1
|
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.
Collapse
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
| |
Collapse
|
2
|
Naef R, Brysiewicz P, Mc Andrew NS, Beierwaltes P, Chiang V, Clisbee D, de Beer J, Honda J, Kakazu S, Nagl-Cupal M, Price AM, Richardson S, Richardson A, Tehan T, Towell-Barnard A, Eggenberger S. Intensive care nurse-family engagement from a global perspective: A qualitative multi-site exploration. Intensive Crit Care Nurs 2021; 66:103081. [PMID: 34116886 DOI: 10.1016/j.iccn.2021.103081] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/31/2021] [Accepted: 04/05/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Critical illness is distressing for families, and often results in negative effects on family health that influence a family's ability to support their critically ill family member. Although recent attention has been directed at improving care and outcomes for families of critically ill patients, the manner in which nurses engage with families is not fully understood. OBJECTIVES To describe nurses' perceptions and practices of family engagement in adult intensive care units from a global perspective. DESIGN A qualitative-descriptive multi-site design using content analysis. SETTINGS The study was conducted in 26 intensive care units of 12 urban, metropolitan, academic medical centers in ten countries, spanning five continents. PARTICIPANTS A total of 65 registered nurses (77% women, age of M = 39.5, SD = 11.4 years) participated. Most held intensive care certification (72%) and had worked on average 10 (SD = 9.6) years in the ICU. METHODS Semi-structured, individual interviews (M = 38.4 min, SD = 12.0) were held with ICU nurses at the hospital (94%) or their home using an interview guide. Qualitative interview data were analysed using inductive content analysis. RESULTS We found that nurse-family engagement was an ebb and flow of relational power that needed to be carefully negotiated and balanced, with nurses holding and often exerting more power than families. Constant fluctuations in nurses' practices of engagement occurred in day-to-day practice from shift-to-shift and from nurse-to-nurse. Family engagement was dependent on individual nurses' attitudes and perceptions of family, the patient's condition, and workload. Lastly, family engagement was shaped by the ICU context, with team culture, collaborative relationships, unit structures and organizational resources either enabling or limiting nurses' ability to engage with families. CONCLUSIONS This global study provides an in-depth understanding of the way nurses engage with families in ICU and reflects many different cultures and health systems. We found that nurse-family engagement was marked by a shifting, yet often unequal power distribution in the nurse-family relationship, inconsistent nurse engagement practices, both of which resulted in variable family engagement in intensive care. Our research contributes a detailed description of engagement as practiced in the everyday delivery of health care. A more concentrated team effort, based on a shared culture and defined framework of family care is needed to ensure that families of critically ill persons are fully engaged in all aspects of intensive care.
Collapse
Affiliation(s)
- Rahel Naef
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitätstrasse 84, 8006 Zurich, Switzerland; Centre of Clinical Nursing Science, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
| | - Petra Brysiewicz
- School of Nursing & Public Health, University of KwaZulu-Natal, King George Mazisi Kunene Road, Glenwood, Durban 4041, South Africa.
| | - Natalie S Mc Andrew
- College of Nursing, University of Wisconsin-Milwaukee, Cunningham Hall, 1921 East Hartford Avenue, P.O. Box 413, Milwaukee, WI 53201-0413, USA; Froedtert & the Medical College of Wisconsin, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
| | - Patricia Beierwaltes
- College of Allied Health and Nursing, School of Nursing, Minnesota State University, 360 Wissink Hall, Mankato, MN 56001, USA.
| | - Vico Chiang
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong.
| | - David Clisbee
- College of Science, Engineering and Technology, Computer Information Science Department, Minnesota State University, 273 Wissink Hall, Mankato, MN 56001, USA.
| | - Jennifer de Beer
- College of Nursing-Jeddah, King Saud bin Abdul Aziz University for Health Sciences-Jeddah, Makkah Highway, Al Haramain Road, Mail Code 65 65, PO Box 9515, Saudi Arabia.
| | - Junko Honda
- Child Health Nursing, College of Nursing Art and Science, University of Hyogo, 13-71, Kitaoji-cho, Akashi, Hyogo 673-8588, Japan.
| | - Shota Kakazu
- Child Health Nursing, Graduate School of Nursing Sciences, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan.
| | - Martin Nagl-Cupal
- Department of Nursing Science, University of Vienna, Alser Strasse 23/12, 1080 Vienna, Austria.
| | - Ann M Price
- School of Nursing, Midwifery and Social Work, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent CT1 1QU, United Kingdom.
| | - Sandra Richardson
- School of Health Sciences, College of Education, Health and Human Development, University of Canterbury, 276 Antigua Street, Christchurch 8011, New Zealand; Emergency Department, Christchurch Hospital, Canterbury District Health Board, 2 Riccarton Avenue, Christchurch 8011, New Zealand.
| | - Anna Richardson
- Bachelor of Nursing Programme, Department of Health Practice, Manawa, Ara Institute of Canterbury Ltd, 276 Antigua Street, Christchurch 8140, New Zealand.
| | - Tara Tehan
- University of Massachusetts Medical School, Graduate School of Nursing, 55 Lake Ave North, Worcester, MA 01655, USA.
| | - Amanda Towell-Barnard
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Western Australia 6027, Australia; Sir Charles Gairdner Hospital, Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia 6009, Australia.
| | - Sandra Eggenberger
- College of Allied Health and Nursing, Glen Taylor Nursing Institute for Family and Society, Minnesota State University, 360 Wissink Hall and 351 7700 France, Mankato, MN 56001, USA.
| |
Collapse
|
3
|
Haave RO, Bakke HH, Schröder A. Family satisfaction in the intensive care unit, a cross-sectional study from Norway. BMC Emerg Med 2021; 21:20. [PMID: 33588760 PMCID: PMC7885442 DOI: 10.1186/s12873-021-00412-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/31/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Becoming critically ill represents not just a great upheaval for the patient in question, but also for the patient's closest family. In recent years, there has been a change in how the quality of the public health service is measured. There is currently a focus on how patients and their families perceive the quality of treatment and care. It can be challenging for patients to evaluate their stay in an intensive care unit (ICU) due to illness and treatment. Earlier studies show that the perceptions of the family and the patient may concur. It is important, therefore, to ascertain the family's level of satisfaction with the ICU stay. The aim of the study was to describe how the family evaluate their satisfaction with the ICU stay. A further aim was to identify which demographic variables were associated with differences in family satisfaction. METHOD The study had a cross-sectional design. A sample of 57 family members in two ICUs in Norway completed the questionnaire: Family satisfaction in the intensive care unit 24 (FS-ICU 24). Statistical analysis was conducted using the Mann-Whitney U test (U), Kruskal Wallis, Spearman rho and a performance-importance plot. RESULTS The results showed that families were very satisfied with a considerable portion of the ICU stay. Families were less satisfied with the information they received and the decision-making processes than with the nursing and care performed during the ICU stay. The results revealed that two demographic variables - relation to the patient and patient survival - significantly affected family satisfaction. CONCLUSION Although families were very satisfied with the ICU stay, several areas were identified as having potential for improvement. The results showed that some of the family demographic variables were significant for family satisfaction. The findings are clinically relevant since the results can strengthen intensive care nurses' knowledge when meeting the family of the intensive care patient.
Collapse
Affiliation(s)
- Randi Olsson Haave
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Gjøvik, Norway.
| | | | - Agneta Schröder
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Gjøvik, Norway
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| |
Collapse
|
4
|
Kılınçel Ş, Altun FT, Nuryüz Ö, Tan E, Erzincan E, Kılınçel O, Yazıcı E, Ayaz M. Effects of COVID-19 Outbreak on Children's Mental Health: A Comparative Study with Children Diagnosed and Isolated from Their Parents. Psychiatry Investig 2021; 18:140-146. [PMID: 33601873 PMCID: PMC7960744 DOI: 10.30773/pi.2020.0372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/27/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The COVID-19 outbreak has negatively affected children in many ways. This study aimed to compare the psychological responses of children exposed to different levels of stress during the COVID-19 outbreak. METHODS The anxiety levels, negative thoughts, and quality of life of COVID-19-positive children with COVID-19-positive parents (Child+ group, n=17), COVID-19-negative children who are separated from COVID-19-positive parents (Parent+ group, n=59), and a control group (n=64) were compared. The participants completed the Screen for Child Anxiety and Related Disorders (SCARED), Children's Negative Cognitive Errors Questionnaire (CNCEQ), and Pediatric Quality of Life Inventory (PedsQL). RESULTS The statistical analysis revealed that the Parent+ group recorded higher SCARED and CNCEQ scores and lower PedsQL scores in comparison with the control group. No statistically significant difference was found between the scores of the Child+ and control groups. Furthermore, high CNCEQ scores and low PedsQL scores in the Parent+ group predicted an increase in their SCARED scores. CONCLUSION Our study indicates that separating children from their parents during the COVID-19 outbreak negatively influences their mental health and increases their anxiety levels.
Collapse
Affiliation(s)
- Şenay Kılınçel
- Sakarya Child and Adolescent Psychiatry Institute, Sakarya, Turkey
| | - Feray Tarımtay Altun
- University of Health Sciences, Department of Clinical Psychology, Istanbul, Turkey
| | - Özgecan Nuryüz
- Mentalica Consultancy Education and Research Center, Istanbul, Turkey
| | - Ezgi Tan
- Department of Psychology, Istanbul Ticaret University, Istanbul, Turkey
| | - Erkal Erzincan
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Oğuzhan Kılınçel
- Department of Psychiatry, Sakarya Yenikent State Hospital, Sakarya, Turkey
| | - Esra Yazıcı
- Department of Psychiatry, Sakarya University Medical Faculty, Sakarya, Turkey
| | - Muhammed Ayaz
- Mentalica Consultancy Education and Research Center, Istanbul, Turkey
| |
Collapse
|
5
|
Lebel V, Charette S. Nursing Interventions to Reduce Stress in Families of Critical Care Patients: An Integrative Review. Crit Care Nurse 2021; 41:32-44. [PMID: 33560437 DOI: 10.4037/ccn2021188] [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 Having a family member admitted to an intensive care unit is a stressful experience that may lead to psychological symptoms including depression, anxiety, and posttraumatic stress disorder. OBJECTIVE To better understand the phenomenon of stress experienced by families of intensive care unit patients and identify nursing interventions that may help reduce it. METHODS An integrative literature review was performed to identify principal stressors for families of patients receiving care in neonatal, pediatric, and adult intensive care units and recommended nursing interventions. RESULTS The principal stressors in the 3 types of intensive care units were change in parental role or family dynamics, appearance and behavior of the patient, the care setting, and communication with the health care staff. Nursing interventions should focus on valuing the role of family members in patient care, improving communication, and providing accurate information. CLINICAL RELEVANCE Family members of intensive care patients will benefit from nursing interventions that adequately acknowledge and address the stress they experience. CONCLUSION Nurses play a crucial role in helping to reduce the stress experienced by family members of intensive care unit patients.
Collapse
Affiliation(s)
- Valérie Lebel
- Valérie Lebel is a professor, Department of Nursing, Université du Québec en Outaouais, Quebec, Canada
| | - Sylvie Charette
- Sylvie Charette is a professor, Department of Nursing, Université du Québec en Outaouais
| |
Collapse
|
6
|
McAndrew NS, Mark L, Butler M. Timely Family Feedback to Guide Family Engagement in the Intensive Care Unit. Crit Care Nurse 2020; 40:42-51. [PMID: 33257964 DOI: 10.4037/ccn2020644] [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 Organizations motivated to provide high-quality care in the intensive care unit are exploring strategies to engage families in patient care. Such initiatives are based on emerging evidence that family engagement improves quality and safety of care. OBJECTIVE To gather family feedback to guide future nurse-led quality improvement efforts to engage families in the intensive care unit setting. METHODS The Critical Care Family Satisfaction Survey, which consists of 20 items rated from 1 (very dissatisfied) to 5 (very satisfied), was paired with open-ended questions and administered to families during the intensive care unit stay from March through December 2017. Content analysis was used to identify themes regarding the family experience. RESULTS Responses were collected from 178 family members. The mean (SD) score on the survey was 4.65 (0.33). Five themes emerged regarding the delivery of family care in the intensive care unit: family interactions with the interdisciplinary team, information sharing and effective communication, family navigation of the intensive care unit environment, family engagement in the intensive care unit, and quality of patient care. CONCLUSIONS This quality improvement project provided foundational information to guide family engagement efforts in the intensive care unit. Real-time solicitation of feedback is essential to improving the family experience and guiding family-centered care delivery in this practice environment.
Collapse
Affiliation(s)
- Natalie S McAndrew
- Natalie S. McAndrew is an assistant professor, College of Nursing, University of Wisconsin-Milwaukee, and a nurse-scientist, Froedtert Hospital, Froedtert & Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Laura Mark
- Laura Mark is a physician assistant in the cardiovascular intensive care unit, Froedtert Hospital, Froedtert & Medical College of Wisconsin
| | - Mary Butler
- Mary Butler is an assistant clinical professor, College of Nursing, University of Wisconsin-Milwaukee
| |
Collapse
|
7
|
Emergency department approach to spirituality care in the era of COVID-19. Am J Emerg Med 2020; 46:765-768. [PMID: 32958381 PMCID: PMC7487517 DOI: 10.1016/j.ajem.2020.09.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 12/02/2022] Open
|
8
|
Petersen JJ, Østergaard B, Svavarsdóttir EK, Rosenstock SJ, Brødsgaard A. A challenging journey: The experience of elderly patients and their close family members after major emergency abdominal surgery. Scand J Caring Sci 2020; 35:901-910. [PMID: 32857474 DOI: 10.1111/scs.12907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/19/2020] [Accepted: 08/02/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE Knowledge of how elderly patients undergoing major emergency abdominal surgery and their close family members experience the course of illness is limited. Little is known about how such surgery and hospitalisation affect elderly patients' daily life after discharge. It is well known that such patients have an increased risk of mortality and that their physical functional level often decreases during hospitalisation, which can make them dependent on family or homecare services. Critical illness and caregiving for a close relative can be a stressful experience for families, which are at risk of developing stress-related symptoms. AIM To explore how elderly patients and their families experience the course of illness during hospitalisation and the first month at home after discharge. METHOD A phenomenological study was conducted to gain in-depth descriptions through 15 family interviews with 15 patients who had undergone major emergency abdominal surgery and 20 of their close adult family members. Data were analysed using a phenomenological approach inspired by Giorgi. FINDINGS The essence of the phenomenon is captured in three themes: (1) Being emotionally overwhelmed, (2) Wanting to be cared for and (3) Finding a way back to life. CONCLUSION Patients and their close family members experienced the course of illness as a challenging journey where they longed for life to become as it was before illness. They experienced illness as a sudden life-threatening incidence. In this situation, it was crucial to be met with empathy from healthcare professionals. The patients' experience of fatigue and powerlessness remained intense one month after discharge and affected their and their close family members' lives.
Collapse
Affiliation(s)
- Julie Jacoby Petersen
- Gastrounit, Surgical Division, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Graduate School of Health, University of Aarhus Graduate School of Health Sciences, Aarhus N, Denmark
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Steffen Jais Rosenstock
- Gastrounit, Surgical Division, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark.,Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark
| |
Collapse
|
9
|
The process of giving information to families in intensive care units: A narrative review. ENFERMERIA INTENSIVA 2020; 32:18-36. [PMID: 32763104 DOI: 10.1016/j.enfi.2019.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 09/26/2019] [Accepted: 11/24/2019] [Indexed: 11/23/2022]
Abstract
AIM Information is one of the most important needs of families of critical patients. Healthcare professionals also identify the great value of communication with families to reduce their anxiety and stress. Despite this, families may feel inadequately informed, causing added suffering. The purpose of this study is to provide an understanding of both families' and healthcare professionals' perspectives on information giving within intensive care units (ICU). METHOD A narrative review was conducted using MEDLINE, CINAHL, PsycINFO databases and the Cochrane Library to identify studies published in either English or Spanish from 2002 to 2018. RESULTS 47 studies were included, and five categories were identified: 1)"the need to know"; 2)family satisfaction with the information received; 3)impact of information on families' experiences in the ICU; 4)nurses and physicians' perceptions of information transmission, and 5)information process in the ICU. CONCLUSIONS Providing honest and truthful information to the families of critical patients is essential to reduce family anxiety and increase family control, although this often appears to be inadequately accomplished by staff. Interdisciplinary involvement in information giving may be beneficial for both families and ICU professionals. This review brings new understanding about the process of information to families of ICU patients and it can be used to improve the quality and humanization of care in the ICUs.
Collapse
|
10
|
Gervais C, Verdon C, deMontigny F, Leblanc L, Lalande D. Creating a space to talk about one's experience of suffering: families' experience of a family nursing intervention. Scand J Caring Sci 2019; 34:446-455. [PMID: 31487072 DOI: 10.1111/scs.12748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 08/08/2019] [Indexed: 12/14/2022]
Abstract
STUDY RATIONALE The impacts of health problems on individual and family functioning, as well as the influence of family on health, are well documented. However, health care and services in the West are mostly oriented towards individuals, and the needs of families often receive little consideration. The Family Support Service (FSS) was developed to address this situation. Its aim is to improve the education of nursing students and contribute to the health of the community by offering family conversations to families whose members have a health problem or who have difficulty adjusting to certain transitions. AIMS AND OBJECTIVES The objective of this study was to explore families' experience of the family conversations in which they participated and their satisfaction with the FSS. METHODOLOGICAL DESIGN AND JUSTIFICATION This study used a descriptive qualitative design based on semi-structured interviews and thematic analysis. The study followed ethical codes of conduct and conformed to the Canadian Tri-Council Policy Statement (TCPS). RESEARCH METHODS Qualitative interviews were conducted with 22 participants who had participated in family conversations as interventions, to evaluate their experience of those family conversations and their satisfaction with the FSS. RESULTS The families reported a very positive experience of the family conversations. Three themes emerged from their statements and explained this satisfaction: (i) the nurse's attitudes and skills as the foundation for meaningful encounters; (ii) a family systems intervention where families feel recognised; and (iii) a structure adapted to the needs of families. CONCLUSIONS This study adds to the existing body of knowledge on families' experience of family system nursing and invites nurses to develop attitudes that are conducive to meaningful encounters with families.
Collapse
Affiliation(s)
- Christine Gervais
- Centre for Studies and Research on Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Chantal Verdon
- Centre for Studies and Research on Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Francine deMontigny
- Centre for Studies and Research on Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Lori Leblanc
- Centre for Studies and Research on Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Dominique Lalande
- Centre for Studies and Research on Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| |
Collapse
|
11
|
McAndrew NS, Schiffman R, Leske J. Relationships among Climate of Care, Nursing Family Care and Family Well-being in ICUs. Nurs Ethics 2019; 26:2494-2510. [PMID: 30832534 DOI: 10.1177/0969733019826396] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Frequent exposure to ethical conflict and a perceived lack of organizational support to address ethical conflict may negatively influence nursing family care in the intensive care unit. RESEARCH AIMS The specific aims of this study were to determine: (1) if intensive care unit climate of care variables (ethical conflict, organizational resources for ethical conflict, and nurse burnout) were predictive of nursing family care and family wellbeing and (2) direct and indirect effects of the climate of care on the quality of nursing family care and family wellbeing. RESEARCH DESIGN A cross-sectional, correlational design was used. PARTICIPANTS AND RESEARCH CONTEXT Convenience sample of 111 nurses and 44 family members from five intensive care units at a Midwest hospital in the United States. INSTRUMENTS The Ethical Conflict Questionnaire-Critical Care Version, Maslach Burnout Inventory-Human Services Survey and Hospital Ethical Climate Scale were used to measure climate of care. The Family-Centered Care-Adult Version and Nurse Provided Family Social Support Scale were family measures of the quality of nursing family care. The Family Wellbeing Index was used to measure family wellbeing. DATA ANALYSIS Hierarchical regression and mediation analysis were used to answer the study aims. ETHICAL CONSIDERATIONS The study was approved by the Institutional Review Board at the study site. FINDINGS In separate regression models, organizational resources for ethical conflict (β = .401, p = .006) and depersonalization (β = -.511, p = .006), a component of burnout, were significant predictors of family-centered care. In simple mediation analysis the relationship between organizational resources for ethical conflict and family-centered care was mediated by depersonalization (β = .341, 95% confidence interval (.015, .707)). DISCUSSION Inadequate organizational resources and depersonalization may be related to family care delivery, and present obstacles to family-centered care in the intensive care unit. CONCLUSION Further research to explicate the relationships among organizational resources, ethical conflict, burnout, and family-centered care is needed to guide the development of effective interventions that enhance the quality of nursing family care in the intensive care unit.
Collapse
Affiliation(s)
| | | | - Jane Leske
- Froedtert & the Medical College of Wisconsin Froedtert Hospital
| |
Collapse
|
12
|
Dorell Å, Sundin K. Expressed emotions and experiences from relatives regarding having a family member living in a nursing home for older people. SAGE Open Med 2019; 7:2050312118823414. [PMID: 30671245 PMCID: PMC6329026 DOI: 10.1177/2050312118823414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives: The purpose of this study was to describe the topics relatives with a family member in a nursing home for older persons choose to talk about and focus on when participating in a nurse-led “Family Health Conversations” intervention. Family Health Conversations consisted of a series of three nurse-led conversations with each family, with a 2-week interval between meetings. Methods: The Family Health Conversations meetings were tape-recorded and analyzed using qualitative content methods. The participants were relatives of family members living in a nursing home for older persons in a municipality in Sweden. Results: The findings showed how the relatives talked about their suffering and difficulties concerning the new situation. The relatives talked about frustration and sadness together in a new way, with a focus on how to manage the future. They also wished that they had been offered an opportunity to talk about this with nurses earlier in the illness trajectory. Conclusion: The relatives had a significant need to talk about their experiences together within the family and together with the nurses. Nurses have an especially important task in supporting relatives having a family member living in a nursing home.
Collapse
Affiliation(s)
- Åsa Dorell
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Karin Sundin
- Department of Nursing, Umeå University, Örnsköldsvik, Sweden
| |
Collapse
|
13
|
Emmamally W, Brysiewicz P. Families’ perceptions of support from health care professionals in the three emergency departments in KwaZulu Natal, South Africa. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
14
|
Mendes AP. Impact of critical illness news on the family: hermeneutic phenomenological study. Rev Bras Enferm 2018; 71:170-177. [PMID: 29324960 DOI: 10.1590/0034-7167-2016-0163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 01/20/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Understand the impact of critical-illness news on the experience of family members at an Intensive Care Unit. METHOD Phenomenological approach according to Van Manen's method. Open interviews were held with 21 family members. From analysis and interpretation of the data, three essential themes were identified: the unexpected; the pronouncement of death; and the impact on self-caring within the family. The study complied with the ethical principles inherent to research involving humans. RESULTS The unexpected news and death of the sick person influence the well-being and self-care of family members, affecting their ability for analysis and decision making. It was observed that the family experiences the news with suffering, mainly due to the anticipation arising from the events. FINAL CONSIDERATIONS The humanity of nurses was revealed in response to the needs of the family. In view of the requirements for information, it was verified that the information transmitted allowed them to become aware of themselves, to become empowered in their daily lives and to alleviate the emotional burden experienced.
Collapse
Affiliation(s)
- Anabela Pereira Mendes
- Escola Superior de Enfermagem de Lisboa, Unit for Research and Development in Nursing. Lisbon, Portugal.,Universidade Católica Portuguesa, Institute of Health Sciences, PhD in Nursing. Lisbon, Portugal
| |
Collapse
|
15
|
MacEachnie LH, Larsen HB, Egerod I. Children's and young people's experiences of a parent's critical illness and admission to the intensive care unit: A qualitative meta-synthesis. J Clin Nurs 2018; 27:2923-2932. [PMID: 29700880 DOI: 10.1111/jocn.14498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about how children and young people experience and manage the critical illness of a parent and a parent's admission to the intensive care unit (ICU). OBJECTIVE The aim of this study was to search and interpret the existing literature describing children's and young people's experiences of a parent's illness trajectory in the ICU. METHOD A qualitative meta-synthesis was conducted based on a systematic literature search of online databases. FINDINGS Four main themes were identified and synthesised to describe the integrated experiences of children and young people: (a) the parent-child bond, (b) the unfamiliar environment, (c) the impact of the illness and (d) the experience of being overseen as close family members. CONCLUSION Experiencing a parent's critical illness and admittance to the ICU is overwhelming. The bond between the parent and child is exposed by the separation from the ill parent. To comprehend and manage the experience, children and young people seek information depending on their individual capacities. They express a need to be close to their ill parent and to be seen and approached as close members of the family. However, children experience being overseen in their needs for support during their parent's ICU illness with the risk of being left in loneliness, sadness and lack of understanding of the parent's illness. RELEVANCE FOR CLINICAL PRACTICE Children and young people as relatives need to be acknowledged as close members of the family, when facing the illness trajectory of a parent, who is admitted to the ICU. They need to be seen as close family members and to be approached in their needs for support in order to promote their well-being during a family illness crisis. Early supportive interventions tailored to include children of the intensive care patient are recommended.
Collapse
Affiliation(s)
- Lise H MacEachnie
- Thoracic Intensive Care Ward, Rigshospitalet University Hospital of Copenhagen, Copenhagen, Denmark
| | | | - Ingrid Egerod
- Intensive Care Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
16
|
Russell LT, Beckmeyer JJ, Su-Russell C. Family-Centered Care and Positive Developmental Outcomes for Youth With Special Health Care Needs: Variations Across Family Structures. JOURNAL OF FAMILY NURSING 2018; 24:29-59. [PMID: 29318920 DOI: 10.1177/1074840717745520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Drawing on a social determinants of health framework, we evaluated associations between perceived family-centered care (FCC) and positive developmental outcomes for youth with special health care needs across six different family structures (married biological families, cohabiting biological families, married stepfamilies, cohabiting stepfamilies, divorced/separated single-mother families, and never-married single-mother families). Using data from the 2011-2012 National Survey of Children's Health, we found that married biological families perceive greater FCC than do other family structures. Perceived FCC was positively associated with all three positive youth outcomes evaluated (children's health, participation in extracurricular activities, and flourishing) in married biological families, and two of the three outcomes (children's health and flourishing) in married stepfamilies and divorced/separated single-mother families. Implications for health care provision and future research with structurally diverse families are discussed.
Collapse
|
17
|
Abstract
The purpose of this study was to examine the effects of family presence during resuscitation (FPDR) in patients who survived trauma from motor vehicle crashes (MVC) and gunshot wounds (GSW). A convenience sample of family members participated within three days of admission to critical care. Family members of 140 trauma patients (MVC n = 110, 79%; GSW n = 30, 21%) participated. Family members ranged in age from 20-84 years (M = 46, SD = 15, Mdn = 47). The majority were female (n = 112, 80%) and related to the patient as spouse (n = 46, 33%). Participating in the FPDR option reduced anxiety (t = -2.43, p =.04), reduced stress (t = -2.86, p = .005), and fostered well-being (t = 3.46, p = .001). Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury.
Collapse
Affiliation(s)
- Jane S. Leske
- College of Nursing University of Wisconsin-Milwaukee, Milwaukee WI
- Froedtert and the Medical College of Wisconsin-Froedtert Hospital, Milwaukee WI
| | - Natalie S. McAndrew
- College of Nursing University of Wisconsin-Milwaukee, Milwaukee WI
- Froedtert and the Medical College of Wisconsin-Froedtert Hospital, Milwaukee WI
| | - Karen J. Brasel
- Oregon Heath & Science University, Division of Trauma, Critical Care & Acute Care Surgery, Portland OR
| | - Suzanne Feetham
- College of Nursing University of Wisconsin-Milwaukee, Milwaukee WI
- Children’s National Health System, Washington DC
| |
Collapse
|
18
|
A qualitative study of factors that influence active family involvement with patient care in the ICU: Survey of critical care nurses. Intensive Crit Care Nurs 2017; 44:67-75. [PMID: 29169879 DOI: 10.1016/j.iccn.2017.08.008] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/08/2017] [Accepted: 08/25/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Family caregiver involvement may improve patient and family outcomes in the intensive care unit. This study describes critical care nurses' approaches to involving family caregivers in direct patient care. RESEARCH METHODOLOGY & DESIGN This is a qualitative content analysis of text captured through an electronic survey. SETTING A convenience sample of 374 critical care nurses in the United States who were subscribers to one of the American Association of Critical Care Nurses social media sites or electronic newsletters. MAIN OUTCOME MEASURE Critical care nurses' responses to five open-ended questions about their approaches to family involvement in direct patient care. FINDINGS Nurse, patient and family caregiver factors intersected in the context of the professional practice environment and the available resources for family care. Two main themes were identified: "Involving family caregivers in patient care in the intensive care unit requires careful ssessment" and "There are barriers and facilitators to caregiver involvement in patient care in the intensive care unit." CONCLUSION Patient care demands, the professional practice environment and a lack of resources for families hindered nursing family caregiver involvement. Greater attention to these barriers as they relate to family caregiver involvement and clinical outcomes should be a priority in future research.
Collapse
|
19
|
Cioffi JM. Collaborative care: Using six thinking hats for decision making. Int J Nurs Pract 2017; 23. [PMID: 28976053 DOI: 10.1111/ijn.12593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 08/09/2017] [Accepted: 08/14/2017] [Indexed: 11/29/2022]
Abstract
AIM To apply six thinking hats technique for decision making in collaborative care. BACKGROUND In collaborative partnerships, effective communications need to occur in patient, family, and health care professional meetings. The effectiveness of these meetings depends on the engagement of participants and the quality of the meeting process. The use of six thinking hats technique to engage all participants in effective dialogue is proposed. DESIGN Discussion paper. DATA SOURCES Electronic databases, CINAHL, Pub Med, and Science Direct, were searched for years 1990 to 2017. IMPLICATIONS FOR NURSING Using six thinking hats technique in patient family meetings nurses can guide a process of dialogue that focuses decision making to build equal care partnerships inclusive of all participants. Nurses will need to develop the skills for using six thinking hats technique and provide support to all participants during the meeting process. CONCLUSION Collaborative decision making can be augmented by six thinking hat technique to provide patients, families, and health professionals with opportunities to make informed decisions about care that considers key issues for all involved. Nurses who are most often advocates for patients and their families are in a unique position to lead this initiative in meetings as they network with all health professionals.
Collapse
Affiliation(s)
- Jane Marie Cioffi
- School of Nursing and Midwifery, University of Western Sydney (retired since submission of paper), Sydney, NSW, Australia
| |
Collapse
|
20
|
Wong P, Liamputtong P, Koch S, Rawson H. Barriers to regaining control within a constructivist grounded theory of family resilience in ICU: Living with uncertainty. J Clin Nurs 2017; 26:4390-4403. [DOI: 10.1111/jocn.13768] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Pauline Wong
- School of Nursing and Midwifery; Faculty of Health; Deakin University; Geelong Vic. Australia
| | - Pranee Liamputtong
- School of Science and Health; Western Sydney University; Penrith NSW Australia
| | - Susan Koch
- Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- University of Sydney Medical School; Hornsby Ku-ring-gai Hospital; NSW Australia
| | - Helen Rawson
- School of Nursing and Midwifery; Faculty of Health; Deakin University; Geelong Vic. Australia
| |
Collapse
|
21
|
Choi J, Donahoe MP, Hoffman LA. Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies. J Korean Acad Nurs 2017; 46:159-67. [PMID: 27182013 DOI: 10.4040/jkan.2016.46.2.159] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/31/2016] [Indexed: 11/09/2022]
Abstract
PURPOSE This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research. METHODS Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors. RESULTS In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking. CONCLUSION Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.
Collapse
Affiliation(s)
- Jiyeon Choi
- Department of Acute & Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Michael P Donahoe
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Leslie A Hoffman
- Department of Acute & Tertiary Care, School of Nursing & Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
22
|
Olding M, McMillan SE, Reeves S, Schmitt MH, Puntillo K, Kitto S. Patient and family involvement in adult critical and intensive care settings: a scoping review. Health Expect 2016; 19:1183-1202. [PMID: 27878937 PMCID: PMC5139045 DOI: 10.1111/hex.12402] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite international bodies calling for increased patient and family involvement, these concepts remain poorly defined within literature on critical and intensive care settings. OBJECTIVE This scoping review investigates the extent and range of literature on patient and family involvement in critical and intensive care settings. Methodological and empirical gaps are identified, and a future agenda for research into optimizing patient and family involvement is outlined. METHODS Searches of MEDLINE, CINAHL, Social Work Abstracts and PsycINFO were conducted. English-language articles published between 2003 and 2014 were retrieved. Articles were included if the studies were undertaken in an intensive care or critical care setting, addressed the topic of patient and family involvement, included a sample of adult critical care patients, their families and/or critical care providers. Two reviewers extracted and charted data and analysed findings using qualitative content analysis. FINDINGS A total of 892 articles were screened, 124 were eligible for analysis, including 61 quantitative, 61 qualitative and 2 mixed-methods studies. There was a significant gap in research on patient involvement in the intensive care unit. The analysis identified five different components of family and patient involvement: (i) presence, (ii) having needs met/being supported, (iii) communication, (iv) decision making and (v) contributing to care. CONCLUSION Three research gaps were identified that require addressing: (i) the scope, extent and nature of patient involvement in intensive care settings; (ii) the broader socio-cultural processes that shape patient and family involvement; and (iii) the bidirectional implications between patient/family involvement and interprofessional teamwork.
Collapse
Affiliation(s)
- Michelle Olding
- British Columbia Centre for Excellence in HIV/AIDSVancouverBCCanada
| | - Sarah E. McMillan
- Collaborative Academic PracticeUniversity Health NetworkTorontoONCanada
| | - Scott Reeves
- Centre for Health and Social Care ResearchKingston University and St. George's University of LondonLondonUK
| | | | | | - Simon Kitto
- Department of Innovation in Medical EducationFaculty of MedicineUniversity of OttawaOttawaONCanada
| |
Collapse
|
23
|
Barreto MDS, Marcon SS, Garcia-Vivar C. Patterns of behaviour in families of critically ill patients in the emergency room: a focused ethnography. J Adv Nurs 2016; 73:633-642. [PMID: 27653638 DOI: 10.1111/jan.13156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2016] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to understand the patterns of behaviour from relatives of critically ill patients admitted to the emergency room. BACKGROUND Admission of a critically ill family member to an accident and emergency department is often a sudden and unexpected experience for the family. This stressful event often creates feelings of instability and intense suffering in relatives. Understanding the experiences of these families is essential for the provision of comprehensive health care in the emergency room. DESIGN A focused ethnography design was applied to the study. METHODS Peripheral participant observation and informal conversations were conducted in an emergency room in southern Brazil during January 2015. Analysis of data was based on Leininger. FINDINGS Suffering was recurrent among family members of critically ill patients admitted to the emergency room. The environment, which was conditioned by the patient's life-threatening situation and professionals' attitudes, resulted in relatives experiencing a range of feelings from suffering to calm. A distant approach and poor communication of professionals made relatives confused and silent. Factors that seemed to foster feelings of calm in families were the establishment of a continuous and close communication with professionals and the possibility to remain with the patient outside the established visiting hours. CONCLUSION The findings of this study challenge emergency department providers and managers to promote comprehensive care in the emergency room by inviting family members to be with the patient and by engaging in family-centred care.
Collapse
Affiliation(s)
- Mayckel da Silva Barreto
- Department of Nursing, State University of Maringá, Maringá, Paraná, Brazil.,Faculty of Philosophy Sciences and Languages of Mandaguari, Mandaguari Paraná, Brazil.,Faculty Intermunicipal Northwest of Paraná, Loanda, Paraná, Brazil
| | - Sonia Silva Marcon
- Department of Nursing, State University of Maringá, Maringá, Paraná, Brazil
| | - Cristina Garcia-Vivar
- School of Nursing, University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
| |
Collapse
|
24
|
A family nursing educational intervention supports nurses and families in an adult intensive care unit. Aust Crit Care 2016; 29:217-223. [PMID: 27688123 DOI: 10.1016/j.aucc.2016.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 11/23/2022] Open
Abstract
The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses' attitudes towards and confidence in providing family care, as well as families' perceptions of support from nurses in an adult critical care setting. An academic-clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members' experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic-clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in other critical care settings.
Collapse
|
25
|
|
26
|
Mendes AP. SENSIBILIDADE DOS PROFISSIONAIS FACE À NECESSIDADE DE INFORMAÇÃO: EXPERIÊNCIA VIVIDA PELA FAMÍLIA NA UNIDADE DE CUIDADOS INTENSIVOS. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-07072016004470014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo objetivou interpretar, na experiência vivida pela família na unidade de cuidados intensivos, a sensibilidade dos profissionais relativamente à sua necessidade de informação. Realizaram-se entrevistas abertas a 21 pessoas adultas, famíliares dos paciente que estiveram internadoss em cuidados intensivos. A análise e interpretação das narrativas, tendo como suporte o programa Nvivo8(r)(r), realizou-se de acordo com a abordagem fenomenológica sugerida por Van Manen. Verificou-se a existência de duas situações: a presença e a ausência de informação. A família refere que a sensibilidade do profissional foi determinante, na resposta encontrada às suas necessidades. O cuidado colocado, no conteúdo que foi transmitido e na forma de o transmitir, foram significativos na experiência vivida. Constatou-se que o conhecimento das necessidades, reais e potenciais, da família é determinante no exercício profissional dos enfermeiros. A resposta à necessidade de informação foi essencial no processo de transição situacional experienciado, face à transição saúde-doença do seu familiar.
Collapse
|
27
|
Eggenberger SK, Krumwiede NK, Young PK. Using Simulation Pedagogy in the Formation of Family-Focused Generalist Nurses. J Nurs Educ 2015; 54:588-93. [DOI: 10.3928/01484834-20150916-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/11/2015] [Indexed: 11/20/2022]
|
28
|
Ahlberg M, Bäckman C, Jones C, Walther S, Hollman Frisman G. Moving on in life after intensive care--partners' experience of group communication. Nurs Crit Care 2015; 20:256-63. [PMID: 26032101 DOI: 10.1111/nicc.12192] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 04/01/2015] [Accepted: 04/29/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Partners have a burdensome time during and after their partners' intensive care period. They may appear to be coping well outwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited. AIM The aim of this study was to describe the experience of participating in group communication with other partners of former intensive care patients. DESIGN The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive care unit (ICU) patients was evaluated. METHODS A strategic selection was made of adult partners to former adult intensive care patients (n = 15), 5 men and 10 women, aged 37-89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote, in a notebook, about their feelings of participating in group communications. To deepen the understanding of the impact of the sessions, six of the partners were interviewed. Content analysis was used to analyse the notebooks and the interviews. FINDINGS Three categories were identified: (1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, (2) Confirmation, consciousness through insight and reflection and (3) The meeting design, group constellation and recommendation to participate in group communication. CONCLUSION Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategies to ever-changing circumstances. Group communications contributed to togetherness and confirmation. To share experiences with others is one way for partners to be able to move forward in life. RELEVANCE TO CLINICAL PRACTICE Group communication with other patients' partners eases the process of going through the burden of being a partner to an intensive care patient. Group communications needs to be further developed and evaluated to obtain consensus and evidence for the best practice.
Collapse
Affiliation(s)
- Mona Ahlberg
- Department of Anesthesiology and Intensive Care, Vrinnevi Hospital, Norrköping, Sweden
| | - Carl Bäckman
- Department of Anesthesiology and Intensive Care, Vrinnevi Hospital, Norrköping, Sweden
| | - Christina Jones
- Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
| | - Sten Walther
- Department of Thoracic and Vascular Surgery and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Gunilla Hollman Frisman
- Anesthetics, Operations and Speciality Surgery Centre and Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
29
|
Adams AMN, Mannix T, Harrington A. Nurses' communication with families in the intensive care unit - a literature review. Nurs Crit Care 2015; 22:70-80. [DOI: 10.1111/nicc.12141] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 08/13/2014] [Accepted: 09/27/2014] [Indexed: 11/29/2022]
Affiliation(s)
- AMN Adams
- MNg; University Hospital of Northern Norway, Intensiv avdeling; 9038 Tromsø Norway
| | - T Mannix
- School of Nursing and Midwifery; Flinders University, Adelaide; GPO Box 2100 Adelaide South Australia Australia
| | - A Harrington
- School of Nursing and Midwifery; Flinders University, Adelaide; GPO Box 2100 Adelaide South Australia Australia
| |
Collapse
|
30
|
Craig SL, Betancourt I, Muskat B. Thinking big, supporting families and enabling coping: the value of social work in patient and family centered health care. SOCIAL WORK IN HEALTH CARE 2015; 54:422-443. [PMID: 25985286 DOI: 10.1080/00981389.2015.1017074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Patient and family-centered care has become a focus in health services. Social work has a rich history of providing responsive patient care. This study identified the contribution and value of social work to PFCC from the key stakeholder perspectives of health social workers (n = 65). Utilizing interpretive description, four themes emerged: (1) Thinking big and holistically, (2) Intervening with families, (3) Enabling patient and family coping, and (4) Maximizing hospital and community resources. Barriers included a lack of power, professional isolation and role creep. Implications for research and practice are provided.
Collapse
Affiliation(s)
- Shelley L Craig
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | | | | |
Collapse
|
31
|
Svavarsdottir EK, Sigurdardottir AO, Konradsdottir E, Stefansdottir A, Sveinbjarnardottir EK, Ketilsdottir A, Blondal K, Jónsdóttir A, Bergs D, Guðmundsdottir H. The Process of Translating Family Nursing Knowledge Into Clinical Practice. J Nurs Scholarsh 2014; 47:5-15. [DOI: 10.1111/jnu.12108] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Erla Kolbrun Svavarsdottir
- Professor at the University of Iceland; Faculty of Nursing and Head of the Center of Excellence in Family Nursing Research and Development at Landspitali University Hospital; Reykjavik Iceland
| | - Anna Olafia Sigurdardottir
- Clinical Nurse Specialist at the Women and Children division at Landspitali University Hospital, and a doctoral student at the Faculty of Nursing; University of Iceland; Reykjavik Iceland
| | - Elisabet Konradsdottir
- Clinical Nurse Specialist at the Women and Children division at Landspitali University Hospital; Reykjavik Iceland
| | - Anna Stefansdottir
- Former Chief Nurse Executive at Landspitali University Hospital; Reykjavik Iceland
| | | | - Audur Ketilsdottir
- Clinical Nurse Specialist at the Internal Medicine division at Landspitali University Hospital; Reykjavik Iceland
| | - Katrin Blondal
- Clinical Nurse Specialist at the Surgical division at Landspitali University Hospital; Reykjavik Iceland
| | - Arndís Jónsdóttir
- Clinical Nurse Specialist at the Internal Medicine division at Landspitali University Hospital; Reykjavik Iceland
| | - Dorothea Bergs
- Clinical Nurse Specialist at the Internal Medicine division at Landspitali University Hospital; Reykjavik Iceland
| | - Hlíf Guðmundsdottir
- Clinical Nurse Specialist at the Internal Medicine division at Landspitali University Hospital; Reykjavik Iceland
| |
Collapse
|
32
|
Adams JA, Anderson RA, Docherty SL, Tulsky JA, Steinhauser KE, Bailey DE. Nursing strategies to support family members of ICU patients at high risk of dying. Heart Lung 2014; 43:406-15. [PMID: 24655938 DOI: 10.1016/j.hrtlng.2014.02.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 01/24/2014] [Accepted: 02/03/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore how family members of ICU patients at high risk of dying respond to nursing communication strategies. BACKGROUND Family members of ICU patients may face difficult decisions. Nurses are in a position to provide support. Evidence of specific strategies that nurses use to support decision-making and how family members respond to these strategies is lacking. METHODS This is a prospective, qualitative descriptive study involving the family members of ICU patients identified as being at high risk of dying. RESULTS Family members described five nursing approaches: Demonstrating concern, building rapport, demonstrating professionalism, providing factual information, and supporting decision-making. This study provides evidence that when using these approaches, nurses helped family members to cope; to have hope, confidence, and trust; to prepare for and accept impending death; and to make decisions. CONCLUSION Knowledge lays a foundation for interventions targeting the areas important to family members and most likely to improve their ability to make decisions and their well-being.
Collapse
Affiliation(s)
- Judith A Adams
- Durham VAMC, 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA.
| | - Ruth A Anderson
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA
| | - Sharron L Docherty
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA
| | - James A Tulsky
- Duke Medicine and Nursing, Duke Palliative Care, DUMC 2706, Durham, NC 27710, USA
| | | | - Donald E Bailey
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA
| |
Collapse
|
33
|
Baltor MRR, de Matos APK, Wernet M, Ferreira NMLA, Dupas G. [The perceptions of families with children having chronic diseases and their relationships with healthcare professionals]. Rev Esc Enferm USP 2013; 47:808-14. [PMID: 24310676 DOI: 10.1590/s0080-623420130000400006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 03/26/2013] [Indexed: 11/22/2022] Open
Abstract
The prevalence of chronic disease in childhood has increased, placing families in constant contact with health professionals. In such situations the relationship with health professionals has an important role. Few scientific studies address this theme, in spite of its being highlighted as fundamental for effective interaction. The aim of this study was to characterize how the family of a child with a chronic disease perceives its relationship with health professionals. Twenty caregivers for children with chronic diseases were interviewed. The theoretical and methodological frameworks were, respectively, symbolic interactionism and thematic content analysis. The analytical process revealed four themes: role of the caregiver, stressful relationships, services and professionals, and seeking welcoming relationships. The outcomes of this interactional process, which show an incongruity of expectations and behaviors between professionals and families, are poor and generate feelings of abandonment. These can be eased through listening and understanding by other families in similar situations.
Collapse
|
34
|
Creasy KR, Lutz BJ, Young ME, Ford A, Martz C. The impact of interactions with providers on stroke caregivers' needs. Rehabil Nurs 2013; 38:88-98. [PMID: 23529947 DOI: 10.1002/rnj.69] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE Preparation for caregiving is improved through engaged interactions between stroke family caregivers and healthcare providers throughout the care trajectory. We explored caregivers' perceptions about interactions with providers in rehabilitation, and how these experiences affected caregiver preparation. DESIGN Seventeen caregivers, included in this grounded theory study, were interviewed during a rehabilitation stay and postdischarge. Data were analyzed using dimensional and comparative analysis. FINDINGS Caregivers described interactions with providers on a continuum from collaborative to disconnected, and a range of strategies to enhance interactions. CONCLUSIONS Caregivers want to be actively engaged with providers during inpatient rehabilitation and collaborative interactions enhance preparedness and care satisfaction. RELEVANCE Family members should be assessed for caregiving capacity and interactions between providers and caregivers should be individualized to specific needs. Providers must also be aware that many caregivers are not active information seekers. They must engage caregivers who may not even know what questions to ask.
Collapse
Affiliation(s)
- Kerry Rae Creasy
- College of Nursing, University of Florida, Gainesville, FL, USA.
| | | | | | | | | |
Collapse
|
35
|
Holtslander L, Solar J, Smith NR. The 15-Minute Family Interview as a learning strategy for senior undergraduate nursing students. JOURNAL OF FAMILY NURSING 2013; 19:230-248. [PMID: 23329627 DOI: 10.1177/1074840712472554] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Nursing care of families continues to be a challenge within complex and demanding health-care systems. Educational strategies to bridge the theory-practice gap, connecting classroom learning with clinical experiences in undergraduate nursing education, enable students to develop the skills required to form meaningful partnerships with families. This article describes how undergraduate nursing students complete a 15-Minute Family Interview in a clinical practice setting, and document the interview process in a reflective major paper. Students integrate research and theory and identify ways to improve the care of families in the clinical setting while building communication skills and confidence in interacting with families in everyday practice. The implementation of the assignment and the evaluation of the process, including quotes from 10 student papers and 2 clinical faculty members, are discussed. Implications for education and ongoing research are offered.
Collapse
|
36
|
Salminen-Tuomaala MH, Åstedt-Kurki P, Rekiaro M, Paavilainen E. Coping with the effects of myocardial infarction from the viewpoint of patients' spouses. JOURNAL OF FAMILY NURSING 2013; 19:198-229. [PMID: 23584761 DOI: 10.1177/1074840713483922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The spouse of a patient who has experienced a myocardial infarction (MI) reportedly has psychological and social needs and challenges during the patient's hospitalization but there is a lack of knowledge regarding spouses' coping experiences and resources. The aim of this study was to develop a substantive theory to help explain the coping experiences of the spouse during the patient's hospitalization following an acute MI. Twenty eight spouses of patients in two Finnish hospitals participated in an open-ended interview within 2 to 5 days of the MI and included 12 husbands and 16 wives. The core category "Seeking balance" included the spouses' emotional, cognitive, and social coping experiences following an acute MI. This study adds new information about spouses' coping experiences as well as tensions and problems in interaction between the patient and the spouse. Challenges were reported in talking about serious illness concerns between the spouse and patient and also with other family members.
Collapse
|
37
|
Coco K, Tossavainen K, Jääskeläinen JE, Turunen H. The provision of emotional support to the families of traumatic brain injury patients: perspectives of Finnish nurses. J Clin Nurs 2013; 22:1467-76. [PMID: 23489840 DOI: 10.1111/jocn.12136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2012] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To examine nursing staff's perceptions about how often they provide interventions of emotional support and the level of competence needed on neurosurgical wards to support traumatic brain injury patients' family members. BACKGROUND Traumatic brain injury in one individual affects the health of their whole family. Studying the emotional support provided by nursing staff is important because such support is crucial for the family members of a traumatic brain injury patient during the acute phase of treatment. Members of the nursing staff provide emotional support to family members by consoling them; this alleviates insecurity, anxiety, hopelessness and depression. DESIGN A structured self-reported questionnaire presented to 172 nurses working on neurosurgical wards. The response rate was 67% (n = 115). METHODS Descriptive statistics were used to determine how often nurses provided emotional support to the traumatic brain injury patients family members and one-way anova to examine the relationships between the background variables and the respondents' evaluations of how often they gave emotional support to brain injury patients' family members. RESULTS Thirty-seven percentage of nurses stated that they always took account of family members' individuality and 65% that they were always respectful. All registered nurses and staff members with long work experience (21 years or more) on a neurosurgical ward reported that they took family members' feelings of anger and guilt into consideration slightly more often than other nursing staff did. Most nurses considered these skills to represent basic competencies. CONCLUSION Further service training on dealing with difficult emotions of traumatic brain injury patients' family members could help nurses to face these situations. Both education and work experience affected the frequency at which nursing staff provided emotional support to traumatic brain injury patients' family members. RELEVANCE TO CLINICAL PRACTICE The results are relevant for example when planning specialised studies or in-service training for neuro-nurses, as well as when selecting the subjects to be addressed during the orientation of a new staff member. In addition, the results should help nursing staff to understand their role in the emotional support of family members.
Collapse
Affiliation(s)
- Kirsi Coco
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
| | | | | | | |
Collapse
|
38
|
Bucher L, Buruschkin R, Kenyon DM, Stenton K, Treseder S. Improving outcomes with therapeutic hypothermia. Nurse Pract 2013; 38:49-52. [PMID: 23262652 DOI: 10.1097/01.npr.0000422209.77303.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
39
|
|
40
|
Affiliation(s)
- Linda Bucher
- Virtua Memorial Hospital in Mount Holly, NJ, USA
| | | | | | | | | |
Collapse
|
41
|
Slatore CG, Hansen L, Ganzini L, Press N, Osborne ML, Chesnutt MS, Mularski RA. Communication by nurses in the intensive care unit: qualitative analysis of domains of patient-centered care. Am J Crit Care 2012; 21:410-8. [PMID: 23117904 DOI: 10.4037/ajcc2012124] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND High-quality communication is a key determinant and facilitator of patient-centered care. Nurses engage in most of the communication with patients and patients' families in the intensive care unit. OBJECTIVE To perform a qualitative analysis of nurses' communications. METHODS Ethnographic observations of 315 hours of interactions and 53 semistructured interviews with 33 nurses were conducted in a 26-bed cardiac-medical intensive care unit in an academic hospital and a 26-bed general intensive care unit in a Veterans Affairs hospital in Portland, Oregon. Communication interactions were categorized into 5 domains of patient-centered care. Interviews were analyzed to identify major themes in nurses' roles and preferences for communicating with patients and patients' families within the domains. RESULTS Most communication occurred in the domains of biopsychosocial information exchange, patient as person, and clinician as person. Nurses endorsed the importance of the domains of shared power and responsibility and therapeutic alliance but had relatively few communication interactions in these areas. Communication behaviors were strongly influenced by the nurses' roles as translators of information between physicians and patients and the patients' families and what the nurses were and were not willing to communicate to patients and patients' families. CONCLUSIONS Critical care, including communication, is a collaborative effort. Understanding how nurses engage in patient-centered communication in the intensive care unit can guide future interventions to improve patient-centered care.
Collapse
Affiliation(s)
- Christopher G Slatore
- Section of Pulmonary and Critical Care Medicine, Portland Veterans Affairs Medical Center, Oregon, USA.
| | | | | | | | | | | | | |
Collapse
|
42
|
Lind R, Lorem GF, Nortvedt P, Hevrøy O. Intensive care nurses’ involvement in the end-of-life process – perspectives of relatives. Nurs Ethics 2012; 19:666-76. [DOI: 10.1177/0969733011433925] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this article, we report findings from a qualitative study that explored how the relatives of intensive care unit patients experienced the nurses’ role and relationship with them in the end-of-life decision-making processes. In all, 27 relatives of 21 deceased patients were interviewed about their experiences in this challenging ethical issue. The findings reveal that despite bedside experiences of care, compassion and comfort, the nurses were perceived as vague and evasive in their communication, and the relatives missed a long-term perspective in the dialogue. Few experienced that nurses participated in meetings with doctors and relatives. The ethical consequences imply increased loneliness and uncertainty, and the experience that the relatives themselves have the responsibility of obtaining information and understanding their role in the decision-making process. The relatives therefore felt that the nurses could have been more involved in the process.
Collapse
Affiliation(s)
| | | | - Per Nortvedt
- University of Oslo, Norway; Oslo and Akershus University College of Applied Sciences, Norway
| | | |
Collapse
|
43
|
Joseph GM, Skinner MW, Yantzi NM. The weather-stains of care: interpreting the meaning of bad weather for front-line health care workers in rural long-term care. Soc Sci Med 2012; 91:194-201. [PMID: 22944147 DOI: 10.1016/j.socscimed.2012.08.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 05/24/2012] [Accepted: 08/02/2012] [Indexed: 11/17/2022]
Abstract
This paper addresses the gap in health services and policy research about the implications of everyday weather for health care work. Building on previous research on the weather-related challenges of caregiving in homes and communities, it examines the experiences of 'seasonal bad weather' for health care workers in long-term care institutions. It features a hermeneutic phenomenology analysis of six transcripts from interviews with nurses and personal support workers from a qualitative study of institutional long-term care work in rural Canada. Focussing on van Manen's existential themes of lived experience (body, relations, space, time), the analysis reveals important contradictions between the lived experiences of health care workers coping with bad weather and long-term care policies and practices that mitigate weather-related risk and vulnerability. The findings contribute to the growing concern for rural health issues particularly the neglected experiences of rural health providers and, in doing so, offer insight into the recent call for greater attention to the geographies of health care work.
Collapse
Affiliation(s)
- Gillian M Joseph
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1.
| | | | | |
Collapse
|
44
|
Svavarsdottir EK, Tryggvadottir GB, Sigurdardottir AO. Knowledge translation in family nursing: does a short-term therapeutic conversation intervention benefit families of children and adolescents in a hospital setting? Findings from the Landspitali University Hospital Family Nursing Implementation Project. JOURNAL OF FAMILY NURSING 2012; 18:303-27. [PMID: 22668768 DOI: 10.1177/1074840712449202] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
In an effort to examine translation of family nursing knowledge to practice, the Landspitali University Hospital Family Nursing Implementation Project (2007-2011), was thoughtfully initiated in Reykjavik, Iceland and systematically evaluated. The mission was to implement family nursing in every department of the hospital. This publication is the first formal research report from this landmark project. The purpose of this research was to evaluate the effectiveness of a short-term therapeutic conversation intervention with families who were receiving health care services at the Children's Hospital at Landspitali University Hospital in Iceland related to childhood and adolescent acute and chronic illnesses. The therapeutic conversation was guided by Family Systems Nursing and used the Calgary Family Assessment and Intervention Models (Wright & Leahey, 2005, 2009). Families (N = 76) were randomly assigned to either an experimental group (short-term therapeutic conversation: n = 41) or to a control group (traditional care: n = 35). Parents in the experimental group reported significantly higher family support after the intervention, compared to the parents in the control group. Differences were noted between families experiencing acute versus chronic illnesses. Recommendations are made for conducting and designing intervention research with families experiencing the hospitalization of a child or adolescent.
Collapse
|
45
|
Olausson S, Ekebergh M, Lindahl B. The ICU patient room: Views and meanings as experienced by the next of kin: A phenomenological hermeneutical study. Intensive Crit Care Nurs 2012; 28:176-84. [DOI: 10.1016/j.iccn.2011.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 11/30/2011] [Accepted: 12/07/2011] [Indexed: 11/15/2022]
|