Nurses’ roles with families: Perceptions of ICU nurses

El-Masri, Maher M; Fox-Wasylyshyn, Susan M.

doi:10.1016/j.iccn.2006.07.003

Cited by 29 publications

(27 citation statements)

References 20 publications

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“…This investigator-developed instrument was derived from a review of the literature and 2 established measures. 2,19 The QFIFE is a 15-item questionnaire that consists of 4 subscales: (1) ICU environment (items 1–5), (2) patient acuity (items 6–7), (3) nurse workflow (items 8–10), and (4) attitude toward family caregiver engagement in care (items 11–15). These subscales measure the nurse perceptions of the physical environment and culture of the ICU, clinical stability of the patient, disruptive workflow, and the attitude toward family engagement in the delivery of ICU care.…”

Section: Methodsmentioning

confidence: 99%

“…However, the literature provides evidence that critical care nurses express resistance to involving family caregivers because of misconceptions such as families’ interfering with care, exhausting the patient, and spreading infection. 2,19–21 Nurses have expressed concerns regarding the safety of family engagement in care in relationship to patients’ severity of illness and their fluctuations in acuity while receiving care in the ICU. 2,4,14,18,20,22,23 …”

mentioning

confidence: 99%

“…Nursing workflow seems to mediate the effects of the ICU environment and patient acuity on nurses’ attitudes toward family engagement. 17–19,23 …”

mentioning

confidence: 99%

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Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Hetland

Hickman

McAndrew

et al. 2017

AACN Advanced Critical Care

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Critical care nurses are vital to promoting family engagement in the intensive care unit. However, nurses have varying perceptions about how much family members should be involved. The Questionnaire on Factors That Influence Family Engagement was given to a national sample of 433 critical care nurses. This correlational study explored the impact of nurse and organizational characteristics on barriers and facilitators to family engagement. Study results indicate that (1) nurses were most likely to invite family caregivers to provide simple daily care; (2) age, degree earned, critical care experience, hospital location, unit type, and staffing ratios influenced the scores; and (3) nursing workflow partially mediated the relationships between the intensive care unit environment and nurses' attitudes and between patient acuity and nurses' attitudes. These results help inform nursing leaders on ways to promote nurse support of active family engagement in the intensive care unit.Keywords critical care; family caregivers; family-centered nursing; family engagement An increasing number of Americans require treatment in the intensive care unit (ICU), and a proportional increase in family caregivers will assume caregiving responsibilities that can have persistent negative effects on their health and overall quality of life. [1][2][3][4][5][6] The conventional ICU care paradigm has primarily targeted the informational needs of family Breanna Hetland is Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH (bdh66@case.edu). HHS Public AccessAuthor manuscript AACN Adv Crit Care. Author manuscript; available in PMC 2017 September 07. Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript caregivers of the critically ill, but has not addressed how to actively engage caregivers in other aspects of the ICU experience such as symptom assessment and the direct provision of care. [7][8][9][10] Although critical care research, policy, and practice guidelines 9,10 increasingly recognize family caregivers as part of a larger patient-provider interaction during critical illness, the literature on family caregiver engagement in this context mainly focuses on passive forms of involvement such as family presence, communication, and decisionmaking. Few studies address family caregivers' active contributions to patient care. 7,8,[11][12][13][14][15][16][17][18] Patient and family engagement are defined as active partnerships among health care providers, patients, and families. 7 Identifying effective ways to implement patient and family engagement is paramount to improving the patient and family experience as well as improving safety, quality, and delivery of care. [7][8][9] In the ICU, critical care nurses are the frontline providers of life-sustaining care and key staff members in promoting patient and family engagement. However, the literature provides evidence that critical care nurses express resistance to involving family caregivers because of misconception...

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Hetland

Hickman

McAndrew

et al. 2017

AACN Advanced Critical Care

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“…Admission to intensive care triggers a variety of emotional and psychological responses in the relatives that often manifest in the form of distress, anxiety, anger, guilt, and fear. Such responses can impede the ability of family members to exercise effective coping strategies (18). In many cases, relatives are so distressed or overwhelmed in the first chaotic phase of admission of their loved one that they cannot fully understand the information provided during the acute phase; at least their understanding is selective.…”

Section: Dilemma 1: Are Proxies Competent Enough During the Acute Phamentioning

confidence: 99%

Deferred proxy consent in emergency critical care research: Ethically valid and practically feasible

Jansen

Kompanje

Bakker

2009

Critical Care Medicine

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Important ethical aspects apply to the process of obtaining consent in emergency critical care research: the incapacity of almost all patients for giving informed consent and the emergency and life-threatening nature of the conditions involved, resulting in short therapeutic time frames. We argue that deferred proxy consent is the preferable substitute for informed patient consent in emergency critical care research. However, researchers can face two problems when using this consent procedure. First, can proxies give a valid judgment for consent or refusal in the acute phase of the life-threatening illness of their relative, and second, what should researchers do with already obtained data when study procedures are finished (e.g., because the patient has died) before proxies can be informed and consent be sought? We propose approaching the relatives with information about the trial and asking them for consent only if it is ethically valid to do so. The first psychological distress may prohibit a complete understanding of the information, which is necessary for a true and valid informed proxy consent. In addition, we recommend using the study data if study procedures are finished before proxies can be informed and consent be sought, provided sufficient privacy measures have been applied.

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“…As found, nurses who communicated with the families of patients and help them in caring had a feeling of being usefulness and calmness [25].…”

Section: Journal Of Infectious Diseases and Medicinementioning

confidence: 94%

The Effect of Educational Program on Status Care in Patients with Tracheostomy and Families’ Anxiety After Discharge

Shiva¹,

Beheshte²,

Maria³

2017

J Infect Dis Med

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Introduction: Diseases and their pertained treatments are of the major cases led to suffering from anxiety. Anxiety, in fact, is an informing process and influences the quality of life of patients and their families and endangers their improvement in case of being continued. Tracheostomy is one of the methods creating artificial air passage and it will be superior over other techniques and performed for a long time in case of needing the artificial air passage. Caring patients with Tracheostomy is very important and stressful; the anxiety of families can deeply influence their ability in decision making and causes the decrease of care skills and their performance in caring patients. Considering the importance of the issue, the purpose of the present study has been to evaluate the changes resulted by the components of educational program provided for patients' families to improve their performance and decrease their anxiety after discharge in 2012-2013.

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Nurses’ roles with families: Perceptions of ICU nurses

Cited by 29 publications

References 20 publications

Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Deferred proxy consent in emergency critical care research: Ethically valid and practically feasible

The Effect of Educational Program on Status Care in Patients with Tracheostomy and Families’ Anxiety After Discharge

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