Inter‐facility transfers for advanced critical care services: Impacts on rural families

Abstract

Aims and Objectives: The aim of this article is to provide an integrative review of rural family members' experiences of a relative's inter-facility transfer to an urban tertiary care centre for advanced critical care services.Background: Although there is an increasing awareness of the negative consequences of a relative's critical illness for family members, there has been limited research conducted on the impacts of this experience for families of patients in rural settings who require an inter-facility transfer for advanced services.Search strategy: The search strategy for this review was framed by the study purpose, research question, and a conceptual structure of key constructs. Databases and reference lists were electronically and manually searched.Inclusion and exclusion criteria: Articles were included if they were research articles, available in English, and focused on family members' experiences of inter-facility transfer during critical illness. Articles focusing on critical care transfers within a single urban setting, elective transfers undertaken for patient or family preference, transfers not associated with critical illness, and systematic or scoping reviews were excluded.Conclusion: Stress and anxiety are central to the rural family members' experience of this phenomenon. These constructs are influenced by modifiable factors, including the actions of health care providers, the financial burden associated with the transfer, the family members' physical proximity to the patient, and their access to information and support networks. Further research is required to explore potential short-and long-term consequences of this experience and the experience of family members who are left behind and to develop and test interventions to support families.Relevance to clinical practice: This review highlights the concern that health care providers frequently misunderstand the needs of family members who are experiencing this phenomenon. Through a better understanding of this phenomenon, health care providers will be better positioned to effectively support these individuals during this unique experience. K E Y W O R D Scritical illness, family, integrative review, interfacility transfer, rural

Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study

“…In recent years, the interest in studying different types of transfers in intensive care has increased (Bergman, Pettersson, Chaboyer, Carlstrom, & Ringdal, 2017;Eiding, Kongsgaard, & Braarud, 2019;Herling et al, 2020). Despite this development, interhospital intensive care unit-to-unit transfers from the family members' perspective have been sparsely investigated (Burns & Petrucka, 2020). Even though transfers may be justified when the patient's level of care needs to be optimised or when there is a lack of ICU resources, this can impose additional stress on the patient's family (Intensive Care Society, 2019;Nadig, Sterba, Johnson, Goodwin, & Ford, 2019).…”

Critical care resource use associated with tourism in Central Australia

“…A cardiovascular diagnosis was an independent risk factor for IHT and tertiary cardiology services, specifically percutaneous coronary intervention and cardiothoracic surgery, are not available at ASH. We speculate that IHT is likely to have resulted in considerable personal expense and difficulty associated with disruption to travel plans and stranding of travel companions and vehicles, adding to the known increased stress and anxiety for relatives of transferred patients 24 …”

Constructivist Grounded Theory or Interpretive Phenomenology? Methodological Choices Within Specific Study Contexts

“…The critical illness experience can increase in complexity if the patient's needs exceed the healthcare service capacity of the local hospital, thereby necessitating an IHT to an urban center a significant distance away for advanced critical care services. Recently, an integrative review of existing literature produced a conceptual map of this phenomenon that included potentiating and mitigating factors for the central constructs of anxiety and stress as experienced by family members (Burns & Petrucka, 2020). However, it was noted that more research is required in this area of healthcare to inform enhanced family-centered care (Burns & Petrucka, 2020).…”

“…Recently, an integrative review of existing literature produced a conceptual map of this phenomenon that included potentiating and mitigating factors for the central constructs of anxiety and stress as experienced by family members (Burns & Petrucka, 2020). However, it was noted that more research is required in this area of healthcare to inform enhanced family-centered care (Burns & Petrucka, 2020).…”