Skip to main content
Erschienen in: Intensive Care Medicine 6/2008

01.06.2008 | Brief Report

Unrecognized contributions of families in the intensive care unit

verfasst von: Jennifer L. McAdam, Shoshana Arai, Kathleen A. Puntillo

Erschienen in: Intensive Care Medicine | Ausgabe 6/2008

Einloggen, um Zugang zu erhalten

Abstract

Objective

To describe the contributions to care that family members perform while their loved one is at high risk of dying in the intensive care unit.

Design

Exploratory, descriptive analysis.

Setting

Two intensive care units at a tertiary medical center in the western United States.

Participants

Through purposive sampling, 25 family members of 24 ICU patients at high risk of dying participated in the study.

Interventions

None.

Measurements and results

A qualitative, descriptive technique was used for data analysis. Three independent raters coded transcripts of audiotaped interviews with family members about their experiences in the ICU. Recurring themes were categorized into roles that family members take on while their loved one is in the ICU. These work roles consisted of active presence, patient protector, facilitator, historian, coach, and voluntary caregiver.

Conclusions

Family members are important to patient care in the ICU. They perform multiple roles that are often not valued or go unrecognized by ICU health care providers. More support and appreciation of family members' contributions to care may provide families opportunities for intimacy and promote a sense of belonging in the highly technical environment of an ICU.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Carlet J, Thijs LG, Antonelli M, Cassell J, Cox P, Hill N, Hinds C, Pimentel JM, Reinhart K, Thompson BT (2004) Challenges in end-of-life care in the ICU. Statement of the 5th International Consensus Conference in Critical Care: Brussels, Belgium. Intensive Care Med 30:770–784PubMedCrossRef Carlet J, Thijs LG, Antonelli M, Cassell J, Cox P, Hill N, Hinds C, Pimentel JM, Reinhart K, Thompson BT (2004) Challenges in end-of-life care in the ICU. Statement of the 5th International Consensus Conference in Critical Care: Brussels, Belgium. Intensive Care Med 30:770–784PubMedCrossRef
2.
Zurück zum Zitat Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, Spuhler V, Todres D, Levy M, Barr J, Ghandi R, Hirsch G, Armstrong D (2007) Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 35:605–622PubMedCrossRef Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, Spuhler V, Todres D, Levy M, Barr J, Ghandi R, Hirsch G, Armstrong D (2007) Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 35:605–622PubMedCrossRef
3.
Zurück zum Zitat McKinley S, Nagy S, Stein-Parbury J, Bramwell M, Hudson J (2002) Vulnerability and security in seriously ill patients in intensive care. Intensive Crit Care Nurs 18:27–36PubMedCrossRef McKinley S, Nagy S, Stein-Parbury J, Bramwell M, Hudson J (2002) Vulnerability and security in seriously ill patients in intensive care. Intensive Crit Care Nurs 18:27–36PubMedCrossRef
4.
Zurück zum Zitat Heyland DK, Rocker GM, Dodek PM, Kutsogiannis DJ, Konopad E, Cook DJ, Peters S, Tranmer JE, O'Callaghan CJ (2002) Family satisfaction with care in the intensive care unit: results of a multiple center study. Crit Care Med 30:1413–1418PubMedCrossRef Heyland DK, Rocker GM, Dodek PM, Kutsogiannis DJ, Konopad E, Cook DJ, Peters S, Tranmer JE, O'Callaghan CJ (2002) Family satisfaction with care in the intensive care unit: results of a multiple center study. Crit Care Med 30:1413–1418PubMedCrossRef
5.
Zurück zum Zitat Bergbom I, Askwall A (2000) The nearest and dearest: a lifeline for ICU patients. Intensive Crit Care Nurs 16:384–395PubMedCrossRef Bergbom I, Askwall A (2000) The nearest and dearest: a lifeline for ICU patients. Intensive Crit Care Nurs 16:384–395PubMedCrossRef
6.
Zurück zum Zitat Lederer MA, Goode T, Dowling J (2005) Origins and development: the Critical Care Family Assistance Program. Chest 128:65S–75SPubMedCrossRef Lederer MA, Goode T, Dowling J (2005) Origins and development: the Critical Care Family Assistance Program. Chest 128:65S–75SPubMedCrossRef
7.
Zurück zum Zitat Johnson SK, Craft M, Titler M, Halm M, Kleiber C, Montgomery LA, Megivern K, Nicholson A, Buckwalter K (1995) Perceived changes in adult family members' roles and responsibilities during critical illness. IMAGE (Journal of Nursing Scholarship) 27:238–243CrossRef Johnson SK, Craft M, Titler M, Halm M, Kleiber C, Montgomery LA, Megivern K, Nicholson A, Buckwalter K (1995) Perceived changes in adult family members' roles and responsibilities during critical illness. IMAGE (Journal of Nursing Scholarship) 27:238–243CrossRef
8.
Zurück zum Zitat Lee LY, Lau YL (2003) Immediate needs of adult family members of adult intensive care patients in Hong Kong. J Clin Nurs 12:490–500PubMedCrossRef Lee LY, Lau YL (2003) Immediate needs of adult family members of adult intensive care patients in Hong Kong. J Clin Nurs 12:490–500PubMedCrossRef
9.
Zurück zum Zitat Auerbach SM, Kiesler DJ, Wartella J, Rausch S, Ward KR, Ivatury R (2005) Optimism, satisfaction with needs met, interpersonal perceptions of the healthcare team, and emotional distress in patients' family members during critical care hospitalization. Am J Crit Care 14:202–210PubMed Auerbach SM, Kiesler DJ, Wartella J, Rausch S, Ward KR, Ivatury R (2005) Optimism, satisfaction with needs met, interpersonal perceptions of the healthcare team, and emotional distress in patients' family members during critical care hospitalization. Am J Crit Care 14:202–210PubMed
10.
Zurück zum Zitat Day L, Puntillo K (2005) What Can Family Members Tell Us About ICU Patient Symptoms. Eleventh World Congress on Pain. Sydney, Australia. 21–26 August (Abstract) Day L, Puntillo K (2005) What Can Family Members Tell Us About ICU Patient Symptoms. Eleventh World Congress on Pain. Sydney, Australia. 21–26 August (Abstract)
11.
Zurück zum Zitat Dowdy MD, Robertson C, Bander JA (1998) A study of proactive ethics consultation for critically and terminally ill patients with extended lengths of stay. Crit Care Med 26:252–259PubMedCrossRef Dowdy MD, Robertson C, Bander JA (1998) A study of proactive ethics consultation for critically and terminally ill patients with extended lengths of stay. Crit Care Med 26:252–259PubMedCrossRef
12.
Zurück zum Zitat Sandelowski M (2000) Whatever happened to qualitative description? Res Nurs Health 23:334–340PubMedCrossRef Sandelowski M (2000) Whatever happened to qualitative description? Res Nurs Health 23:334–340PubMedCrossRef
13.
Zurück zum Zitat Wilson HK (1989) Research in nursing and health, 2nd edn. Addison-Wesley, Redwood City, California Wilson HK (1989) Research in nursing and health, 2nd edn. Addison-Wesley, Redwood City, California
14.
Zurück zum Zitat Murphy MR, Escamilla MI, Blackwell PH, Lucke KT, Miner-Williams D, Shar V, Lewis SL (2007) Assessment of caregivers' willingness to participate in an intervention research study. Res Nurs Health 30:347–355PubMedCrossRef Murphy MR, Escamilla MI, Blackwell PH, Lucke KT, Miner-Williams D, Shar V, Lewis SL (2007) Assessment of caregivers' willingness to participate in an intervention research study. Res Nurs Health 30:347–355PubMedCrossRef
15.
Zurück zum Zitat Molter NC (1979) Needs of relatives of critically ill patients: a descriptive study. Heart Lung 8:332–339PubMed Molter NC (1979) Needs of relatives of critically ill patients: a descriptive study. Heart Lung 8:332–339PubMed
16.
Zurück zum Zitat Leske JS (1986) Needs of relatives of critically ill patients: a follow-up. Heart Lung 15:189–193PubMed Leske JS (1986) Needs of relatives of critically ill patients: a follow-up. Heart Lung 15:189–193PubMed
17.
Zurück zum Zitat Kirchhoff KT, Walker L, Hutton A, Spuhler V, Cole BV, Clemmer T (2002) The vortex: families' experiences with death in the intensive care unit. Am J Crit Care 11:200–209PubMed Kirchhoff KT, Walker L, Hutton A, Spuhler V, Cole BV, Clemmer T (2002) The vortex: families' experiences with death in the intensive care unit. Am J Crit Care 11:200–209PubMed
18.
Zurück zum Zitat Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, Barnoud D, Bleichner G, Bruel C, Choukroun G, Curtis JR, Fieux F, Galliot R, Garrouste-Orgeas M, Georges H, Goldgran-Toledano D, Jourdain M, Loubert G, Reignier J, Saidi F, Souweine B, Vinvent F, Barnes NK, Pochard F, Schlemmer B, Azoulay E (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356:469–478PubMedCrossRef Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, Barnoud D, Bleichner G, Bruel C, Choukroun G, Curtis JR, Fieux F, Galliot R, Garrouste-Orgeas M, Georges H, Goldgran-Toledano D, Jourdain M, Loubert G, Reignier J, Saidi F, Souweine B, Vinvent F, Barnes NK, Pochard F, Schlemmer B, Azoulay E (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356:469–478PubMedCrossRef
19.
Zurück zum Zitat Abbott KH, Sago JG, Breen CM, Abernethy AP, Tulsky JA (2001) Families looking back: one year after discussion of withdrawal or withholding of life-sustaining support. Crit Care Med 29:197–201PubMedCrossRef Abbott KH, Sago JG, Breen CM, Abernethy AP, Tulsky JA (2001) Families looking back: one year after discussion of withdrawal or withholding of life-sustaining support. Crit Care Med 29:197–201PubMedCrossRef
20.
Zurück zum Zitat Engstrom A, Soderberg S (2004) The experiences of partners of critically ill persons in an intensive care unit. Intensive Crit Care Nurs 20:299–310PubMedCrossRef Engstrom A, Soderberg S (2004) The experiences of partners of critically ill persons in an intensive care unit. Intensive Crit Care Nurs 20:299–310PubMedCrossRef
Metadaten
Titel
Unrecognized contributions of families in the intensive care unit
verfasst von
Jennifer L. McAdam
Shoshana Arai
Kathleen A. Puntillo
Publikationsdatum
01.06.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 6/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1066-z

Weitere Artikel der Ausgabe 6/2008

Intensive Care Medicine 6/2008 Zur Ausgabe

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.