The Association of Spiritual Care Providers’ Activities With Family Members’ Satisfaction With Care After a Death in the ICU*

Abstract

Objective Spiritual distress is common in the ICU, and spiritual care providers are often called upon to provide care for patients and their families. Our goal was to evaluate the activities spiritual care providers’ conduct to support patients and families, and whether those activities are associated with family satisfaction with ICU care. Design Prospective cohort study. Setting 350-bed, 65-ICU bed tertiary care teaching hospital. Subjects Spiritual care providers and family members of patients who died in the ICU or within 30 hours of transfer from the ICU. Measurements Spiritual care providers completed surveys reporting their activities. Family members completed validated measures of satisfaction with care and satisfaction with spiritual care. Clustered regression was used to assess the association between activities completed by spiritual care providers and family ratings of care. Results Of 494 eligible patients, 275 family members completed surveys (response rate, 56%). Fifty-seven spiritual care providers received surveys relating to 268 patients, completing 285 surveys for 244 patients (response rate, 91%). Spiritual care providers commonly reported activities related to supporting religious and spiritual needs (>=90%) and providing support for family feelings (90%). Discussions about the patient’s wishes for end-of-life care and a greater number of spiritual care activities performed were both associated with increased overall family satisfaction with ICU care (p<0.05). Discussions about a patient’s end-of-life wishes, preparation for a family conference, and total number of activities performed were associated with improved family satisfaction with decision-making in the ICU (p<0.05). Conclusions Spiritual care providers engage in a variety of activities with families of ICU patients; several are associated with increased family satisfaction with ICU care in general and decision-making in the ICU specifically. These findings provide insight into spiritual care provider activities and provide guidance for interventions to improve spiritual care delivered to families of critically ill patients.

Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families’ satisfaction with adult critical care services in the NHS

“…9,10,53,54,[59][60][61][62][63][64][65][66][67][68][69][70][71]76,77 These studies are reported between 2002 and 2014.…”

“…Most of the studies were based in North America -the USA (n = 9) 53,54,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][76][77][78][79][80] and Canada (n = 3) 9,10,56,74 -with other studies based in Greece (n = 2), 41,42 Switzerland (n = 2), 17,55 Germany (n = 1), 39 Israel (n = 1), 57 the Netherlands (n = 1), 75 the Philippines (n = 1) 38 and Turkey (n = 1). 40 Nine studies were single centre, with the remainder being multicentre, ranging from 2 to 23 centres.…”

A Novel Picture Guide to Improve Spiritual Care and Reduce Anxiety in Mechanically Ventilated Adults in the Intensive Care Unit

“…We specifically measured participants' emotions, showed improvement in symptoms of anxiety and stress, and elicited feedback that suggests spiritual care helps ICU survivors cope with critical illness. Prior studies have shown that chaplain-led spiritual care improves family satisfaction with end-of-life care in the ICU (23,24), but our study is the first to proactively and systematically engage mechanically ventilated ICU patients who are not necessarily dying. With technological advances, many critically ill patients now survive what were previously fatal illnesses (40,41), but survivors of mechanical ventilation are increasingly recognized to suffer from anxiety, depression, and posttraumatic stress disorder (42)(43)(44).…”

“…took the chaplain a median (IQR) of 18 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) minutes to both use the card with participants and provide a desired spiritual care intervention (Table 2). For 34 participants (68%), identifying a spiritual affiliation consisted of the chaplain pointing to the affiliation on the card that was listed in the medical record or given by family members and observing the subject nod in acknowledgment.…”

“…Although previous studies in the ICU have shown that chaplain care is associated with increased family satisfaction (23,24), the focus has traditionally been on the family members of dying patients and not the patients themselves (25). There is growing recognition of a need for a comprehensive approach to providing proactive spiritual support to ICU patients (24)(25)(26)(27)(28).…”