scholarly journals The Effect of Information Booklets on Family Members’ Satisfaction with Decision Making in an Intensive Care Unit of Malaysia

2016 ◽  
Vol 8 (2) ◽  
pp. 128-132 ◽  
Author(s):  
Hamidah Othman ◽  
Pathmawathi Subramanian ◽  
Noor Azizah Mohd Ali ◽  
Haszalina Hassan ◽  
Mainul Haque
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Family Members

Admission of the very elderly to the intensive care unit: Family members’ perspectives on clinical decision-making from a multicenter cohort study

2015 ◽  
Vol 29 (4) ◽  
pp. 324-335 ◽  
Author(s):  
Daren K Heyland ◽  
Peter Dodek ◽  
Sangeeta Mehta ◽  
Deborah Cook ◽  
Allan Garland ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Cohort Study ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Family Members ◽  
Very Elderly

Background: Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. Aim: To describe family members’ perspectives about care provided to very elderly critically ill patients. Design: Multicenter, prospective, cohort study. Participants and setting: In total, 535 family members of patients aged 80 years or older admitted to 22 intensive care units for more than 24 h. Results: Family members reported that the “patient be comfortable and suffer as little as possible” was their most important value and “the belief that life should be preserved at all costs” was their least important value considered in making treatment decisions. Most family members (57.9%) preferred that life support be used for their family member, whereas 24.1% preferred comfort measures only, and 14.4% were unsure of their treatment preferences. Only 57.3% reported that a doctor had talked to them about treatment options for the patient. Overall, 29.7% of patients received life-sustaining treatments for more than 7 days and 50.3% of these died in hospital. Families were most satisfied with the skill and competency of nurses and least satisfied with being included and supported in the decision-making process and with their sense of control over the patient’s care. Conclusion: There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.

Beyond the hour of death: Family experiences of grief and bereavement following an end-of-life hospitalization in the intensive care unit

2020 ◽  
pp. 136345932094647
Author(s):  
Julia I Bandini
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Family Experiences ◽  
End Of Life Decision ◽  
Life Decision

End-of-life decision-making is an important area of research, and few sociological studies have considered family grief in light of end-of-life decision-making in the hospital. Drawing on in-depth interviews with family members in the intensive care unit (ICU) during an end-of-life hospitalization and into their bereavement period up to six months after the death of the patient, this article examines bereaved family members’ experiences of grief by examining three aspects from the end-of-life hospitalization and decision-making in the ICU that informed their subsequent bereavement experiences. First, this article explores how the process of advance care planning (ACP) shaped family experiences of grief, by demonstrating that even prior informal conversations around end-of-life care outside of having an advance directive in the hospital was beneficial for family members both during the hospitalization and afterwards in bereavement. Second, clinicians’ compassionate caring for both patients and families through the “little things” or small gestures were important to families during the end-of-life hospitalization and afterwards in bereavement. Third, the transition time in the hospital before the patient’s death facilitated family experiences of grief by providing a sense of support and meaning in bereavement. The findings have implications for clinicians who provide end-of-life care by highlighting salient aspects from the hospitalization that may shape family grief following the patient’s death. Most importantly, the notion that ACP as a social process may be a “gift” to families during end-of-life decision-making and carry through into bereavement can serve as a motivator to engage patients in ACP.

Symptoms of anxiety and depression in family members of intensive care unit patients: Ethical hypothesis regarding decision-making capacity

2001 ◽  
Vol 29 (10) ◽  
pp. 1893-1897 ◽  
Author(s):  
Frédéric Pochard ◽  
Elie Azoulay ◽  
Sylvie Chevret ◽  
François Lemaire ◽  
Philippe Hubert ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Family Members ◽  
Anxiety And Depression ◽  
Decision Making Capacity

scholarly journals Developing Family Satisfaction with Care in Adult Critical Care Public Hospital Terengganu, Malaysia

2021 ◽  
pp. 31-35
Author(s):  
Wan Nor Aliza Wan Abdul Rahman ◽  
Abdul Karim Othman ◽  
Yuzana Mohd Yusop ◽  
Asyraf Afthanorhan ◽  
Hasnah Zani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Shared Decision Making ◽  
Family Members ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Shared Decision ◽  
Cross Sectional ◽  
The Family

In admissions to the intensive care unit (ICU), there is a high possibility of a life-threatening condition and possible emotional distress for family members. When the family is distressed and hospitalized, a significant level of stress and anxiety will be generated among family members, thereby decreasing their ability to make responsible decisions. As a result, the family members need full and up-to-date details, helping them to retain hope, and this contributes to lower stress levels. While there is growing evidence of the effectiveness of shared decision-making for family members who are directly involved in decisions, particularly regarding shared decision-making in the Malaysian context, there is less evidence that supported decisions help overall outcome. This study aims to developing the family satisfaction with decision making in the Intensive Care Unit (FS-ICU)-33 Malay language version of family member’s satisfaction with care and decision making during their stay at the intensive care units. A quantitative, cross-sectional validation study and purposive sampling was conducted from 1st November 2017 and 10 October 2018 to January 2020 among 208 of family members.  The family members of the ICU patients involved in this study had an excellent satisfaction level with service care. Higher satisfaction in ICU care resulting in higher decision-making satisfaction and vice versa.

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

scholarly journals Measuring Family Satisfaction With Care Delivered in the Intensive Care Unit

2016 ◽  
Vol 36 (6) ◽  
pp. e8-e14 ◽  
Author(s):  
Kathleen Clark ◽  
Kerry A. Milner ◽  
Marlene Beck ◽  
Virginia Mason
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Family Members ◽  
Family Satisfaction ◽  
Surgical Intensive Care Unit ◽  
Satisfaction With Care ◽  
Free Text ◽  
The Mean

BackgroundIn our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families’ needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families’ satisfaction with care in this setting.ObjectiveTo implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit. To assess the feasibility of the selected tool for measuring family satisfaction and to make recommendations that are based on the results.MethodA descriptive survey design using the Family Satisfaction in the Intensive Care Unit 24-item questionnaire to measure satisfaction with care and decision-making.ResultsForty family members completed the survey. Overall, the mean score for families’ satisfaction with care was 72.24% (SD, 14.87%) and the mean score for families’ satisfaction with decision-making was 72.03% (SD, 16.61%). Families reported that nurses put them at ease and provided understandable explanations. Collaboration, inclusion of families in clinical discussions, and timely information regarding changes in the patient’s condition were the most common points brought up in free-text responses from family members. Written communication, including directions and expectations, would have improved the families’ experience.ConclusionAlthough patients’ family members reported being satisfied with their experience in the intensive care unit, there is room for improvement. Effective communication among the health care team, patients’ families, and patients will be targeted for quality improvement initiatives.

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 At the end: A vignette-based investigation of strategies for managing end-of-life decisions in the intensive care unit

2020 ◽  
pp. 175114372095472
Author(s):  
Tom W Reader ◽  
Ria Dayal ◽  
Stephen J Brett
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
End Of Life ◽  
Family Members ◽  
Decision Makers ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Background Decision-making on end-of-life is an inevitable, yet highly complex, aspect of intensive care decision-making. End-of-life decisions can be challenging both in terms of clinical judgement and social interaction with families, and these two processes often become intertwined. This is especially apparent at times when clinicians are required to seek the views of surrogate decision makers (i.e., family members) when considering palliative care. Methods Using a vignette-based interview methodology, we explored how interactions with family members influence end-of-life decisions by intensive care unit clinicians ( n = 24), and identified strategies for reaching consensus with families during this highly emotional phase of care. Results We found that the enactment of end-of-life decisions were reported as being affected by a form of loss aversion, whereby concerns over the consequences of not reaching a consensus with families weighed heavily in the minds of clinicians. Fear of conflict with families tended to arise from anticipated unrealistic family expectations of care, family normalization of patient incapacity, and belief systems that prohibit end-of-life decision-making. Conclusions To support decision makers in reaching consensus, various strategies for effective, coherent, and targeted communication (e.g., on patient deterioration and limits of clinical treatment) were suggested as ways to effectively consult with families on end-of-life decision-making.

scholarly journals Family satisfaction in the trauma and surgical intensive care unit: another important quality measure

2019 ◽  
Vol 4 (1) ◽  
pp. e000302
Author(s):  
Tom Maxim ◽  
Agustin Alvarez ◽  
Yvonne Hojberg ◽  
Derek Antoku ◽  
Chioma Moneme ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Language Translation ◽  
Family Members ◽  
Family Satisfaction ◽  
Surgical Intensive Care Unit ◽  
Satisfaction With Care ◽  
Surgical Intensive Care ◽  
Total Satisfaction

BackgroundA growing body of research has explored patient satisfaction as one of the healthcare quality measures. To date, scarce data are available regarding family experience in the trauma and surgical intensive care unit (TSICU). The purpose of this study was to describe and analyze the results of a family satisfaction survey in the TSICU.MethodsFamily members of patients at a level 1 trauma center were invited to participate in this study after 72 hours of intensive care unit stay. Participants completed a modified version of the Family Satisfaction in the Intensive Care Unit questionnaire, a validated survey measuring family satisfaction with care and decision-making. Data collection spanned from April 2016 to July 2017. Patient characteristics were compiled from the medical record. Quantitative analysis was performed using a 5-point Likert score, converted to a scale of 0 (poor) to 100 (excellent).ResultsThe overall response rate was 78.6%. Of the 103 family members for 88 patients, most were young (median age: 41 years) and female (75%). Language fluency was 44.6% English-only, 31.7% Spanish-only, and 23.8% bilingual. Mean summary family satisfaction scores (±SD) were 80.6±26.4 for satisfaction with care, 79.3±27.1 for satisfaction with decision-making, and 80.1±26.7 for total satisfaction. Respondents were less satisfied with the frequency of communication with physicians (70.7±27.4) and language translation (73.2±31.2).DiscussionOverall family satisfaction with the care provided to patients in the TSICU is high, although opportunities for improvement were noted in the frequency of communication between physicians and family and language translation services. Further quality improvement projects are warranted.Level of evidenceCare management study: level V.

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