Spiritual Distress in Family Members of Critically Ill Patients: Perceptions and Experiences

Ordons, Amanda L Roze des; Stelfox, Henry T.; Sinuff, Tasnim; Grindrod-Millar, Kathleen; Smiechowski, Jennifer; Sinclair, Shane

doi:10.1089/jpm.2019.0235

Cited by 11 publications

(9 citation statements)

References 28 publications

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“…While patients experience physiological crises, family members may be in a state of psychological crisis. Previous studies pointed out that the ICU setting may contribute to family emotional distress negative emotional distress from lack of information, uncertainty, and lack of support for joint decision‐making (Roze des Ordons et al., 2020 ; Schmitt et al., 2019 ; Wong et al., 2019a ). Frequent communication generates a better family understanding of the healthcare process and families can receive timely and accurate information, thus meeting their information needs and effectively participating in decision‐making (Hönig & Gündel, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Family‐centred care interventions to reduce the delirium prevalence in critically ill patients: A systematic review and meta‐analysis

et al. 2022

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Aim This study aimed to determine whether family‐centred care (FCC) intervention reduces the ICU delirium prevalence. Design A systematic review and meta‐analysis. Methods The databases, including PubMed, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Complete, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), WANFANG Data and VIP Information, were systematically searched up to 30 November 2021. The search term includes keywords related to intensive care units, delirium and family‐centred care. Meta‐analyses were performed and presented by risk ratio (RR), mean difference (MD) and corresponding 95% confidence intervals (CIs). Results The meta‐analysis results showed that compared with the usual care, FCC intervention has positive effects on reducing ICU delirium prevalence [RR = 0.54, 95% CIs (0.36, 0.81), p < .05]. However, no effect was observed on ICU stays, mechanical ventilation duration and ICU‐acquired infection between the two groups. Conclusions Family‐centred care is an effective intervention to reduce the ICU delirium prevalence. But the result should be treated cautiously as the high levels of heterogeneity, further high‐quality studies are required to determine the effectiveness of FCC intervention in the ICU setting.

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Section: Discussionmentioning

confidence: 99%

Family‐centred care interventions to reduce the delirium prevalence in critically ill patients: A systematic review and meta‐analysis

et al. 2022

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“…Some groups have designed specific tools for the screening of psychologic distress for family members of pediatric patients (21). The expression of psychologic distress varies over time and is derived from multiple factors (22). Relatives describe it as suffering related to "loss of meaning, purpose and connection with oneself " that creates a tension in their value system grappling with preexisting beliefs about illness, life, death, and spirituality (22).…”

Section: Discussionmentioning

confidence: 99%

“…The expression of psychologic distress varies over time and is derived from multiple factors (22). Relatives describe it as suffering related to "loss of meaning, purpose and connection with oneself " that creates a tension in their value system grappling with preexisting beliefs about illness, life, death, and spirituality (22). According to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, the psychologic distress associated with admission to the ICU is included in the mixed subtype of adaptive disorders, consisting of a combination of depression and anxiety (23).…”

Section: Discussionmentioning

confidence: 99%

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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“…In the setting of the intensive care unit (ICU), the need for spiritual care is pressing given the burdens of end-of-life decision making and the relational, spiritual, and existential challenges faced by patients and their families. 14 , 15 Despite the recognized need, the integration of spiritual care into the care of patients in the ICU is variable. 16–19 The reasons for this are likely several, but may reflect poor or incomplete provider knowledge of the work of chaplains.…”

Section: Introductionmentioning

confidence: 99%

Chaplain Care in the Intensive Care Unit at the End of Life: A Qualitative Analysis

McCurry

Jennett

et al. 2021

Palliative Medicine Reports

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Background: The provision of spiritual care is a key component of high-quality patient-centered care, particularly in the intensive care unit (ICU). However, the integration of spiritual care into the care of patients in the ICU is variable, especially at the end of life, which may be due in part to poor or incomplete provider knowledge of the work of chaplains. Objective: To characterize the care and services provided by chaplains to patients in an ICU at the end of life and/or their families. Design: A retrospective chart review was performed to identify all patients admitted over a three-month period to an ICU who had visits with a chaplain and an ICU course that ended in death, discharge to a palliative care facility or discharge to hospice. Subjects/setting: Twenty-five chaplains at a U.S. medical center. Measurements: Qualitative analysis was performed using directed content analysis on the notes written by the chaplains. Results: Qualitative analyses of the chaplain notes revealed four broad themes regarding the activities of chaplains in the ICU with respect to patients and families. These were that chaplains provide comfort to patients and family facing the end of life, provide prayers with a variety of purposes, assist in supporting family members through complex medical decision making, and provide connections to appropriate resources. Conclusions: Chaplains contribute to the care of patients in the ICU through a wide range of activities that demonstrate the unique intermediary and collaborative role chaplains can play within the health care team at the end of life in the ICU.

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Spiritual Distress in Family Members of Critically Ill Patients: Perceptions and Experiences

Cited by 11 publications

References 28 publications

Family‐centred care interventions to reduce the delirium prevalence in critically ill patients: A systematic review and meta‐analysis

Family‐centred care interventions to reduce the delirium prevalence in critically ill patients: A systematic review and meta‐analysis

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

Chaplain Care in the Intensive Care Unit at the End of Life: A Qualitative Analysis

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