Coping strategies of family members of intensive care unit patients

Frota, Oleci Pereira; Sene, Adamerflan Gouveia de; Ferreira-Júnior, Marcos Antonio; Giacon-Arruda, Bianca Cristina Ciccone; Teston, Élen Ferraz; Pompeo, Daniele Alcalá; Paula, Fabiana Martins de

doi:10.1016/j.iccn.2020.102980

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…The cultural aspects related to different geographical contexts, attitudes and beliefs affecting the care of patients in ICU should not be underestimated. Family members may prefer to be involved in decision‐making rather than direct care 31 or their coping strategies may differ across cultures 32 . The current study found few significant differences between continents in the QFIFE results, which might be due to the small sample size.…”

Section: Discussioncontrasting

confidence: 53%

“…Family members may prefer to be involved in decision-making rather than direct care 31 or their coping strategies may differ across cultures. 32 The current study found few significant differences between continents in the QFIFE results, which might be due to the small sample size. More exploration into the complexity, including cultural aspects, affecting family engagement across the world is, therefore, needed.…”

Section: Discussioncontrasting

confidence: 48%

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Factors influencing critical care nurses' family engagement practices: An international perspective

Price

McAndrew

Thaqi

et al. 2022

Nursing in Critical Care

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Background: Family engagement positively impacts patient and family members' experiences of care and health outcomes. While partnering with families denotes best practice in intensive care units (ICUs), its full adoption requires improvement. A better understanding of the factors that influence the implementation of family engagement practices is necessary. Aim: To investigate the factors that enable or hinder adult ICU nursefamily engagement and to explore potential international variations. Study design: Descriptive, cross-sectional survey. Nurses from 10 countries completed the 'Questionnaire on Factors that Influence Family Engagement' (QFIFE), including five open-ended questions. We performed descriptive statistics on quantitative data and content analysis for open-ended questions, and then integrated the findings according to influencing factors and geographical patterns. This was part of a larger qualitative study where 65 nurses participated from adult intensive care units. Results: Sixty-one nurses completed the questionnaire, making a response rate of 94%. Overall, patient acuity (Md = 5.0) and nurses' attitudes (Md = 4.6) seemed to be the most influential facilitator, followed by nurse workflow (Md = 4.0) and ICU environment (Md = 3.1) (score 1-6 most influential). The open-ended question data showed a more nuanced picture of the complexity of family engagement in care around these four determinants. Adding a fifth determinant, namely Families are complex structures that respond uniquely to the ICU and patient, revealed that difficult family dynamics, miscommunication and family having difficulty in understanding the situation or health literacy, hindered family engagement. Exploring geographical variations, Africa/Middle East consistently differed from others on three of the four QFIFE subscales, showing lower median levels. Conclusions: Some determinants are perceived to be more influential than others, becoming barriers or enablers to nurse-family engagement in adult ICU. Research that investigates contextual determinants and which compares implementation and improvement initiatives tailored to address family engagement practices barriers and enablers are needed. Relevance to clinical practice: Knowledge of this international study expands our understanding of enablers and barriers in family engagement that may inform family engagement practice improvement efforts around the world.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussioncontrasting

confidence: 48%

Factors influencing critical care nurses' family engagement practices: An international perspective

Price

McAndrew

Thaqi

et al. 2022

Nursing in Critical Care

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“…Coping was more adequate in men than in women and was highest in the 40–50 age group but worsened with increasing age, like other studies (8). As described by Pererira Frota et al (26), subjects with a higher level of education employed an active coping style. They also had a lower risk of psychologic distress at discharge, which was a protective factor, as was the emotion-focused strategy.…”

Section: Discussionmentioning

confidence: 87%

The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours

Iglesias

Martı́n

Alcañiz

et al. 2022

Critical Care Explorations

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OBJECTIVES: To identify the psychologic impact of admission to the ICU on the relatives of critically ill patients, the influence of coping, and the factors involved. DESIGN: We performed a cohort study with repeated measures evaluation using descriptive and comparative bivariate and multivariate analyses. SETTINGS: An adult ICU of a third-level complexity hospital. PATIENTS: The family members of patients (maximum of three per patient) staying longer than 3 days. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Psychologic impact was assessed using two subgroups of psychologic distress: anxiety (by the State-Trait Anxiety Inventory) and depression (by the Beck Depression Inventory). Satisfaction and coping were assessed by the Critical Care Family Needs Inventory and the Brief Coping Orientations to Problems Experienced Inventory, respectively. We included 104 family members; psychologic distress was high at admission (72% had anxiety, 45% had depression, and 42% had both) but decreased at discharge (34% had anxiety, 23% had depression, and 21% had both). The risk factors related to psychologic impact were severity (anxiety: Acute Physiology and Chronic Health Evaluation score ≥ 18 points: relative risk [RR], 2; 95% CI, 1–4; p = 0.03), invasive mechanical ventilation (anxiety: RR, 1.9; 95% CI, 1–3.6; p = 0.04), recent psychotropic medication use by relatives (depression: RR, 1.6; 95% CI, 1–2.9; p = 0.05), a restrictive visiting policy (anxiety: RR, 5.7; 95% CI, 2–10.4; p = 0.002), no emotion-focused coping strategy (anxiety: strategy < 11 points, RR, 6.1; 95% CI, 1.2–52; p = 0.01), and functional impairment (depression: Barthel index ≤ 60 points, RR, 7.4; 95% CI, 1.7–26.3; p = 0.01). CONCLUSIONS: The psychologic impact from admission to the ICU on family members is high. Visiting hours is the main modifiable factor to reduce the impact.

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“…Although the efficiency of coping strategies is related to the nature of the stressor (Lazarus & Folkman, 1984), disengaged coping strategies were often found to be related to higher distress and poorer adjustment (Gori et al, 2020;Mouzon, 2022;Park et al, 2021;Shapiro et al, 2010), whereas engaged coping strategies were consistently associated with lower distress and better physical health and well-being (Frota et al, 2021;Park et al, 2021). Carstensen (2006) and Charles (2010) suggested that during the ageing process, individuals shift from engaged coping towards disengaged coping, such as avoiding situations that may elicit emotional distress and distancing themselves from negative emotions.…”

Section: Chronic Stressors Coping Strategies and Depressive Symptomsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic stressors, coping strategies, and depressive symptoms: A comparison across older age groups

2023

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Background: Late-life depression is a prevalent mental health problem among older adults. Variations may exist in the intensity of chronic stressors experienced by people in different older age groups and their effects on depressive symptoms.Aim: To examine differences among older adults by age group in the experienced intensity of chronic stressors in relation to depressive symptoms and assess the mediating role of disengaged and engaged coping strategies.Methods: Participants were 114 older adults. The sample was divided into three age groups: 65-72, 73-81, and 82-91. The participants completed questionnaires on coping strategies, depressive symptoms, and chronic stressors. Moderation and mediation analyses were conducted.Results: The lowest levels of depressive symptoms were in the young-old age group and the highest levels were in the oldest-old age group. The young-old age group used more engaged and less disengaged coping strategies than the two other groups. The association between intensity of chronic stressors and depressive symptoms was stronger in the two older age groups compared to the youngest (moderating effect of age groups). The association of stressor intensity with depressive symptoms was mediated by disengaged coping, whereas engaged coping was not associated with depressive symptoms.Conclusion: Differences exist in the relationships among chronic stressors, coping strategies, and depressive symptoms by age groups in the older adult population. Professionals should be aware of these differences between age groups in depressive symptoms and the impact of stressors and coping strategies on depressive symptoms in different older adult age groups.

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Coping strategies of family members of intensive care unit patients

Cited by 6 publications

References 24 publications

Factors influencing critical care nurses' family engagement practices: An international perspective

Factors influencing critical care nurses' family engagement practices: An international perspective

The Psychological Impact on Relatives of Critically Ill Patients: The Influence of Visiting Hours

Chronic stressors, coping strategies, and depressive symptoms: A comparison across older age groups

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