The experiences and needs of relatives of intensive care unit patients during the transition from the intensive care unit to a general ward: A qualitative study

Abstract

a b s t r a c tBackground: Relatives of intensive care unit (ICU) patients play an important role as caregivers and can experience emotional distress, also referred to as post-intensive care syndrome-family. A deeper understanding of what relatives go through and what they need may provide input on how to strengthen family-centred care and, in the end, contribute to the reduction of symptoms of post-intensive care syndrome-family. Method: This is a qualitative descriptive study with semistructured face-to-face interviews after ICU transfers. Findings: A total of 13 relatives of ICU patients participated. Relatives of ICU patients expressed five types of experiences after transfer from the ICU to the general ward: (1) relief, (2) uncertainty, (3) need to be acknowledged in becoming a caregiver, (4) sharing expectations, and (5) need for continuity in care. Relatives experience major uncertainties and prefer to be more actively involved in care and care decisions. Conclusion: Relatives of ICU patients experience gaps in care during the transition from the ICU to a general ward. Nurses can play a crucial role in the need for continuity of care by proactively involving relatives during the care pathway of ICU patients.

Challenges of the patient transition process from the intensive care unit: a qualitative study

“…The ambiguity between the positive and negative experiences during the transfer from the ICU to the general wards is in line with the studies of Cullinane and Plowright [ 24 ] and Cypress [ 25 ]. Snow et al [ 12 ] and Op ‘t Hoog et al [ 26 ] reported that the patients and their families were confused and felt abandoned because of conflicting advice from health care providers and an inability to communicate with the health care team for guidance. Forsberg et al [ 27 ] indicated feelings of anxiety, and fear on the part of the patient and the family during the transition to an unfamiliar environment.…”

“…Patients need to be psychologically prepared to gradually separate from equipment and monitoring [ 13 , 30 ]. According to Op ‘t Hoog et al [ 26 ], this difference is less prominent depending on the contrast between the two wards, perhaps, some participants were better at putting the new context into perspective, or they had a different coping style. Patients experienced the shift from being the center of all attention to being just ‘one in the crowd’.…”

Características del síndrome post cuidado intensivo: revisión de alcance

“…Los estudios de intervención que utilizan diarios de la UCI o estrategias de comunicación personalizadas han demostrado ser prometedores para disminuir la carga de los síntomas del TEPT (50). Así, el personal de enfermería puede desempeñar un papel fundamental en la satisfacción de las necesidades de la atención centrada en la familia, especialmente durante las diversas transiciones y transferencias que realizan los pacientes de la UCI (52).…”

The value and challenges of continuity of care

“…Unfortunately, this was not an isolated case. 5,6 This is a typical example. One morning one specialist changed my brother's medication regime without consulting the team.…”