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Glæemose AO, Hanifa ALB, Haslund-Thomsen H. Peer support in intensive care unit follow-up: A qualitative evaluation. Nurs Crit Care 2024; 29:785-794. [PMID: 38740516 DOI: 10.1111/nicc.13089] [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: 02/28/2024] [Revised: 04/19/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Patients formerly admitted to an intensive care unit and their relatives seek information about life after critical illness to understand their symptoms and what to expect as survivors, and they express a desire to talk to others with similar experiences. Various operational models of post-intensive care peer support exist, and studies have reported potential beneficial mechanisms in patients involved in peer support programs. However, most models have not been formally evaluated. AIM To evaluate the content and setting of structured group meetings and explore participants' experiences of meeting peers. STUDY DESIGN A qualitative evaluation combining focused ethnographic observations and semi-structured interviews with 22 participants attending three intensive care unit café meetings in a university hospital. A thematic analysis was conducted using all data collected. FINDINGS Three main themes emerged; 'Accommodating the diversity of patients and relatives', 'A range of possibilities for identification' and 'A newfound community'. Findings indicate that the content, setting and timing of the café meetings were of minor concern for the participants. Patients and relatives should attend together because the consequences of surviving a critical illness affect both. Larger groups of participants appeared to increase the likelihood of encountering broad variances in participants' experiences from the critical illness trajectory. The findings indicate that before attending a meeting, the participants did not find previous experiences sufficient in managing their new life situations and they felt alone in their experiences. CONCLUSION Peer support invited participants into a secure community and eased their sense of being alone in their struggles. Meeting peers seemed to be more important than following a specific model of peer support. RELEVANCE TO CLINICAL PRACTICE When setting up peer support for former intensive care patients, the most important aspect is to create a secure space for patients and their relatives to meet.
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Affiliation(s)
- Anne Okkels Glæemose
- Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
| | - Ann Louise Bødker Hanifa
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Helle Haslund-Thomsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Gistrup, Denmark
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Büyükbayram Z, Aksoy M, Yılmaz R. Difficult lives: A descriptive and relational study on the coping with stress and care burden of caregivers of patients with epilepsy. Epilepsy Behav 2023; 145:109297. [PMID: 37336137 DOI: 10.1016/j.yebeh.2023.109297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
AIM This study was conducted to examine the relationship between coping with stress status and the burden of care of the caregivers of patients with epilepsy. MATERIALS AND METHODS This descriptive correlational study was carried out with a total of 230 voluntary caregivers of patients with epilepsy who visited the neurology clinics and outpatient clinics of a training and research hospital in the southeastern part of Turkiye between March 2022 and February 2023. Study data were collected through the Personal Information Form, the Zarit Caregiver Burden Assessment and the Ways of Coping Scale. Descriptive statistics and multiple regression analysis were used for the evaluation of the data. FINDINGS While the mean score of the caregivers from the Zarit Caregiver Burden Assessment was 41.20 ± 12.44, they had mean scores of 12.12 ± 3.25, 8.93 ± 1.93, 12.24 ± 3.61, 8.77 ± 3.17, and 7.89 ± 1.95, respectively, from the self-confident approach, optimistic approach, helpless approach, submissive approach, and social support-seeking approach sub-dimensions. In the study, a moderate positive statistically significant relationship was found between the caregivers' burden of care and the mean scores of the helpless and submissive approach sub-dimensions(p < 0.05). CONCLUSION The caregivers' burden of care and coping with stress were at moderate levels. The helpless approach, which is one of the ineffective methods of coping with stress, was found to be higher. The helpless and submissive approaches were found to increase in this study as the caregivers' burden of care increased. IMPLICATIONS The use of effective coping skills to reduce the level of personal burden of care would improve the caregiver's physical health and psychological well-being.
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Affiliation(s)
- Zeliha Büyükbayram
- Siirt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Siirt, Turkey.
| | - Meyreme Aksoy
- Siirt University, Faculty of Health Sciences, Department of Nursing Fundamentals, Siirt, Turkey.
| | - Rıdvan Yılmaz
- Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.
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Schorr CA, Seckel MA, Papathanassoglou E, Kleinpell R. Nursing Implications of the Updated 2021 Surviving Sepsis Campaign Guidelines. Am J Crit Care 2022; 31:329-336. [PMID: 35773196 DOI: 10.4037/ajcc2022324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sepsis is a life-threatening illness that affects millions of people worldwide. Early recognition and timely treatment are essential for decreasing mortality from sepsis. The Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, the fifth iteration of the guidelines, was released in October 2021 and includes 93 recommendations for the management of sepsis. The evidence-based guidelines include recommendations and rationales for screening and early treatment, initial resuscitation, mean arterial pressure targets, admission to intensive care, management of infection, hemodynamic monitoring, ventilation, and additional therapies. A new section addresses long-term outcomes and goals of care. This article presents several recommendations, changes, and updates in the 2021 guidelines and highlights the important contributions nurses have in delivering timely and evidence-based care to patients with sepsis. Recommendations may be for or against an intervention, according to the evidence. Although many recommendations are unchanged, several new recommendations directly affect nursing care and may require specialized training (eg, venovenous extracorporeal membrane oxygenation). The newest section, long-term outcomes and goals of care, is aimed at using available resources to provide care that is aligned with the patient and the patient's family through goals-of-care discussions and shared decision-making. Interventions aimed at improving recovery across the continuum of care should include attention to long-term outcomes. Nurses are essential in identifying patients with sepsis, administering and assessing response to treatment, supporting the patient and family, and limiting sequelae from sepsis. This article highlights the 2021 recommendations that influence nursing care for patients with sepsis.
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Affiliation(s)
- Christa A Schorr
- Christa A. Schorr is a professor of medicine, Cooper Medical School of Rowan University, and a clinical nurse scientist, Cooper University Health Care, Camden, New Jersey
| | - Maureen A Seckel
- Maureen A. Seckel is a medical critical care quality and safety clinical nurse specialist and a sepsis coordinator, ChristianaCare, Newark, Delaware
| | - Elizabeth Papathanassoglou
- Elizabeth Papathanassoglou is a professor of nursing, University of Alberta, and the scientific director, Neurosciences, Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Ruth Kleinpell
- Ruth Kleinpell is the associate dean for clinical scholarship and a professor, Vanderbilt University School of Nursing, Nashville, Tennessee
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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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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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Coombs MA, Statton S, Endacott CV, Endacott R. Factors influencing family member perspectives on safety in the intensive care unit: a systematic review. Int J Qual Health Care 2021; 32:625-638. [PMID: 32901816 DOI: 10.1093/intqhc/mzaa106] [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: 05/06/2020] [Revised: 08/12/2020] [Accepted: 09/02/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Patient safety has developed as a strong marker for healthcare quality. Safety matters are important in the intensive care unit (ICU) where complex clinical decisions are made, intensive technology is used, and families hold a unique role. The aim of this review was to identify and describe factors that influence family member's perceptions of safety in the adult ICU. DATA SOURCES Searches were conducted between September and November 2018 and repeated in July 2020 using CINAHL, MEDLINE (EBSCO), PubMed and PsycINFO databases. STUDY SELECTION Published primary studies undertaken in adult ICUs and involving adult family member participants exploring safety or feeling safe. No date restrictions were applied. DATA EXTRACTION A data extraction form collected information about sample, study design, data collection methods and results from each paper. Methodological quality was assessed using the QualSyst tools for qualitative and quantitative studies. Narrative synthesis was undertaken. RESULTS OF DATA SYNTHESIS Twenty papers were included with 11 papers published since 2010. The majority of papers reported on qualitative studies (n = 16). Four factors were identified that influenced whether family members felt that the patient was safe in ICU: family visiting, information and communication, caring and professional competence. CONCLUSION In detailing specific practices that make families feel safe and unsafe in ICU, these review findings provide a structure for clinicians, educators and researchers to inform future work and gives opportunity for the family role in patient safety to be reconsidered.
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Affiliation(s)
- M A Coombs
- School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, Devon, PL4 8AA, UK.,School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington, New Zealand
| | - S Statton
- School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, Devon, PL4 8AA, UK.,NIHR Exeter Clinical Research Facility, Level 2 RILD Building, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - C V Endacott
- School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, Devon, PL4 8AA, UK.,Bradford Institute of Health Research, Bradford Royal Infirmary, Duckworth lane, Bradford, BD9 6RJ, UK
| | - R Endacott
- School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, Devon, PL4 8AA, UK.,School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building E, Peninsula Campus, 47-49 Moorooduc Highway, Frankston, Victoria, 3199, Australia
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Millward K, McGraw C, Aitken LM. The expressed support needs of families of adults who have survived critical illness: A thematic synthesis. Int J Nurs Stud 2021; 122:104048. [PMID: 34392173 DOI: 10.1016/j.ijnurstu.2021.104048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Surviving critical illness can result in ongoing psychological, physical and cognitive impairments for both survivors and families. During the time from the critical illness through to the period of adaptation back to community living, families, alongside survivors, have support needs. OBJECTIVES This systematic review aimed to provide an in-depth insight into the expressed support needs of families of adults who survived an admission to an intensive care unit and returned to a home environment. It also aimed to explore how these needs change over time, and what support provisions families perceived to be helpful. METHODS This was a systematic review using thematic synthesis methodology. Predefined searches were conducted in CINAHL, Medline, PsychINFO, SocIndex, EMbase, Academic Search Complete, EThOS and OpenGrey to locate studies published in English from 2000. Two reviewers screened each study against the inclusion criteria. Quality appraisal was undertaken using Joanna Briggs Institute tools. Extracted data were managed in Nvivo12® and analysed to identify descriptive and analytical themes. The Timing it Right Framework was used to frame changes in need across the recovery continuum. RESULTS Thirty-nine studies were included, 30 qualitative, eight quantitative and one mixed methods. Five key family needs were identified across the recovery continuum: for security; to make sense of the situation; finding a balance; holding everything together; and for trust. DISCUSSION Families found the following interventions helpful: written information; care coordination and navigation; input from intensive care staff after discharge to support continuity; and provision of family support groups. Although there are similarities between the needs of families and survivors, there are sufficient differences to warrant the development of processes to identify and address family need throughout the recovery continuum. CONCLUSION More research is required to develop a tool to better identify the needs of families across the recovery continuum, identify gaps in current service provision, and design interventions to meet these needs. STUDY REGISTRATION CRD42019136883 (PROSPERO).
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Affiliation(s)
- Kat Millward
- School of Health Sciences, City, University of London, 10 Northampton Square, London EC1V 0HB, United Kingdom.
| | - Caroline McGraw
- School of Health Sciences, City, University of London, 10 Northampton Square, London EC1V 0HB, United Kingdom.
| | - Leanne M Aitken
- School of Health Sciences, City, University of London, 10 Northampton Square, London EC1V 0HB, United Kingdom.
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Ozcelik H, Erdogan N. Relationship Between the Needs of Turkish Relatives of Patients Admitted to an Intensive Care Unit and Their Coping Styles. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:990-1006. [PMID: 32962532 DOI: 10.1177/0030222820960963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Admission to an intensive care unit is a traumatic event for many patients' relatives. Also, the relatives may be subject to many requirements to during this process. Therefore, it is very important to determine their requirements and coping styles. This study used a descriptive, relational design. The sample of the research consisted of 247 relatives of patients staying in six intensive care units. It was found that, 65.2% of the patients' relatives were women, and their mean age was 37.25 ± 12.7 years. What they mostly needed was support, proximity, information, assurance and comfort. In that order; among the coping styles it was found that they usually used the following approaches: self-confident approach, an problem-focused coping method; was found to be used by relatives most frequently, followed by helpless approach, an emotion-focused coping style. Requirements: Assurance, information, support and comfort sub-dimension scores and problem-focused coping style; self-confident approach and social support search approach sub-dimension scores between statistically positive, significant relationship was found. Information, proximity, support and comfort sub-dimension scores and emotion-focused coping style; helpless approach and submissive sub-dimension scores between statistically positive, significant relationship was found (p<0.05). It was found that patients' relatives used the helpless approach and submissive approach to cope with stres: during this process their information needs increased and upon fulfillment of requirements, they started using self-confident approach and the social support approach, which are problem-focused coping styles.
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Affiliation(s)
- Hanife Ozcelik
- Zubeyde Hanim School of Health, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Nilgun Erdogan
- Nigde Omer Halisdemir University, Training and Research Hospital, Nigde, Turkey
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Scholes J, Albarran J. What's in this issue. Nurs Crit Care 2018; 23:223-224. [PMID: 30133110 DOI: 10.1111/nicc.12383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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