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Vanhanen M, Meriläinen M, Ala-Kokko T, Kyngäs H, Kaakinen P. Intensive care professionals' perceptions of the quality of counselling provided in the ICU: A cross-sectional study. Nurs Crit Care 2023; 28:1004-1011. [PMID: 35635243 DOI: 10.1111/nicc.12782] [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: 09/03/2020] [Revised: 04/18/2022] [Accepted: 05/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intensive care professionals (ICPs) have a key role in counselling adult intensive care unit (ICU) patients and their family members. The counselling provided to ICU patients and their family members can be described based on the content, implementation, benefits, and resources. AIMS The study had two specific aims: first, to assess ICPs' perceptions of the quality of counselling provided to ICU patients and their family members; and second, to explore which factors ICPs feel is associated with the quality of counselling. STUDY DESIGN A cross-sectional survey of ICPs working in adult ICUs in Finnish university hospitals. Data were collected using the Counselling Quality Instrument. The data were analysed by descriptive statistics and chi-square and t-test statistical methods. RESULTS A total of 182 ICPs returned the questionnaire, reflecting a response rate of 18.6%. Most of the respondents were nurses (97%) and the mean age was 42 years. The ICPs reported having adequate time for patient- (77%) and family-centered (73%) counselling, but only 47% felt that their units had the appropriate facilities. There were statistically significant differences between patient- and family-centered counselling and the ICP's self-assessed competence (p < .001), goal-oriented counselling (p < .001), and atmosphere during counselling (p < .001). ICPs' attitudes towards counselling impacted how these professionals assessed patients' and family members' confidence, along with patient recovery (p < .001). CONCLUSIONS This study confirms that the provision of high-quality counselling has beneficial effects; however, it also indicates that there is a need for training that considers each ICP's professional experience and patient- and family-centered factors, which may differ from one another. RELEVANCE TO CLINICAL PRACTICE According to ICPs, the quality of counselling can be enhanced by empowering ICPs to improve counselling and providing appropriate ICU facilities for counselling, such as a private room for family members.
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Affiliation(s)
- Minna Vanhanen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Oulu University of Applied Sciences, Oulu, Finland
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center Oulu, Oulu, Finland
- Oulu University Hospital, Oulu, Finland
| | - Tero Ala-Kokko
- Oulu University Hospital, Oulu, Finland
- Research Group of Surgery, Anesthesiology and Intensive Care Medicine, University of Oulu and Medical Research Center (MRC), Oulu University Hospital, Oulu, Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Northern Ostrobothnia Hospital District, Oulu, Finland
| | - Pirjo Kaakinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Medical Research Centre, Oulu, Finland
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Padilla-Fortunatti C, Rojas-Silva N, Molina-Muñoz Y, Avendaño-Jara S. Cultural adaptation and psychometric properties of the Chilean-Spanish version of the Family Satisfaction in the Intensive Care Unit - 24 questionnaire. Med Intensiva 2023; 47:140-148. [PMID: 36068147 DOI: 10.1016/j.medine.2022.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To adapt and validate the Spanish version of the Family Satisfaction in the Intensive Care Unit - 24 (FS ICU-24) questionnaire among relatives of critically ill patients in a teaching hospital in Chile. DESIGN Prospective observational study aimed to validate a measuring instrument. SETTING Medical-surgical intensive care unit (ICU) of a teaching hospital in Chile. PATIENTS OR PARTICIPANTS Two hundred and forty relatives of critically ill patients with at least48 h in the ICU, older than 18 years, and with at least one visit to the patient. INTERVENTIONS None. MAIN VARIABLES OF INTEREST Content validity, construct validity, and reliability analysis of the Spanish version of the FS ICU-24 were evaluated. RESULTS The Spanish version of the FS ICU-24 was adapted, improving its understanding and clarity. The factor analysis showed an optimal solution of 3 factors for the Chilean-Spanish version of the FS ICU-24, which explain 51% of the total variance. Reliability was adequate for the global scale (α = 0.93) and the dimensions of satisfaction with patient and family care (α = 0.82), satisfaction with communication (α = 0.91) and satisfaction with decision-making (α = 0.71). CONCLUSIONS The Chilean-Spanish version of the FS ICU-24 proved to be valid and reliable for the evaluation of family satisfaction in the ICU. Having a valid instrument will allow health institutions to accurately identify areas for improvement in the care of the family members and the critically ill patient.
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Affiliation(s)
| | - Noelia Rojas-Silva
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Yerko Molina-Muñoz
- Escuela de Psicología, Universidad Adolfo Ibáñez, Peñalolén, Santiago, Chile
| | - Stefany Avendaño-Jara
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
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Padilla-Fortunatti C, Rojas-Silva N, Molina-Munoz Y, Avendano-Jara S. Adaptación cultural y propiedades psicométricas de la versión en español-chileno del cuestionario Family Satisfaction in the Intensive Care Unit – 24. Med Intensiva 2022. [DOI: 10.1016/j.medin.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Zhan Y, Yu J, Chen Y, Liu Y, Wang Y, Wan Y, Li S. Family caregivers' experiences and needs of transitional care during the transfer from intensive care unit to a general ward: A qualitative study. J Nurs Manag 2021; 30:592-599. [PMID: 34799985 DOI: 10.1111/jonm.13518] [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: 08/19/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/28/2022]
Abstract
AIM To explore the family caregivers' experiences and needs of transitional care during the transfer from an intensive care unit to a general ward in China. BACKGROUND The transfer of patients from the intensive care unit to the ward is a vulnerable time for patients and caregivers, exposing the risk of readmission and death. However, there are few qualitative studies on the family caregivers' views of transitional care for their loved ones in China. METHODS With a qualitative research design, 15 interviews were conducted with 15 family caregivers of hospitalized patients transferred from the neurosurgery ICU to the general ward. Colaizzi's (1978) method of data analysis was performed using the NVivo 11.0 software. RESULTS Based on data analysis, four themes were obtained: perception of transfer decision, the experience of transitional care, the obstacles to maintaining care efficiency and demand for transitional care. CONCLUSION In order to enhance the continuity of care and improve patient safety during the transfer from an ICU to a general ward in China, priorities should be given to the implementation of effective strategies and methods, including providing psychological and emotional support, encouraging active participation of caregivers, and various communication and collaboration procedures. IMPLICATIONS FOR NURSING MANAGEMENT The findings from this study can be used as a guide to better preparation and awareness among health care professionals to achieve the much-needed demands of family caregivers, as well as the increased quality of transitional care.
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Affiliation(s)
- Yuxin Zhan
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaohua Yu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yufang Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingyue Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Wan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suyun Li
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Padilla Fortunatti C, De Santis JP, Munro CL. Family Satisfaction in the Adult Intensive Care Unit: A Concept Analysis. ANS Adv Nurs Sci 2021; 44:291-305. [PMID: 33624988 DOI: 10.1097/ans.0000000000000360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Admission of patients to an intensive care unit is often a stressful event for family members. In the context of patient- and family-centered care, family satisfaction is recognized as a quality indicator of intensive care unit care. However, family satisfaction has not been consistently used or conceptualized in the literature. A modified version of Walker and Avant's method for concept analysis was utilized to examine the concept of family satisfaction in the adult intensive care unit. Antecedents, attributes, consequences, and empirical referents of family satisfaction are presented and implications for practice, research, and policy.
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Affiliation(s)
- Cristobal Padilla Fortunatti
- University of Miami, School of Nursing & Health Studies, Coral Gables, Florida (Ms Padilla Fortunatti and Drs De Santis and Munro); and Department of the Adult and the Senescent, Pontificia Universidad Católica de Chile, School of Nursing, Santiago, Chile (Ms Padilla Fortunatti)
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Eltaybani S, Ahmed FR. Family satisfaction in Egyptian adult intensive care units: A mixed-method study. Intensive Crit Care Nurs 2021; 66:103060. [PMID: 33875339 DOI: 10.1016/j.iccn.2021.103060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine family members' satisfaction in adult intensive care units. METHODOLOGY This is mixed-method research. Family members of critically ill patients responded to a structured questionnaire and then were interviewed using semi-structured interviews. Quantitative and qualitative data were analyzed separately and integrated during the discussion. SETTINGS Six adult intensive care units in university hospitals in Egypt. MAIN OUTCOME MEASURES Family satisfaction was assessed using the Critical Care Family Satisfaction Survey and field notes of the interviews. RESULTS The mean total satisfaction score was 12.8 ± 3.5, and comfort has the lowest subscale mean score: 2.07 ± 0.96. Multivariate regression analysis showed that family members' satisfaction was positively associated with their ability to communicate with patients (B [95% confidence interval]: 2.1 [1.19 to 3.02]) and negatively with daily purchasing of medications and supplies (-2.41 [-3.23 to -1.59]), low economic status (-1.57 [-2.47 to -0.67]), and perceiving patient condition to be deteriorating (-0.99 [-1.93 to -0.04]). Content analysis of qualitative data revealed four themes: aspects of family care, aspects of patient care, organizational and administrative issues and environment. CONCLUSIONS In Egyptian adult intensive care units, regular family meetings, flexible visiting hours, shared decision-making, increasing staff-to-patient ratio and ensuring comfortable waiting rooms are promising strategies to enhance family satisfaction.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Egypt. https://twitter.com/@Sameh_Eltaybani
| | - Fatma Refaat Ahmed
- Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Egypt; Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
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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.
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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
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Cody SE, Sullivan-Bolyai S, Reid-Ponte P. Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit. Crit Care Nurse 2018; 38:18-26. [PMID: 29858192 DOI: 10.4037/ccn2018128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. OBJECTIVES To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. METHODS A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. RESULTS Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. CONCLUSION What health care providers say to patients' families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information.
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Affiliation(s)
- Shawn E Cody
- Shawn E. Cody was the Associate Chief Nursing Officer for critical care at UMass Memorial Medical Center, Worcester, Massachusetts, when this article was written. .,Susan Sullivan-Bolyai is a professor of Nursing at the University of Massachusetts Medical School, Graduate School of Nursing, Worcester, Massachusetts. .,Patricia Reid-Ponte is a clinical associate professor at Boston College Connell School of Nursing, Chestnut Hill, Massachusetts.
| | - Susan Sullivan-Bolyai
- Shawn E. Cody was the Associate Chief Nursing Officer for critical care at UMass Memorial Medical Center, Worcester, Massachusetts, when this article was written.,Susan Sullivan-Bolyai is a professor of Nursing at the University of Massachusetts Medical School, Graduate School of Nursing, Worcester, Massachusetts.,Patricia Reid-Ponte is a clinical associate professor at Boston College Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Patricia Reid-Ponte
- Shawn E. Cody was the Associate Chief Nursing Officer for critical care at UMass Memorial Medical Center, Worcester, Massachusetts, when this article was written.,Susan Sullivan-Bolyai is a professor of Nursing at the University of Massachusetts Medical School, Graduate School of Nursing, Worcester, Massachusetts.,Patricia Reid-Ponte is a clinical associate professor at Boston College Connell School of Nursing, Chestnut Hill, Massachusetts
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Effects of family-centered empowerment intervention on stress, anxiety, and depression among family caregivers of patients with epilepsy. Epilepsy Behav 2018; 88:106-112. [PMID: 30243109 DOI: 10.1016/j.yebeh.2018.08.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/04/2018] [Accepted: 08/20/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Family caregivers face numerous challenges in taking care of their family members with epilepsy. The empowerment of this group of people, who can be described as forgotten patients, should always be considered through supportive interventions; therefore, this study investigated the effect of a family-centered intervention program on stress, anxiety, and depression among family caregivers of patients with epilepsy. METHODS In 2017, a trial was conducted in Iran among subjects selected by the convenience sampling method and randomly assigned to two groups: intervention and control. After five sessions per week over a four-week period, the intervention- and control-group data were collected using the Depression Anxiety Stress Scale (DASS) in three stages: before, immediately after, and two months after the intervention. Data were analyzed with Statistical Package for the Social Sciences (SPSS) software using descriptive and analytical statistics, an independent t-test, and repeated measures Analysis of variance (ANOVA). RESULTS In this study, the family caregivers included 61.3% women and 38.7% men, with a mean age of 37.5 years. The findings showed no significant differences in the mean scores of stress (p = 0.93), anxiety (p = 0.91), and depression (p = 0.56) before the interventional program between the intervention and control groups, but these differences were statistically significant in the mean score of stress (p = 0.003) in the immediately after the interventional program, whereas the mean scores of depression were not decreased significantly (p = 0.3). Two months after the interventional program the mean scores of stress (p = 0.001) and anxiety (p = 0.001) were significantly decreased in the intervention group, but the mean score of depression was not decreased significantly (p = 0.09). CONCLUSION The results suggested that a family-centered intervention program reduced the stress, anxiety, and depression of caregivers because of feasibility, simplicity, and utility of intervention. This program was focused on psychological issues of caregivers, and an emphasis on their empowerment helped them in managing their problems in the caregiving situation and achieved greater psychological potency in the caring process.
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Padilla Fortunatti C, Rojas Silva N. Families on adult intensive care units: Are they really satisfied? A literature review. Aust Crit Care 2018; 31:318-324. [DOI: 10.1016/j.aucc.2017.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/05/2017] [Accepted: 08/15/2017] [Indexed: 10/19/2022] Open
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Clark K, Milner KA, Beck M, Mason V. Measuring Family Satisfaction With Care Delivered in the Intensive Care Unit. Crit Care Nurse 2018; 36:e8-e14. [PMID: 27908955 DOI: 10.4037/ccn2016276] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families' needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families' satisfaction with care in this setting. OBJECTIVE To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit. To assess the feasibility of the selected tool for measuring family satisfaction and to make recommendations that are based on the results. METHOD A descriptive survey design using the Family Satisfaction in the Intensive Care Unit 24-item questionnaire to measure satisfaction with care and decision-making. RESULTS Forty family members completed the survey. Overall, the mean score for families' satisfaction with care was 72.24% (SD, 14.87%) and the mean score for families' satisfaction with decision-making was 72.03% (SD, 16.61%). Families reported that nurses put them at ease and provided understandable explanations. Collaboration, inclusion of families in clinical discussions, and timely information regarding changes in the patient's condition were the most common points brought up in free-text responses from family members. Written communication, including directions and expectations, would have improved the families' experience. CONCLUSION Although patients' family members reported being satisfied with their experience in the intensive care unit, there is room for improvement. Effective communication among the health care team, patients' families, and patients will be targeted for quality improvement initiatives.
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Affiliation(s)
- Kathleen Clark
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts.,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing.,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing.,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts
| | - Kerry A Milner
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts. .,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing. .,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing. .,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts.
| | - Marlene Beck
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts.,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing.,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing.,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts
| | - Virginia Mason
- Kathleen Clark is an adjunct professor at Sacred Heart University College of Nursing, Fairfield, Connecticut, and a critical care nurse at Newton Wellesley Hospital, Newton, Massachusetts.,Kerry A. Milner is an associate professor at Sacred Heart University College of Nursing.,Marlene Beck is a clinical assistant professor and director of the MSN and DNP online programs at Sacred Heart University College of Nursing.,Virginia Mason is a coordinator and critical care/intensive care unit nurse education specialist at UMASS Memorial Medical Center, Worcester, Massachusetts
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Nurhaeni N. Reliability and validity of the family satisfaction instrument in families of children with pneumonia. ENFERMERIA CLINICA 2018. [DOI: 10.1016/s1130-8621(18)30166-9] [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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Mohamed WRA, Leach MJ, Reda NA, Abd-Ellatif MM, Mohammed MA, Abd-Elaziz MA. The effectiveness of clinical pathway-directed care on hospitalisation-related outcomes in patients with severe traumatic brain injury: A quasi-experimental study. J Clin Nurs 2018; 27:e820-e832. [PMID: 29193516 DOI: 10.1111/jocn.14194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2017] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To compare the effectiveness of clinical pathway-directed care to usual care on hospitalisation-related outcomes in patients with severe traumatic brain injury (STBI). BACKGROUND Severe traumatic brain injury is a major cause of disability and mortality in young adults. Clinical pathways endeavour to bring evidence and clinical practice closer together to foster the delivery of best practice and to improve patient outcomes. DESIGN Quasi-experimental study. METHODS The study was conducted in a trauma intensive care unit of a large teaching hospital in Egypt. Patients aged 18-60 years with a diagnosis of STBI, a Glasgow Coma Scale score between 3-8 and a nonpenetrating head injury were consecutively assigned to 15 days of care. The outcomes assessed were complications related to hospitalisation, clinical variances, length of intensive care unit (ICU) stay, ICU readmission rate and patient/family satisfaction. RESULTS Sixty participants completed the study (30 in each arm). Apart from age, there were no significant differences between groups in baseline characteristics. The clinical pathway group demonstrated statistically significantly fewer cases of hospitalisation-related complications on day 15, and a significantly shorter length of ICU stay, lower ICU readmission rate and a high level of patient/family satisfaction when compared with the usual care group. The effect of the intervention on fever, pressure ulceration, hyperglycaemia and readmission to the ICU was no longer statistically significant after controlling for age. CONCLUSIONS The findings of the current study suggest that the implementation of a clinical pathway for patients with severe TBI may be helpful in improving the patient experience as well as some hospitalisation-related outcomes. RELEVANCE TO CLINICAL PRACTICE The provision of clinical pathway-directed care in a trauma ICU may offer benefits to the patient, family and institution beyond that provided by usual care.
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Affiliation(s)
| | - Matthew J Leach
- Department of Rural Health, University of South Australia, Adelaide, SA, Australia
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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.
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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
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Mahrous MS. Relating family satisfaction to the care provided in intensive care units: quality outcomes in Saudi accredited hospitals. Rev Bras Ter Intensiva 2017; 29:188-194. [PMID: 28591370 PMCID: PMC5496753 DOI: 10.5935/0103-507x.20170018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/14/2017] [Indexed: 11/20/2022] Open
Abstract
Objectives This study aims to identify the satisfaction levels of the family members of
patients in intensive care units. Methods This is a cross-sectional analytical study. General intensive care units
offer a variety of services to clinical and surgical patients. For the
purpose of this study, a trained interviewer communicated with the families
of patients, either before or after visiting hours. Results The study included 208 participants: 119 (57.2%) males and 89 (42.8%)
females. Seventy-three (35.1%) of the patients attended a private hospital,
and 135 (64.9%) attended a public hospital in the city of Al Madinah Al-
Munawarah. All of the participants were either family members or friends of
patients admitted to the intensive care units at the hospitals. The
responses of both groups yielded low scores on the satisfaction index.
However, a relatively high score was noted in response to questions 2, 6,
and 10, which concerned the care that was extended by the hospital staff to
their patients, the courteous attitude of intensive care unit staff members
towards patients, and patients' satisfaction with the medical care provided,
respectively. A very low score was obtained for item 11, which was related
to the possibility for improvements to the medical care that the patients
received. Overall, greater satisfaction with the services offered by the
public intensive care units was reported compared to the satisfaction with
the services offered by the private intensive care units. Conclusion An overall low score on the satisfaction index was obtained, and further
studies are recommended to assess the current situation and improve the
satisfaction and quality of care provided by intensive care units.
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Sedation versus no sedation: Are there differences in relatives' satisfaction with the Intensive Care Unit? A survey study based on data from a randomised controlled trial. Intensive Crit Care Nurs 2017; 39:59-66. [PMID: 27887881 DOI: 10.1016/j.iccn.2016.08.002] [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: 02/12/2016] [Revised: 08/17/2016] [Accepted: 08/20/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Currently there is a trend towards less or no use of sedation of mechanically ventilated patients. Still, little is known about how different sedation strategies affect relatives' satisfaction with the Intensive Care Unit (ICU). AIM To explore if there was a difference in relatives' personal reactions and the degree of satisfaction with information, communication, surroundings, care and treatment in the ICU between relatives of patients who receive no sedation compared with relatives of patients receiving sedation during mechanical ventilation in the ICU. METHOD A survey study using a questionnaire with 39 questions was distributed to relatives of mechanically ventilated patients, who had been randomised to either sedation with daily wake up or no sedation. RESULTS Forty-nine questionnaires were sent out and 36 relatives answered. The response rate was 73%. We found no differences in relatives' personal reactions or in the degree of satisfaction with information, communication, care and treatment in the ICU between relatives of patients in the two groups. Relatives of patients treated with no sedation felt more bothered by disturbances in the surroundings compared with relatives of patients who were sedated (p=0.03). CONCLUSION Treating the patient during mechanical ventilation with no sedation does not affect relatives' satisfaction adversely.
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Dehkordi LM, Babashahi M, Irajpour A. Nonprofessional Care in Chronic Critically Ill Patient: A Qualitative Study. Int J Prev Med 2016; 7:125. [PMID: 28028426 PMCID: PMC5159692 DOI: 10.4103/2008-7802.195209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 10/04/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Decision-making about patients with critical condition transfer from Intensive Care Unit to the general wards be delegated to their families. The aim of the study was explaining the experiences of family caregiver's about care of chronic critically ill patient. METHODS This study was conducted with a qualitative content analysis using unstructured interview. Participants were selected purposively from May 2014 to May 2015 and data collection continued until data saturation. Analysis was based on conventional content analysis. RESULTS Participants' experiences classified into three main categories as following: nonprofessional care, enhancing factors of care, and inhibiting factors of care. CONCLUSIONS Finding of the current study showed different aspects of care. Care of chronic critically ill patients is a long-term process that affected by different factors. It seems that the exploration of caregivers needs and planning supportive interventions based on their needs improve the quality of care.
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Affiliation(s)
- Leila Mardanian Dehkordi
- Department of Adult Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Monireh Babashahi
- Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Alireza Irajpour
- Nursing and Midwifery Care Research Centre, Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Social Determinants of Health Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
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Hajj M, Gulgulian T, Haydar L, Saab A, Dirany F, Badr LK. The satisfaction of families in the care of their loved ones in CCUs in Lebanon. Nurs Crit Care 2015; 22:203-211. [PMID: 26256561 DOI: 10.1111/nicc.12195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/07/2015] [Accepted: 05/28/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care. AIMS To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction. METHODS A cross-sectional descriptive design was conducted using the Critical Care Family Satisfaction Survey (CCFSS). The participants were 123 adult relatives or significant others of patients cared for in both adult and paediatric intensive care units for at least 3 days. RESULTS The CCFSS showed acceptable internal reliability and construct validity in a Lebanese population. In general, families were satisfied with the care their loved ones received in the CCUs, and the least satisfaction was in the area of 'comfort' and the highest was in 'assurance'. Younger family members with more education were less satisfied with care and Christian families expressed less satisfaction with informational needs compared with Muslim families. Families of children in the paediatric CCU expressed least satisfaction with care. Gender, residency, relationship to patient, unit, prior experience in a CCU and diagnosis had no effect on satisfaction scores. CONCLUSIONS Assessment of family satisfaction in different cultures is important as each culture has specific needs that are essential to decipher. IMPLICATIONS FOR PRACTICE Patient satisfaction leads to improved quality of care; thus, it behoves nurses to meet the needs of families from different cultures to help them cope and increase their satisfaction, which leads to improve patient outcomes.
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Affiliation(s)
- Madeleine Hajj
- Department of Nursing, Keserwan Medical Center, Jounieh, Lebanon
| | - Taline Gulgulian
- School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Lili Haydar
- PICU, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amali Saab
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatima Dirany
- American University of Beirut Medical Center, Beirut, Lebanon
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Omar AS, Sivadasan PC, Gul M, Taha R, Tuli AK, Singh R. Impact of fast-track discharge from cardiothoracic intensive care on family satisfaction. BMC Anesthesiol 2015; 15:78. [PMID: 26002357 PMCID: PMC4443507 DOI: 10.1186/s12871-015-0060-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 05/20/2015] [Indexed: 11/25/2022] Open
Abstract
Background Dissatisfaction with the intensive care unit may threaten medical care. Clarifying treatment preferences can be useful in these settings, where physician direction may influence decision making and therefore medical treatment. This study aimed to evaluate whether fast-track discharge from intensive care units affects the satisfaction of family members. Methods We used a single-center non-randomized trial, with all eligible family members involved. To evaluate family satisfaction, we used the Society of Critical Care Family Needs Assessment questionnaire (SCCMFNAQ). We hypothesized that those discharged within 24 h of intensive care unit admission and their families would have higher levels of satisfaction. Patients were scored using the therapeutic interventions scoring system (TISS) and additive EuroSCORE. Results Two-hundred fifty-five family members were enrolled. The mean patient age was 53 years, and 92 % were male. The median satisfaction level among family members was 17.9 (range 14–31). Patients were divided into two groups, one receiving fast-track discharge (116 patients), and one whose members stayed longer (139 patients). The overall satisfaction was affected significantly by quality of the delivered care and dissatisfaction increased by lack of comfort in hospital settings, including the waiting room. No significant differences were seen between the two groups for overall satisfaction (p = 0.546) and individual components of the questionnaire. Higher satisfaction was linked to higher levels of education among family members (p = 0.045) and information being relayed by a senior physician p = 0.03 (two-tailed test). Conclusions Fast-track discharge from intensive care did not influence family satisfaction as hypothesized. Satisfaction relied on family members’ level of education and the level of seniority of the physician relaying information.
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Affiliation(s)
- Amr S Omar
- Department of Cardiothoracic Surgery/Intensive Care Unit Section, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. .,Department of Critical Care Medicine, Beni Suef University, Beni Suef, Egypt.
| | - Praveen C Sivadasan
- Department of Cardiothoracic Surgery/Intensive Care Unit Section, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Mumi Gul
- Department of Cardiothoracic Surgery/Intensive Care Unit Section, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Rula Taha
- Department of Cardiothoracic Surgery/Intensive Care Unit Section, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Alejandro Kohn Tuli
- Department of Cardiothoracic Surgery/Intensive Care Unit Section, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Rajvir Singh
- Department of Medial Research, Hamad Medical Corporation, Doha, Qatar.
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20
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Abstract
Purpose
– Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward.
Design/methodology/approach
– The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden.
Findings
– A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU.
Research limitations/implications
– The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.
Practical implications
– The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.
Originality/value
– The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.
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Huffines M, Johnson KL, Smitz Naranjo LL, Lissauer ME, Fishel MAM, D’Angelo Howes SM, Pannullo D, Ralls M, Smith R. Improving Family Satisfaction and Participation in Decision Making in an Intensive Care Unit. Crit Care Nurse 2013; 33:56-69. [DOI: 10.4037/ccn2013354] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background
Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together.
Objectives
To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients’ families.
Methods
A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families’ satisfaction scores before and after implementation of the algorithm.
Results
Satisfaction scores for participation in decision making (45% vs 68%; z = −2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = −2.10, P = .04) improved significantly after implementation.
Conclusions
Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit’s team works together.
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Affiliation(s)
- Meredith Huffines
- Meredith Huffines is a senior clinical nurse II in the surgical intensive care unit at University of Maryland Medical Center in Baltimore
| | - Karen L. Johnson
- Karen L. Johnson is director of nursing research, Banner Healthcare System, Phoenix, Arizona. At the time of this project, she was director of nursing research and evidence-based practice at University of Maryland Medical Center
| | - Linda L. Smitz Naranjo
- Linda L. Smitz Naranjo was the clinical practice coordinator in the surgical intensive care unit at the University of Maryland Medical Center at the time of this project
| | - Matthew E. Lissauer
- Matthew E. Lissauer is the medical director of the surgical intensive care unit and an assistant professor of surgery in the trauma program at University of Maryland School of Medicine in Baltimore
| | - Marmie Ann-Michelle Fishel
- Marmie Ann-Michelle Fishel was a patient advocate at the University of Maryland Medical Center at the time of this project
| | - Susan M. D’Angelo Howes
- Susan M. D’Angelo Howes is a senior clinical nurse I in the surgical intensive care unit at University of Maryland Medical Center
| | - Diane Pannullo
- Diane Pannullo was a member of the palliative care team at the University of Maryland Medical Center at the time of this project. She is now a staff nurse in the surgical intensive care unit
| | - Mindy Ralls
- Mindy Ralls is a senior clinical nurse I in the surgical intensive care unit at the University of Maryland Medical Center
| | - Ruth Smith
- Ruth Smith is lead chaplain in the surgical intensive care unit at the University of Maryland Medical Center
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Gerasimou-Angelidi S, Myrianthefs P, Chovas A, Baltopoulos G, Komnos A. Nursing Activities Score as a predictor of family satisfaction in an adult Intensive Care Unit in Greece. J Nurs Manag 2013; 22:151-8. [DOI: 10.1111/jonm.12089] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - Pavlos Myrianthefs
- Faculty of Nursing; National and Kapodistrian University of Athens; Athens Greece
- Department of Intensive Care at Agioi Anargyroi General Hospital; Athens Greece
| | - Achileas Chovas
- Department of Intensive Care; General Hospital of Larissa; Larissa
| | - George Baltopoulos
- Department of Intensive Care at Agioi Anargyroi General Hospital; Athens Greece
- Faculty of Nursing; National and Kapodistrian University of Athens; Athens
| | - Apostolos Komnos
- Department of Intensive Care; General Hospital of Larissa, Biomed/Cereteth; Research Institution of Larissa; Larissa Greece
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Hickman RL, Daly BJ, Douglas SL, Burant CJ. Evaluating the critical care family satisfaction survey for chronic critical illness. West J Nurs Res 2011; 34:377-95. [PMID: 21427449 DOI: 10.1177/0193945911402522] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recognition of the family as a component of patient-centered critical care has shifted our attention to the assessment of family satisfaction in the intensive care unit (ICU). To date, there are no established measures of satisfaction with ICU care for family members of the chronically critically ill (CCI). This study evaluated psychometric properties of the Critical Care Family Satisfaction Survey (CCFSS) in 326 family members of the CCI using exploratory and confirmatory factor analysis (CFA). From the exploratory factor analysis, two unique structural models emerged, each with alpha coefficients of .72 to .91 and discriminant validity among factors (r < .70). The CFA confirmed the best-fitting structural model was a 14-item, three-factor solution (χ(2) = 354, df = 148, p < .001, Tucker Lewis Index = .88, Comparative Fit Index = .90, root mean square error of approximation = .06). Thus, the modified 14-item version of the CCFSS is reliable and valid in family members of CCI patients.
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