A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward

Investigating stress, social support, and decisional conflict dynamics in surrogates of intensive care unit patients with cancer

PURPOSE

The purpose of this study is to examine fluctuations in stress, social support, and decisional conflict among surrogates during the admission and discharge phases of intensive care unit (ICU) patients with cancer. Additionally, this study seeks to identify the factors that influence changes in decisional conflict experienced by these surrogates.

METHODS

This study involved surrogates of ICU patients with cancer. Data were collected within three days of ICU admission and during the discharge phase.

RESULTS

The study included 115 surrogates of ICU patients with cancer. Following ICU discharge, the surrogates experienced a significant reduction in mean stress levels (t =  - 7.205; p < .001), improved family support (t = 3.748; p < .001), and decreased support from healthcare professionals (t =  - 3.286; p = .001). Younger surrogates, high-stress levels in surrogates, and low social support from healthcare professionals were associated with high decisional conflict. Stepwise multiple regression analysis indicated that surrogates' age, changes in stress, and changes in healthcare professionals' support explained 5%, 8%, and 16% of the variation in changes in decisional conflict, respectively.

CONCLUSIONS

To effectively reduce decisional conflict, particularly during the transition of patients with cancer from the ICU, a robust support system and comprehensive information on the treatment and prognosis of diseases in patients with cancer should be provided to younger surrogates. Healthcare professionals can facilitate family meetings and ensure comprehensive communication of the treatment plan. Practical guidance, social work assistance, timely clarification, and thorough information healthcare professionals provide can effectively mitigate decisional conflicts and enhance decision-making processes.

Family caregivers' experiences and needs of transitional care during the transfer from intensive care unit to a general ward: A qualitative study

AIM

To explore the family caregivers' experiences and needs of transitional care during the transfer from an intensive care unit to a general ward in China.

BACKGROUND

The transfer of patients from the intensive care unit to the ward is a vulnerable time for patients and caregivers, exposing the risk of readmission and death. However, there are few qualitative studies on the family caregivers' views of transitional care for their loved ones in China.

METHODS

With a qualitative research design, 15 interviews were conducted with 15 family caregivers of hospitalized patients transferred from the neurosurgery ICU to the general ward. Colaizzi's (1978) method of data analysis was performed using the NVivo 11.0 software.

RESULTS

Based on data analysis, four themes were obtained: perception of transfer decision, the experience of transitional care, the obstacles to maintaining care efficiency and demand for transitional care.

CONCLUSION

In order to enhance the continuity of care and improve patient safety during the transfer from an ICU to a general ward in China, priorities should be given to the implementation of effective strategies and methods, including providing psychological and emotional support, encouraging active participation of caregivers, and various communication and collaboration procedures.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings from this study can be used as a guide to better preparation and awareness among health care professionals to achieve the much-needed demands of family caregivers, as well as the increased quality of transitional care.