Transitional Care After the Intensive Care Unit

Clinical validity of a relocation stress scale for the families of patients transferred from intensive care units

“…Based on previous empirical studies, the four major components of relocation stress are: 'separation anxiety' (Cutler & Garner 1995, Barbetti & Choate 2003, Mitchell et al 2003, Chaboyer et al 2005, 'recognition of changes in treatment condition or environment' (Cutler & Garner 1995, Hall-Smith et al 1997, Burr 1998, Leith 1999, Whittake & Ball 2000, Chaboyer et al 2005, 'recognition that the patient is still critically ill' (Coyle 2001, McKinney & Deeny 2002 and 'apprehensions about nursing care and treatment in a general ward' (Leith 1999, Chaboyer et al 2005. Upon close examination of the items loaded onto each component as shown by this study, most items included in the family relocation stress scale are likely to correspond with these four major components of relocation stress.…”

“…The transfer of an intensive care unit (ICU) patient to a general ward may cause marked emotional distress to the patient and his/her family members (Chaboyer et al 2005), and is described as 'relocation stress syndrome (RSS)' (Mc-Kinney & Melby 2002, Son et al 2008. Compromised relocation stress care may result in inability to cope with illness and reduced response to treatment, and consequently, increased length of stay in hospital, a decreased sense of well-being, reduced quality of life and distrust of health care teams (Chaboyer et al 2005, Watts et al 2005.…”

“…Transfers from ICUs have negative impacts on both patients and their families (Coyle 2001, Chaboyer et al 2005, Gustad et al 2008. Initially, patients and their families may be overpowered by the pervasive nature of ICUs.…”

“…Initially, patients and their families may be overpowered by the pervasive nature of ICUs. However, this same environment often creates positive feelings of reassurance, safety, and security engendered by the constant monitoring and care provided by ICU staff, and thus, transfer from an ICU to a general ward may create marked emotional distress to patients and families (Chaboyer et al 2005). This anxiety or distress is closely related with loss of a secure environment and to loss of the staff on whom patients and families have come to rely (McKinney & Melby 2002, Beard 2005, Chaboyer et al 2007, Field et al 2008, Son et al 2008, St-Louis & Brault 2011.…”

“…Some investigators have emphasised the importance of environmental factors, such as, the suddenness of environmental change (Chaboyer et al 2007, Gustad et al 2008, Son et al 2008), a lack of predictability of the ward environment (Carpenito 2000, Chaboyer et al 2005, and insufficient information regarding the destination ward (Chaboyer et al 2005(Chaboyer et al , 2007, on relocation stress. In addition, inadequate preparation for relocation (Beard 2005, Chaboyer et al 2005, Son et al 2008, recognition that a patient is still critically ill and patients' perceptions of vague or severity of illness (McKinney & Deeny 2002) have been found to significantly affect relocation stress.…”