Needs of Chinese families with a relative in a critical care unit

Needs and experiences of intensive care patients' families: a Saudi qualitative study

AIM

To identify the perceived needs of Saudi families of patients in Intensive Care in relation to their culture and religion.

BACKGROUND

Admission of a family member to an intensive care unit (ICU) is a deeply distressing and often unexpected life event to the family. Families of critically ill patients have needs that should be acknowledged and met by the ICU team. Literature is virtually silent on the issue of recognizing the ICU family needs in relation to the influence of their cultural values and religious beliefs.

DESIGN

A descriptive exploratory qualitative study.

METHOD

Individual, semi-structured interviews of a purposive sample of 12 family members were carried out between November 2011 and February 2012. The closest family members were recruited to participate in the interviews with a mean age of 44·25 years in eight mixed medical-surgical ICUs of eight major trauma hospitals in Saudi Arabia.

RESULTS

The family needs and experiences are described via six major themes: looking for information, maintaining reassurance, spiritual healing, maintaining close proximity, involvement in care and support not being facilitated. The results indicated that family members sought to access information readily to diminish their anxiety. They also needed to be reassured that the best care was being delivered to their loved one and to feel supported during this critical time. Saudi families have cultural and spiritual healing beliefs and practices including faith in God and that God is the ultimate healer, reading of the Qur'an, prayer and charity. These lessen their stress and connect them to hold on to hope. In addition, maintaining proximity to their ill family member was considered of the greatest importance to the families.

CONCLUSION

The study provided an in-depth understanding of the family members' experience of having a relative in Intensive Care and focussed on a range of unmet needs, particularly those related to culture and religion. The ICU team need to work collaboratively with family members to improve their experience.

RELEVANCE TO PRACTICE

The recognition of family needs, experiences and situations can enhance the care provided by the critical care team to patients and families.

Families' needs of critical care Muslim patients in Saudi Arabia: a quantitative study

AIM

To identify the needs of families of adult intensive care unit (ICU) patients in Saudi Arabia as perceived by family members and health care providers.

BACKGROUND

Family members of critically ill patients are likely to have specific needs that should be addressed by the critical care team and which, if unmet, may produce stress for patients' families and health care providers. The literature has yet to identify the needs of Muslim families in relation to religious beliefs and cultural values in critical care settings in Saudi Arabia.

DESIGN

A cross-sectional survey design.

METHOD

A total of 176 family members and 497 intensive health care providers were recruited from eight adult mixed medical-surgical ICUs between November 2011 and February 2012 utilizing a four-point Likert type scale self-administered questionnaire.

RESULTS

The findings revealed that family members and health care providers ranked assurance, information and cultural and spiritual needs as the most important, and support and proximity as least important. There were significant differences in the mean values found between family members and health care providers. A significant finding not identified in other studies was 'The need to have the health care providers handle the body of the dead Muslim with extreme caution and respect' which, under the dimension of cultural and spiritual needs, was perceived by family members to be the most important and by the health care providers as the fifth most important need.

CONCLUSION

The recognition of family needs in the critical care unit informed the development of interventions to meet family needs and improve the care quality.

Family member presence during resuscitation in the emergency department: An Australian perspective

OBJECTIVE

The practice of family member presence during resuscitation in the ED has attracted widespread attention over the last few decades. Despite the recommendations of international organizations, clinical staff remain reluctant to engage in this practice in many EDs. This paper separates the evidence from opinion to determine the current state of knowledge about this practice.

METHODS

A search strategy was developed and used to locate research based publications, which were subsequently reviewed for the strength of evidence providing the basis for recommendations.

RESULTS

The literature was examined to reveal what patients and their family members want; the outcomes of family presence during resuscitation for patients and their family members; staff views and practices regarding family presence during resuscitation. Findings suggest that providing the opportunity to be with their critically ill family member is both important to and beneficial for families, however, disparity in staff views has been identified as a major obstacle to family presence during resuscitation. Examination of published guidelines and staff practices described in the literature revealed consistent elements.

CONCLUSION

Although critics point to the lack of rigour in this body of literature, the current state of knowledge suggests merit in pursuing future research to examine and measure effects of family member presence during resuscitation on patients, family members and healthcare providers.