abstract
AIM AND OBJECTIVES To determine the effect of structured Virtual Patient Visits (sVPVs) on the anxiety, satisfaction, hospital anxiety and depression levels of intensive care unit (ICU) COVID-19 patients and their relatives. BACKGROUND There is no evidence regarding the direct effect of virtual patient visits in the ICU. DESIGN The STROBE statement guided this study. This investigator-initiated, prospective and single-centre study included COVID-19 patients and their relatives in an adult ICU between July and December 2020. We implemented daily sVPVs between all patients and their relatives. The study's primary outcome was the daily anxiety levels of patients and relatives immediately before and after sVPVs. The secondary outcomes were as follows: 1) hospital anxiety (HADS-A) and depression (HADS-D) levels during admission to and after discharge from the ICU and 2) satisfaction levels regarding the ICU and sVPVs of patients' relatives. RESULTS A total number of 301 daily sVPVs were conducted between 50 patients and their relatives. There was a significant difference between daily anxiety levels before and after sVPVs in both patients (2.97 vs. 1.49) and their relatives (5.70 vs. 3.53; p > .05). Whereas the anxiety levels of patients with basic face or high flow nasal cannula and non-invasive mechanical ventilation decreased statistically significantly more than those with IMV after a sVPV (p < .001), there was not a significant difference in decreased anxiety levels of patients' relatives according to the type of respiratory support provided to the patient (p > .05). HADS-A levels of relatives decreased statistically significantly after discharge/death. There was no statistically significant difference in HADS-A and HADS-D levels after discharge/death between the relatives of patients who died or did not die (p > .05). Furthermore, the overall ICU satisfaction rates were statistically significantly lower in relatives of patients who died than those who did not die (p < .05). CONCLUSION Regardless of whether the patients were intubated, sVPVs reduced the anxiety levels of all patients and relatives. The sVPV programme offered emotional support to patients and family members, with high levels of satisfaction, as well as provided regular informative updates and the opportunity for daily visits or final goodbyes. RELEVANCE FOR CLINICAL PRACTICE The sVPV programme is essential for all ICUs during the COVID-19 pandemic.
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Affiliation(s)
- Ayda Kebapcı
- Koç University School of Nursing, Istanbul, Turkey
| | - Emine Türkmen
- Istinye University Faculty of Health Sciences, Istanbul, Turkey
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14
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Avcı M, Ayaz-Alkaya S. Anxiety, social support and satisfaction of patients' families in intensive care units: A descriptive-correlational study. J Clin Nurs 2021; 31:2765-2773. [PMID: 34693581 DOI: 10.1111/jocn.16094] [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: 03/02/2021] [Revised: 08/20/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
AIMS & OBJECTIVES This study was conducted with family members of patients' in the intensive care unit (ICU) to identify their anxiety level, social support and satisfaction with the ICU. BACKGROUND Admission of critical patients to the ICU usually involves the participation of family members. DESIGN A descriptive-correlational design was used and reported according to the STROBE checklist. METHODS The sample consisted of 250 family members in ICUs in a city of Turkey. Data were collected by the Multidimensional Perceived Social Support Scale, the State-Trait Anxiety Inventory and the Family Satisfaction in the Intensive Care Unit scale. RESULTS A negative correlation was found between family satisfaction of the ICU and state anxiety (r = -0.349, p < 0.001), and a negative relationship between the satisfaction of the ICU and trait anxiety of the participants (r = -0.151, p < 0.05). There was a significant relationship between the state anxiety level (Adjusted R² = 0.080, F = 8.247, p < 0.001), trait anxiety level (Adjusted R² = 0.185, F = 19.821, p < 0.001), the perceived social support (Adjusted R² = 0.094, F = 9.640, p < 0.001) and satisfaction (Adjusted R² = 0.013, F = 4.161, p < 0.001) of family members and their sociodemographic characteristics. CONCLUSIONS The study concluded that anxiety levels of relatives of the families were high, their social support and satisfaction with the intensive care unit were at a moderate level. There was a correlation between anxiety levels, satisfaction with the intensive care unit, and the perceived social support of families. RELEVANCE TO CLINICAL PRACTICE Holistic care for the psychosocial needs of families who have a member in the ICU should be planned to increase satisfaction. Nurses should observe families closely for anxiety, allow them to ask questions and include them in the care of their family member.
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Affiliation(s)
- Miyase Avcı
- Nursing Department, Aksaray University Faculty of Health Sciences, Aksaray, Turkey
| | - Sultan Ayaz-Alkaya
- Nursing Department, Gazi University Faculty of Health Sciences, Ankara, Turkey
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15
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Norouzadeh R, Heidari MR, Rahimi F, Kazemnejad A. Psychometric Properties of the "ICU Nurses" Perceptions Questionnaire of Self-Performance with Families of Critically Ill Patients (Persian Version). J Nurs Meas 2021; 30:135-147. [PMID: 34518435 DOI: 10.1891/jnm-d-20-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Nurses' self-perception of their performance toward family members of patients is one of the most important issues in predicting family adaptive behaviors. This study analyze the psychometric properties of the Persian version of ICU nurses' perceptions questionnaire of self-performance with families of critically ill patients. METHODS Among 135 intensive care nurses, to determine face validity, 10 nurses were asked to comment on, comprehensibility, grammar, and writing of items. Exploratory factor analysis was used to assess construct validity. RESULTS The intra-cluster correlation coefficient (ICC) was 0.82 and Cronbach's alpha was 0.74. Exploratory factor analysis showed the first nine related factors have 65.22% variance. CONCLUSION Persian version of "ICU nurses' perceptions of self-performance with families of critically ill patients" had good reliability and validity.
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16
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Bloomer MJ, Walshe C. Smiles behind the masks: A systematic review and narrative synthesis exploring how family members of seriously ill or dying patients are supported during infectious disease outbreaks. Palliat Med 2021; 35:1452-1467. [PMID: 34405753 DOI: 10.1177/02692163211029515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Infection control measures during infectious disease outbreaks can have significant impacts on seriously ill and dying patients, their family, the patient-family connection, coping, grief and bereavement. AIM To explore how family members of patients who are seriously ill or who die during infectious disease outbreaks are supported and cared for during serious illness, before and after patient death and the factors that influence family presence around the time of death. DESIGN Systematic review and narrative synthesis. DATA SOURCES CINAHL, Medline, APA PsycInfo and Embase were searched from inception to June 2020. Forward and backward searching of included papers were also undertaken. Records were independently assessed against inclusion criteria. Included papers were assessed for quality, but none were excluded. FINDINGS Key findings from 14 papers include the importance of communication and information sharing, as well as new ways of using virtual communication. Restrictive visiting practices were understood, but the impact of these restrictions on family experience cannot be underestimated, causing distress and suffering. Consistent advice and information were critical, such as explaining personal protective equipment, which family found constraining and staff experienced as affecting interpersonal communication. Cultural expectations of family caregiving were challenged during infectious disease outbreaks. CONCLUSION Learning from previous infectious disease outbreaks about how family are supported can be translated to the current COVID-19 pandemic and future infectious disease outbreaks. Consistent, culturally sensitive and tailored plans should be clearly communicated to family members, including when any restrictions may be amended or additional supports provided when someone is dying.
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Affiliation(s)
- Melissa J Bloomer
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
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17
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Saeid Y, Moradian ST, Ebadi A, Salaree MM. The family intensive care unit syndrome: A qualitative content analysis. Nurs Crit Care 2021; 27:401-409. [PMID: 34405490 DOI: 10.1111/nicc.12683] [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: 10/15/2020] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hospitalization of patients in an intensive care unit (ICU) is associated with a series of psychological problems for their family members called family intensive care unit syndrome (FICUS). Nonetheless, family members of patients in ICU often receive little attention from health care providers. Exploring family members' experiences of their patients' hospitalization in ICU helps health care providers focus more clearly on their problems. AIMS AND OBJECTIVES This study aimed to explore FICUS-related experiences among the family members of patients in ICU. DESIGN This was a qualitative content analysis study. METHODS This qualitative study was conducted in 2019. Participants were 14 family members of patients in ICU who were purposively selected from three hospitals in Tehran, Iran. Data were collected using semi-structured interviews and were analyzed using qualitative content analysis. RESULTS Participants' experiences of FICUS fell into four categories, that is, threat to psychological well-being (with four subcategories), threat to physical health (with three subcategories), threat to social health (with three subcategories), and change in spiritual orientation (with two subcategories). The 12 subcategories of these categories were emotional disturbances, hopelessness, changes in sleep pattern, mood changes, physical symptoms, aggravation of the existing illnesses, negligence towards personal health, alteration in social interactions, alteration in the burden of responsibility, alternation in the life process, resort to spiritual beliefs, and spiritual conflict, respectively. CONCLUSION FICUS symptoms are not limited to psychological problems, rather they include a wide range of psychological, physical, social, and spiritual problems, which can affect the different aspects of family members' lives. Along with care delivery to patients in ICU, health care providers should provide care and support to patients' family members. RELEVANCE TO CLINICAL PRACTICE FICUS is a major threat to health among the family members of patients in ICU. Careful assessment of these family members helps identify family members who are at risk for FICUS and identify FICUS effects on their decisions and health status.
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Affiliation(s)
- Yaser Saeid
- Trauma Research Committee and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Tayeb Moradian
- Atherosclerosis Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Science Research Center, Life Style Institute and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Salaree
- Health Research Center, Life Style Institute and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
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18
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Haruna J, Tatsumi H, Kazuma S, Kuroda H, Goto Y, Aisaka W, Terada H, Masuda Y. Using an ICU Diary to Communicate With Family Members of COVID-19 Patients in ICU: A Case Report. J Patient Exp 2021; 8:23743735211034094. [PMID: 34377772 PMCID: PMC8323441 DOI: 10.1177/23743735211034094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Visitation restrictions for family members are problematic in intensive care management
due to the COVID-19 pandemic. We analyzed the usefulness of an intensive care unit (ICU)
diary about the experiences of family members of critical COVID-19 patients. Four family
members of 2 COVID-19 patients participated in this report. Both patients were transferred
to our ICU after 2 weeks of treatment at another ICU. An ICU diary was given to their
family members post-transfer. The family members were interviewed before and after the
patients’ discharge; the recorded interviews were analyzed and categorized into several
clusters using a text mining method. Five categories regarding their anxious feelings were
classified before the use of the ICU diary, and 3 categories were based on their positive
feelings after the use of the ICU diary. Intensive care unit diaries may be beneficial for
disclosing patients’ information when visitation restrictions are exercised due to the
COVID-19 pandemic.
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Affiliation(s)
- Junpei Haruna
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiroomi Tatsumi
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Satoshi Kazuma
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiromitsu Kuroda
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuya Goto
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Wakiko Aisaka
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Hirofumi Terada
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
| | - Yoshiki Masuda
- Department of Intensive Care Medicine, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan
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19
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Aghaie B, Anoosheh M, Foroughan M, Mohammadi E, Kazemnejad A. A Whirlpool of Stress in Families of Intensive Care Unit Patients: A Qualitative Multicenter Study. Crit Care Nurse 2021; 41:55-64. [PMID: 34061191 DOI: 10.4037/ccn2021322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family members of patients admitted to the intensive care unit must tolerate high levels of stress, making them emotionally and physically vulnerable. However, little is known about the kinds of stress family members may experience. OBJECTIVE To explore perceived stress in the families of patients admitted to the intensive care unit. METHODS This qualitative content analysis study involved 23 family members of patients admitted to intensive care units. Participants were drawn from family members of patients hospitalized in intensive care units of 3 public and 2 private hospitals. Data were collected through semistructured interviews. RESULTS Three themes emerged from the data: "distrust," "repeated stress exposure," and "a whirlpool of persistent negative emotional-physical state." The first theme had 2 categories: "fearful mindset" and "negative beliefs about professional caregivers." The second theme also had 2 categories: "fear of the future" and "sustained accumulation of tensions." The third theme had 3 categories: "impaired mental health," "impaired physical health," and "impaired family function." CONCLUSIONS The findings of this study may help critical care nurses better understand the nature and sources of family stresses during a patient's intensive care unit stay. Supervisory nurses should alert their staff to these issues so that family care programs can address them, thereby reducing family members' risk of posttraumatic stress disorder and post-intensive care syndrome-family.
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Affiliation(s)
- Bahman Aghaie
- Bahman Aghaie is an assistant professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Monireh Anoosheh
- Monireh Anoosheh is an associate professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahshid Foroughan
- Mahshid Foroughan is an associate professor, Research Center on Aging, Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Esa Mohammadi
- Esa Mohammadi is a professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University
| | - Anoshirvan Kazemnejad
- Anoshirvan Kazemnejad is a professor, Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University
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20
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Kynoch K, Coyer F, Mitchell M, McArdle A. The intensive care unit visiting study: A multisite survey of visitors. Aust Crit Care 2021; 34:587-593. [PMID: 33941440 DOI: 10.1016/j.aucc.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Being able to visit a critically ill relative provides comfort to family members and has recognised benefits to the patient. Limited research has been conducted on demographic characteristics and visiting behaviours of family members with a relative in the intensive care unit (ICU). OBJECTIVES The objective was to provide an overview of local ICU visitor behaviours and practices across four metropolitan units in Australia. METHODS A convenience sample of 440 participants from four ICUs across a metropolitan city in eastern Australia was required for the study. A descriptive 22-item self-report survey was used. Data were collected from four ICUs in a metropolitan city in eastern Australia. Sample characteristics and other variables were analysed using descriptive statistics. RESULTS Data collection was undertaken from April 2018 to May 2019. Four hundred sixty-two (n = 462) ICU visitors responded. There were no significant differences between visitor characteristics across the four hospitals. The mean age of the respondents was 49 years, the youngest participant being 18 years and the oldest being 93 years, with most visitors being women (n = 312, 68%). The participants were more likely to be close relatives such as spouses (n = 117, 25%), parents (n = 113, 24%), or children (n = 79, 17%). Visitors reported different methods by which they received information about visiting policies across units and indicated that they would have visited more frequently if able. Although most respondents rated their ICU visiting experience favourably, some reported being frequently asked to leave the patient's bedside impacted their experience. CONCLUSIONS This study has highlighted that families want to remain in close proximity when they have a relative in the ICU. Despite visiting hours being flexible, most families visit midmorning so that they can talk with staff. Data captured in this study can be used toward improving the ICU visiting experience for family members.
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Affiliation(s)
- Kate Kynoch
- Evidence in Practice Unit, Mater Misericoridae Limited, Raymond Terrace, South Brisbane, QLD, 4101, Australia.
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology (QUT) and Intensive Care Services (ICS), Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, 4029, Australia
| | - Marion Mitchell
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Annie McArdle
- Evidence in Practice Unit, Mater Misericoridae Limited, Raymond Terrace, South Brisbane, QLD, 4101, Australia
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21
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Mechanism of a Flexible ICU Visiting Policy for Anxiety Symptoms Among Family Members in Brazil: A Path Mediation Analysis in a Cluster-Randomized Clinical Trial. Crit Care Med 2021; 49:1504-1512. [PMID: 33870915 DOI: 10.1097/ccm.0000000000005037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate whether the effect of a flexible ICU visiting policy that includes flexible visitation plus visitor education on anxiety symptoms of family members is mediated by satisfaction and involvement in patient care. DESIGN We embedded a multivariable path mediation analysis within a cluster-randomized crossover trial as a secondary analysis of The ICU Visits Study (ClinicalTrials.gov number: NCT02932358). SETTING Thirty-six medical-surgical ICUs in Brazil. PATIENTS Closest relatives of adult ICU patients. INTERVENTIONS Flexible visitation (12 hr/d) supported by family education or usual restricted visitation (median, 1.5 hr/d). MEASUREMENTS AND MAIN RESULTS Overall, 863 family members were assessed (mean age, 44.7 yr; women, 70.1%). Compared with the restricted visitation (n = 436), flexible visitation (n = 427) resulted in better mean anxiety scores (6.1 vs 7.8; mean difference, -1.78 [95% CI, -2.31 to -1.22]), as well as higher standardized scores of satisfaction (67% [95% CI, 55-79]) and involvement in patient care (77% [95% CI, 64-89]). The mediated effect of flexible visitation on mean anxiety scores through each incremental SD of satisfaction and involvement in patient care were -0.47 (95% CI, -0.68 to -0.24) and 0.29 (95% CI, 0.04-0.54), respectively. Upon exploratory analyses, emotional support, helping the ICU staff to understand patient needs, helping the patient to interpret ICU staff instructions, and patient reorientation were the domains of involvement in patient care associated with increased anxiety. CONCLUSIONS A flexible ICU visiting policy reduces anxiety symptoms among family members and appears to work by increasing satisfaction. However, increased participation in some activities of patient care as a result of flexible visitation was associated with higher severity of anxiety symptoms.
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22
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Zhang J, Zhu L, Li S, Huang J, Ye Z, Wei Q, Du C. Rural-urban disparities in knowledge, behaviors, and mental health during COVID-19 pandemic: A community-based cross-sectional survey. Medicine (Baltimore) 2021; 100:e25207. [PMID: 33787602 PMCID: PMC8021359 DOI: 10.1097/md.0000000000025207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/25/2021] [Indexed: 02/05/2023] Open
Abstract
To examine the knowledge level, behaviors, and psychological status of the Chinese population during the COVID-19 pandemic, and to explore the differences between urban and rural areas.We carried out a cross-sectional survey of the knowledge, behaviors related to COVID-19, and mental health in a probability sample of 3001 community residents in 30 provinces or districts across China from February 16-23, 2020. Convenience sampling and a snowball sampling were adopted. We used General Anxiety Disorder (GAD), the 9-item Patient Health Questionnaire (PHQ-9), and knowledge and behaviors questionnaire of community residents regarding COVID-19 designed by us to investigate the psychological status, disease-related knowledge, and the behavior of Chinese urban and rural residents during the pandemic.The average score of anxiety and depression among urban residents was 9.15 and 11.25, respectively, while the figures in rural areas were 8.69 and 10.57, respectively. There was a statistically significant difference in the levels of anxiety (P < .01) and depression (P < .01). Urban participants reported significantly higher levels of knowledge regarding COVID-19 in all aspects (transmission, prevention measures, symptoms of infection, treatment, and prognosis) (P < .01), compared to their rural counterparts. While a majority of respondents in urban areas obtained knowledge through WeChat, other apps, and the Internet (P < .01), residents in rural areas accessed information through interactions with the community (P < .01). Urban residents fared well in exchanging knowledge about COVID-19 and advising others to take preventive measures (P < .01), but fared poorly in advising people to visit a hospital if they displayed symptoms of the disease, compared to rural residents (P < .01). Regression analysis with behavior showed that being female (OR = 2.106, 95%CI = 1.259-3.522), aged 18 ≤ age < 65 (OR = 4.059, 95%CI = 2.166-7.607), being satisfied with the precautions taken by the community (OR = 2.594, 95%CI = 1.485-4.530), disinfecting public facilities in the community (OR = 2.342, 95%CI = 1.206-4.547), having knowledge of transmission modes (OR = 3.987, 95%CI: 2.039, 7.798), symptoms (OR = 2.045, 95%CI = 1.054-4.003), and outcomes (OR = 2.740, 95%CI = 1.513-4.962) of COVID-19, and not having anxiety symptoms (OR = 2.578, 95%CI = 1.127-5.901) were positively associated with affirmative behavior in urban areas. Being married (OR = 4.960, 95%CI = 2.608-9.434), being satisfied with the precautions taken by the community (OR = 2.484, 95%CI = 1.315-4.691), screening to ensure face mask wearing before entering the community (OR = 8.809, 95%CI = 2.649-19.294), and having knowledge about precautions (OR = 4.886, 95%CI = 2.604-9.167) and outcomes (OR = 2.657, 95%CI = 1.309-5.391) were positively associated with acceptable conduct in rural areas.The status of anxiety and depression among urban residents was more severe compared to those living in rural areas. There was a difference in being positively associated with constructive behaviors between rural and urban areas.
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Affiliation(s)
- Jianmei Zhang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China Hospital, West China School of Nursing, Sichuan University
| | - Liang Zhu
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China Hospital, West China School of Nursing, Sichuan University
| | - Simin Li
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China Hospital, West China School of Nursing, Sichuan University
| | - Jing Huang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Zhiyu Ye
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China Hospital, West China School of Nursing, Sichuan University
| | - Quan Wei
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
| | - Chunping Du
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China Hospital, West China School of Nursing, Sichuan University
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Raymond V, Phulpin H, Galliot G, Ducos G, Lafont Rapnouil S, Salles J. A novel approach to the psychiatric assessment of family members of ICU patients with COVID-19. Gen Hosp Psychiatry 2021; 70:139-140. [PMID: 33685662 PMCID: PMC7816964 DOI: 10.1016/j.genhosppsych.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Valentin Raymond
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie, Toulouse F-31000, France
| | - Hugo Phulpin
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie, Toulouse F-31000, France
| | - Gael Galliot
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie, Toulouse F-31000, France
| | - Guillaume Ducos
- CHU de Toulouse, Service de réanimation polyvalente, Toulouse F-31000, France
| | | | - Juliette Salles
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie, Toulouse F-31000, France; INSERM U1043, Centre de Physiopathologie de Toulouse Purpan, Université Paul Sabatier, Toulouse, France; CHU de Toulouse, Institut des Handicaps Neurologiques, Psychiatriques et Sensoriels, Toulouse F-31000, France.
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Tate JA, Choi J. Positive Appraisal of Caregiving for Intensive Care Unit Survivors: A Qualitative Secondary Analysis. Am J Crit Care 2020; 29:340-349. [PMID: 32869072 DOI: 10.4037/ajcc2020953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND More than half of intensive care unit survivors require assistance from family caregivers after discharge. Caregiving is associated with negative consequences including poor health-related quality of life, psychosocial distress, and burden. Little is known about how family caregivers find satisfaction and meaning in their experience. OBJECTIVES To explore positive descriptions of the experiences of family caregivers of critically ill patients and to describe factors that family caregivers view as important to a positive caregiving experience from hospitalization to 4 months after discharge. METHODS Qualitative secondary analysis was performed on data from semistructured interviews conducted as part of a longitudinal study that examined physical and psychological responses to stress in a convenience sample of family caregivers of adult intensive care unit patients who underwent prolonged mechanical ventilation (≥ 4 days). Interviews were conducted at 4 time points: during the hospitalization and within 2 weeks, 2 months, and 4 months after discharge. RESULTS Participants (n = 41) reported factors that helped them positively appraise their caregiving experience in 113 interviews conducted face to face or via telephone. During patients' hospitalization, caregivers described changes in their role, with their primary responsibility being to advocate for the patient. They described how this experience fulfilled their identity and strengthened their relationship with the patient. Most family caregivers mentioned the importance of social support and prayer. CONCLUSIONS Family caregivers of intensive care unit patients can identify positive aspects of caregiving during the experience. Interventions to reframe the caregiving experience in a positive light are warranted.
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Affiliation(s)
- Judith A. Tate
- Judith A. Tate is an assistant professor at the Ohio State University College of Nursing, Columbus, Ohio
| | - JiYeon Choi
- JiYeon Choi is an assistant professor at Yonsei University College of Nursing, Mo-Im Kim Nursing Research Institute, Seoul, Korea. At the time of the study, Choi was at the University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
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Beesley SJ, Hirshberg EL, Wilson EL, Butler JM, Oniki TA, Kuttler KG, Orme JF, Hopkins RO, Brown SM. Depression and Change in Caregiver Burden Among Family Members of Intensive Care Unit Survivors. Am J Crit Care 2020; 29:350-357. [PMID: 32869070 DOI: 10.4037/ajcc2020181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family members of patients in intensive care units may experience psychological distress and substantial caregiver burden. OBJECTIVE To evaluate whether change in caregiver burden from intensive care unit admission to 3-month follow-up is associated with caregiver depression at 3 months. METHODS Caregiver burden was assessed at enrollment and 3 months later, and caregiver depression was assessed at 3 months. Depression was measured with the Hospital Anxiety and Depression Score. The primary analysis was the association between depression at 3 months and change in caregiver burden, controlling for a history of caregiver depression. RESULTS One hundred one participants were enrolled; 65 participants had a surviving loved one and completed 3-month follow-up. At 3-month follow-up, 12% of participants met criteria for depression. Increased caregiver burden over time was significantly associated with depression at follow-up (Fisher exact test, P = .004), although this association was not significant after controlling for self-reported history of depression at baseline (Cochran-Mantel-Haenszel test, P = .23). CONCLUSIONS Family members are increasingly recognized as a vulnerable population susceptible to negative psychological outcomes after a loved one's admission to the intensive care unit. In this small sample, no significant association was found between change in caregiver burden and depression at 3 months after controlling for baseline depression.
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Affiliation(s)
- Sarah J. Beesley
- Sarah J. Beesley is an assistant professor, Pulmonary Division and Center for Humanizing Critical Care, Intermountain Medical Center and an adjunct assistant professor, Department of Medicine, University of Utah, both in Salt Lake City, Utah
| | - Eliotte L. Hirshberg
- Eliotte L. Hirshberg is an associate professor, Pulmonary Division and Center for Humanizing Critical Care, Intermountain Medical Center; an associate professor, Department of Internal Medicine, University of Utah School of Medicine; and an adjunct associate professor, Department of Pediatrics, University of Utah, all in Salt Lake City
| | - Emily L. Wilson
- Emily L. Wilson is a statistician, Pulmonary Division and Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City
| | - Jorie M. Butler
- Jorie M. Butler is an assistant professor, Department of Internal Medicine, Division of Geriatrics, University of Utah School of Medicine and an investigator with the Geriatric Research, Education, and Clinical Center (GRECC), Veterans Affairs Medical Center and the Center for Humanizing Critical Care, Intermountain Medical Center, all in Salt Lake City, Utah
| | - Thomas A. Oniki
- Thomas A. Oniki and Kathryn G. Kuttler are data specialists, Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City, Utah
| | - Kathryn G. Kuttler
- Thomas A. Oniki and Kathryn G. Kuttler are data specialists, Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City, Utah
| | - James F. Orme
- James F. Orme is a professor, Pulmonary Division and Center for Humanizing Critical Care, Intermountain Medical Center and a professor, Department of Medicine, University of Utah, both in Salt Lake City
| | - Ramona O. Hopkins
- Ramona O. Hopkins is a professor, Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah and the Pulmonary Division and Center for Humanizing Critical Care, Intermountain Medical Center, Salt Lake City, Utah
| | - Samuel M. Brown
- Samuel M. Brown is an associate professor, Pulmonary Division and Center for Humanizing Critical Care, Intermountain Medical Center and an associate professor, Department of Medicine, University of Utah, Salt Lake City
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Wong P, Redley B, Digby R, Correya A, Bucknall T. Families’ perspectives of participation in patient care in an adult intensive care unit: A qualitative study. Aust Crit Care 2020; 33:317-325. [DOI: 10.1016/j.aucc.2019.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022] Open
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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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Schmollgruber S. Family care in intensive care units. SOUTHERN AFRICAN JOURNAL OF CRITICAL CARE 2019; 35:10.7196/SAJCC.2019.v35i1.402. [PMID: 36959817 PMCID: PMC10029741 DOI: 10.7196/sajcc.2019.v35i1.402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- S Schmollgruber
- Department of Nursing Education, University of the Witwatersrand,
Johannesburg, South Africa
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Yousefzadeh-Chabok S, Khodadadi-Hassankiadeh N, Saberi A, Ghanbari Khanghah A, Zarrabi H, Yeganeh MR, Hakimi H, Dehnadi Moghadam A. Research Paper: Anxiety, Depression, and Their Related Factors in Patients Admitted to Intensive Care Units. CASPIAN JOURNAL OF NEUROLOGICAL SCIENCES 2018. [DOI: 10.29252/cjns.4.15.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Abstract
Research highlights the psychosocial impact of critical illness on family who typically adopt a caregiver role to the survivor. We review evidence on informal caregiver psychosocial outcomes and interventional studies designed to improve them. We argue informal caregivers have distinct and complex needs that differ from patients. Interventional studies ought to be designed for this cohort with careful attention paid to the timing of interventions. We consider the influence of social isolation on recovery and discuss service improvement approaches to build social support networks to enhance recovery, where caregivers and survivors are involved in the design of aftercare programs.
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Affiliation(s)
- Kimberley J Haines
- Department of Physiotherapy, Western Health, Sunshine Hospital, 176 Furlong Road, St Albans, Melbourne, Victoria 3021, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia.
| | - Tara Quasim
- Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, 84 Castle Street, Glasgow G4 0SF, Scotland; School of Medicine, Dentistry and Nursing, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland
| | - Joanne McPeake
- Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, 84 Castle Street, Glasgow G4 0SF, Scotland; School of Medicine, Dentistry and Nursing, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland
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Concern About the Association Between Salivary Cortisol and Subsequent Anxiety Among Family Members of ICU Patients. Crit Care Med 2018; 46:e624. [DOI: 10.1097/ccm.0000000000003028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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