Family-Centered Communication and Acute Stress in Israeli Intensive Care Units

2019 ◽  
Vol 28 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Freda DeKeyser Ganz ◽  
Gilat Yihye ◽  
Nicole Beckman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Perceived Stress ◽  
Acute Stress ◽  
Family Members ◽  
Personal Characteristics ◽  
Perceived Stress Scale ◽  
Stress Scale ◽  
Family Centered

Background Intensive care unit stays can be stressful for patients’ family members. Family-centered communication has 6 components: fostering relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. Whether these communication components decrease family members’ stress is unknown. Objective To describe levels of family-centered communication and associations with acute stress while patients are in the intensive care unit. Methods A convenience sample of 130 family members of patients in 2 intensive care units in a Jerusalem, Israel, tertiary medical center received a family-centered communication questionnaire, the Perceived Stress Scale, and a personal characteristics questionnaire. Results Most respondents were women (n = 79, 60.8%), children of the patient (n = 67, 51.9%), and familiar with the patient’s diagnosis (n = 111, 85.4%). Mean (SD) participant age was 45.7 (13.6) years. Most considered the patient medically stable (n = 75, 57.7%). Mean (SD) intensive care unit stay was 7.45 (5.8) days. Mean (SD) total and item scores for family-centered communication were 98.75 (18.21) and 3.80 (0.70), respectively; for the Perceived Stress Scale, 19.63 (5.92) and 1.96 (0.59), respectively. Relationship building (r = −0.31, P = .002), participation in care management (r = −0.32, P = .001), and emotional support (r = −0.29, P = .003), and were significantly related to stress. Conclusions Stress levels were mild to moderate and communication scores were moderate to high. Better nurse communication with family members was associated with decreased acute stress, irrespective of personal characteristics or perceptions of the patient’s medical status.

Is Open Visitation Really “Open” in Adult Intensive Care Units in the United States?

2020 ◽  
Vol 29 (3) ◽  
pp. 221-225 ◽  
Author(s):  
Kerry A. Milner ◽  
Susan Goncalves ◽  
Suzanne Marmo ◽  
Sheri Cosme
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Best Practice ◽  
The United States ◽  
National Study ◽  
Adult Intensive Care Unit ◽  
Centered Care ◽  
Intensive Care Unit Nurses ◽  
Family Centered

Background Evidence indicates that open visitation in adult intensive care units is a best practice for patient- and family-centered care, and nurses substantially influence such visitation patterns. However, it is unclear whether intensive care units in Magnet and Pathway to Excellence (MPE) facilities nationwide implement this in practice. Objective To describe current national visitation practices in adult intensive care units and determine whether they have changed since the last national study, which used data from 2008 to 2009. Methods From February through April 2018, websites of MPE hospitals were reviewed in order to identify their adult intensive care unit visitation policy. If this information was unavailable online, the hospital was telephoned to obtain the policy. From May through August 2018, follow-up telephone calls were made to hospitals that reported open visitation, during which intensive care unit nurses at the hospitals were asked to verify that the policy did not restrict visiting hours or the number, type, or age of visitors. Results Among the 536 MPE hospitals contacted, 51% (n = 274) indicated that they allowed open visitation. Further examination, however, revealed that 64% (n = 175) restricted the number (68.2%), age (59.5%), or type (4.4%) of visitors, or visiting hours (19.8%). Only 18.5% of MPE hospitals (n = 99) allowed unrestricted visitation. Conclusion This study suggests a lack of progress toward implementing open visitation in adult intensive care units nationwide. Research on MPE hospitals that have adopted truly open visitation policies is needed to identify successful methods for implementing and sustaining open visitation.

Visiting Preferences of Patients in the Intensive Care Unit and in a Complex Care Medical Unit

2004 ◽  
Vol 13 (3) ◽  
pp. 194-198 ◽  
Author(s):  
Colleen E. Gonzalez ◽  
Diane L. Carroll ◽  
Jeanne S. Elliott ◽  
Patricia A. Fitzgerald ◽  
Heather J. Vallent
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Family Members ◽  
Structured Interview ◽  
Complex Care ◽  
Medical Unit ◽  
Healthcare Environment ◽  
Perceived Satisfaction

• Background Within the challenging healthcare environment are nurses, patients, and patients’ families. Families want proximity to their loved ones, but the benefits of such proximity depend on patients’ conditions and family-patient dynamics. • Objectives To describe patients’ preferences for family visiting in an intensive care unit and a complex care medical unit. • Methods Sixty-two patients participated in a structured interview that assessed patients’ preferences for visiting, stressors and benefits of visiting, and patients’ perceived satisfaction with hospital guidelines for visiting. • Results Patients in both units rated visiting as a nonstressful experience because visitors offered moderate levels of reassurance, comfort, and calming. Patients in the intensive care unit worried more about their families than did patients in the complex care medical unit but valued the fact that visitors could interpret information for the patients while providing information to assist the nurse in understanding the patients. Patients in the intensive care unit were more satisfied with visiting practices than were patients in the complex care medical unit, although both groups preferred visits of 35 to 55 minutes, 3 to 4 times a day, and with usually no more than 3 visitors. • Conclusions These data provide the input of patients in the ongoing discussion of visiting practices in both intensive care units and complex care medical units. Patients were very satisfied with a visiting guideline that is flexible enough to meet their needs and those of their family members.

Half the family members of intensive care unit patients do not want to share in the decision-making process: A study in 78 French intensive care units*

2004 ◽  
Vol 32 (9) ◽  
pp. 1832-1838 ◽  
Author(s):  
Élie Azoulay ◽  
Frédéric Pochard ◽  
Sylvie Chevret ◽  
Christophe Adrie ◽  
Djilali Annane ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Family Members ◽  
Decision Making Process ◽  
The Family

Assessment of Family Needs in Neonatal Intensive Care Units

2010 ◽  
Vol 19 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Cynthia A. Mundy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Family Needs ◽  
Care Providers ◽  
Mothers And Fathers ◽  
Family Centered

Background Limited research has been conducted to assess family needs in neonatal intensive care units. Health care providers often make assumptions about what families need, but these assumptions are unfounded and can lead to inappropriate conclusions. When assessed appropriately, family needs can be incorporated into individualized plans of care, enhancing family-centered care. Objective To assess the needs of parents in neonatal intensive care units, we asked the following 3 questions: What are the most and least important needs of families in a level III neonatal intensive care unit? Do parents’ needs differ at admission and discharge? Do the needs of mothers and fathers differ? Methods Parents were interviewed by using the Neonatal Intensive Care Unit Family Needs Inventory. Participants rated statements as not important (1), slightly important (2), important (3), very important (4), or not applicable (5). Results Fifty-two (93%) of the 56 items were rated as important or very important, and parents rated assurance-type needs highest. Parents at admission rated support needs higher than parents at discharge rated those needs. Needs of mothers and fathers did not differ significantly. Conclusions Identifying the needs of parents in neonatal intensive care units can enhance nursing communication and allow nurses to incorporate parents’ needs into families’ plans of care. The family needs inventory can help identify those needs and allows the integration of individualized nursing care to fulfill those needs, providing a positive family-centered experience in the unit for patients and their families.

scholarly journals Heart rate variability and subsequent psychological distress among family members of intensive care unit patients

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110578
Author(s):  
Benjamin RE Harris ◽  
Sarah J Beesley ◽  
Ramona O Hopkins ◽  
Eliotte L Hirshberg ◽  
Emily Wilson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Psychological Distress ◽  
Acute Stress ◽  
Family Members ◽  
Fluctuation Analysis ◽  
Post Traumatic Stress ◽  
Adult Intensive Care Unit

Objective To determine whether heart rate variability (HRV; a physiological measure of acute stress) is associated with persistent psychological distress among family members of adult intensive care unit (ICU) patients. Methods This prospective study investigated family members of patients admitted to a study ICU. Participants’ variability in heart rate tracings were measured by low frequency (LF)/high frequency (HF) ratio and detrended fluctuation analysis (DFA). Questionnaires were completed 3 months after enrollment to ascertain outcome rates of anxiety, depression, and post-traumatic stress disorder (PTSD). Results Ninety-nine participants were enrolled (median LF/HF ratio, 0.92 [interquartile range, 0.64–1.38]). Of 92 participants who completed the 3-month follow-up, 29 (32%) had persistent anxiety. Logistic regression showed that LF/HF ratio (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.43, 1.53) was not associated with 3-month outcomes. In an exploratory analysis, DFA α (OR 0.93, 95% CI 0.87, 0.99), α1 (OR 0.97, 95% CI 0.94, 0.99), and α2 (OR 0.94, 95% CI 0.88, 0.99) scaling components were associated with PTSD development. Conclusion Almost one-third of family members experienced anxiety at three months after enrollment. HRV, measured by LF/HF ratio, was not a predictor of psychologic distress, however, exploratory analyses indicated that DFA may be associated with PTSD outcomes.

scholarly journals Investigation of the association between family members’ satisfaction with patient care in the Intensive Care Unit, spirituality and resilience.

2019 ◽  
Author(s):  
Iokasti Papathanasiou ◽  
Vasileios Tzenetidis ◽  
Athanasios Nikolentzos ◽  
Pavlos Sarafis ◽  
Maria Malliarou
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Patient Care ◽  
Perceived Stress ◽  
Family Members ◽  
Satisfaction With Care ◽  
Psychological Burden ◽  
Unit Scale ◽  
The Family

Abstract Background: The admission of a patient in the Intensive Care Unit (ICU) is a traumatic experience for the patient himself and his support group which mainly consists of his family members. The psychological burden of the family members increases, as they experience negative feelings. The implementation of family-centered care helps family members to satisfy their needs, eliminates psychological impact and improves patient’s health outcomes. The aim of this study is to investigate the family members’ satisfaction with patient care in the ICU, their perceived stress, spirituality and resilience.Methods: One hundred and four family members of patients admitted in the ICU for greater than 48 hours between January and March 2019 were enrolled. The questionnaire included the following psychometric tools: the Family Satisfaction with care in the Intensive Care Unit scale, the Perceived Stress Scale, the Connor – Davidson Resilience Scale, the Daily Spiritual Experience Scale and the Acute Physiology and Chronic Health Evaluation Scale. Results: The mean value of satisfaction with care was 88,9%, of satisfaction with decision making was 79,1% and of the overall satisfaction was 85%. Resilience was associated with perceived stress (p<0,001) and with spirituality (p= 0,019). Spirituality was associated with satisfaction with care (p= 0.013), with satisfaction with decision making (p= 0,018) and with the overall satisfaction (p= 0,003).Conclusions: Family members were highly satisfied. Those with higher spirituality score were more satisfied and those who were more resilient had less perceived stress. These data suggest that interventions should aim at increasing resilience and providing spiritual assistance to family members of ICU treated patients.

scholarly journals Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study

2020 ◽  
pp. 147451512091938 ◽  
Author(s):  
Runa Sundelin ◽  
Chatarina Bergsten ◽  
Per Tornvall ◽  
Patrik Lyngå
Keyword(s):  
Mixed Methods ◽  
Perceived Stress ◽  
Acute Stress ◽  
Qualitative Interviews ◽  
Takotsubo Syndrome ◽  
Perceived Stress Scale ◽  
Stress Scale ◽  
Number Of Patients

Background A relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients’ self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome. Aims The aim of this study was to describe stress before and after the onset of Takotsubo syndrome. Methods Twenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up. Results Self-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful. Conclusion Patients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.

Sleep in the Intensive Care Unit in a Model of Family-Centered Care

2017 ◽  
Vol 28 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Robert L. Owens ◽  
Truong-Giang Huynh ◽  
Giora Netzer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Circadian Rhythm ◽  
Sleep Deprivation ◽  
Family Members ◽  
Poor Sleep ◽  
Family Centered Care ◽  
Cognition And Emotion ◽  
Centered Care ◽  
Family Centered

The desire for families to be physically present to support their loved ones in the intensive care unit, and guidelines in favor of this open visitation approach, require that clinicians consider both patient and family sleep. This article reviews the causes of poor sleep for patients and their family members in the intensive care unit as well as the expected changes in cognition and emotion that can result from sleep deprivation. Measures are proposed to improve the intensive care unit environment to promote family sleep. A framework to educate family members and engage them in preservation of their and their loved one’s circadian rhythm is also presented. Although further research is needed, the proposed framework has the potential to improve outcomes for patients and their families in the intensive care unit.

A Whirlpool of Stress in Families of Intensive Care Unit Patients: A Qualitative Multicenter Study

2021 ◽  
Vol 41 (3) ◽  
pp. 55-64
Author(s):  
Bahman Aghaie ◽  
Monireh Anoosheh ◽  
Mahshid Foroughan ◽  
Esa Mohammadi ◽  
Anoshirvan Kazemnejad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Family Care ◽  
Critical Care Nurses ◽  
Private Hospitals ◽  
Negative Beliefs ◽  
Semistructured Interviews

Background Family members of patients admitted to the intensive care unit must tolerate high levels of stress, making them emotionally and physically vulnerable. However, little is known about the kinds of stress family members may experience. Objective To explore perceived stress in the families of patients admitted to the intensive care unit. Methods This qualitative content analysis study involved 23 family members of patients admitted to intensive care units. Participants were drawn from family members of patients hospitalized in intensive care units of 3 public and 2 private hospitals. Data were collected through semistructured interviews. Results Three themes emerged from the data: “distrust,” “repeated stress exposure,” and “a whirlpool of persistent negative emotional-physical state.” The first theme had 2 categories: “fearful mindset” and “negative beliefs about professional caregivers.” The second theme also had 2 categories: “fear of the future” and “sustained accumulation of tensions.” The third theme had 3 categories: “impaired mental health,” “impaired physical health,” and “impaired family function.” Conclusions The findings of this study may help critical care nurses better understand the nature and sources of family stresses during a patient’s intensive care unit stay. Supervisory nurses should alert their staff to these issues so that family care programs can address them, thereby reducing family members’ risk of posttraumatic stress disorder and post–intensive care syndrome-family.

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