Families’ experiences of their interactions with staff in an Australian intensive care unit (ICU): A qualitative study

Wong, Pauline; Liamputtong, Pranee; Koch, Susan; Rawson, Helen

doi:10.1016/j.iccn.2014.06.005

Cited by 86 publications

(76 citation statements)

References 60 publications

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“…Health care professionals (HCP) expect families to absorb highly technical and potentially devastating information while making rapid decisions when they face the critical injury of a family member (Blom, Gustavsson, & Sundler, 2013; Eggenberger & Nelms, 2007; Leske, 2000). Challenges in forming and maintaining relationships with other family members and HCP are the most frequently cited family stressors (Azoulay et al, 2001; Rodriguez, 2005; Wong, Liamputtong, Koch, & Rawson, 2015). …”

Section: Background Literaturementioning

confidence: 99%

Family Presence During Resuscitation After Trauma

Leske

McAndrew

Brasel

et al. 2017

Journal of Trauma Nursing

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Purpose The primary aim 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) in the emergency department. Background The ongoing controversy of FPDR, dearth of comparative designs, small sample sizes, and survey methods makes it difficult to come to a definitive conclusion about any benefits of FPDR. Methods The Resiliency Model guided the selection of variables. A multivariate, comparison, prospective design was used. A convenience sample of family members participated within three days of admission to critical care. Family strengths were measured by the Family Crisis Oriented Personal Scale, Family Inventory of Resources for Management, and Family Problem Solving Communication Index. Family outcomes were measured by the State anxiety portion of the State Trait Anxiety Inventory, Acute Stress Disorder Scale, Family Member Well-being Index, and Family Satisfaction in the Intensive Care Unit Scale. Results 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) but was not significant for satisfaction with critical care (t= −.28, p=.78). Discussion Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury. Long term effects of FPDR remain unknown.

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Section: Background Literaturementioning

confidence: 99%

Family Presence During Resuscitation After Trauma

Leske

McAndrew

Brasel

et al. 2017

Journal of Trauma Nursing

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“…Furthermore, unless relatives understand the available information, they will not be able to pass it on to others or participate in treatment decisions [23]. Little is known about the consequences of deficiencies at these communication levels or the link between poor information provision on the part of medical professionals and unsupportive interactions with families [24]. Nonetheless, a study by Curtis et al.…”

Section: Discussionmentioning

confidence: 99%

Prioritizing information topics for relatives of critically ill patients

Hoffmann

Holl

Burgsteiner

et al. 2018

Wien Klin Wochenschr

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SummaryA patient’s admission to an intensive care unit (ICU) has a significant impact on family members and other relatives. In order for them to be able to cope with such a stressful situation, the availability of appropriate understandable and accessible information is crucial. The information asymmetry between relatives and medical professionals may adversely affect satisfaction of relatives and their risk of subsequent anxiety, depression and stress symptoms. The aim of this study was therefore to understand which topics are most important to the relatives of ICU patients and to quantify the perceptions of medical professionals regarding the information needs of relatives. A cross-sectional survey was conducted in 2015. The survey had 42 questions, such as ‘diagnosis’, ‘treatment’, ‘comfort’, ‘family’ and ‘end of life’. In total, the survey was handed out to four different groups. A total of 336 persons answered the survey (26 relatives, 28 ICU physicians, 202 ICU nurses and 80 ICU medical professionals in a closed Facebook© group [Facebook, Menlo Park, California, USA]). Relatives ranked the five most important topics as follows: ‘recent events (crisis)’, ‘my participation’, ‘contamination in hospital’, ‘physical pain’, and ‘probability’. Several significant differences (p<0.001) were detected, for example for the topics fever, medication, recent events (crisis), appointments, relapse, and investigations. Even the topic with the lowest ranking (religion) had a score of 3.15 (min. 1.00, max. 5.00) among relatives. The ICU professionals appear to have divergent opinions regarding the most important topics for ICU relatives as compared to relatives themselves.Electronic supplementary materialThe online version of this article (10.1007/s00508-018-1377-1) contains supplementary material, which is available to authorized users.

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“…The severity and complexity of illness warranting care in the ICU often limits patient participation in care . As such, it is often family members who act as the patient's voice to communicate their wishes and hence are often to best ones to recall the patient's care journey . Finally, the research was conducted using a single consensus process involving nine panel members in a single health‐care system and was restricted to ICU services.…”

Section: Discussionmentioning

confidence: 99%

Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making

McKenzie

Potestio

Boyd

et al. 2017

Health Expectations

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BackgroundProviders have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations.ObjectiveTo describe the decision‐making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list.DesignWe employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio‐recorded, transcribed and analysed using qualitative content analysis to explore the decision‐making process for establishing consensus.Setting and participantsNine panellists including three providers, three decision makers and three family members of previously critically ill patients.ResultsPanellists rated and revised 28 priorities over three rounds of review and reached consensus on the “Top 5” priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion.ConclusionsOur study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups.

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Families’ experiences of their interactions with staff in an Australian intensive care unit (ICU): A qualitative study

Cited by 86 publications

References 60 publications

Family Presence During Resuscitation After Trauma

Family Presence During Resuscitation After Trauma

Prioritizing information topics for relatives of critically ill patients

Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making

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