Spiritual Care in the Intensive Care Unit: Experiences of Dutch Intensive Care Unit Patients and Relatives

A Brief Report: The Role of Spiritual Care in Cardiac Arrests

Background: Communication during cardiac arrest codes is inherently challenging. We designed a quality improvement project wherein chaplains responded to medical/surgical unit cardiac arrest codes. Methods: Chaplains were added to the cardiac arrest alert paging system and responded to these pages. Code alerts and chaplain responses to them were tracked. After four months, chaplains completed a survey to assess their experiences. Results: Chaplains attended a total of 42 codes. Chaplains responded to 19 of 24 daytime working-hour codes and followed up on overnight ones, for a total of 42 code responses. They supported patients, family members or visitors, patient roommates, and medical staff. The overwhelming majority (92%) found providing spiritual care during a cardiac arrest code to be meaningful. Discussion: Chaplains' presence during and after cardiac arrest codes was feasible and perceived as a useful intervention. Adding chaplains to the cardiac arrest code pager allows them to provide support to patients, their families, and staff members during these critical moments.

Spiritual Care Interventions for Adult Patients in Intensive Care Units: A Scoping Review Protocol

Caring for patients in intensive care units (ICUs) requires healthcare workers to recognize the importance of a spiritual care approach in these settings. Moving toward a holistic and patient-centered care model that incorporates spiritual care is essential for enhancing patients' healing process. The disease-centered approach of ICU and the perceived deficit of spiritual care highlight the need to add knowledge on integrating spiritual care interventions into daily ICU practices. The aim of this scoping review will be to develop a comprehensive overview of the characteristics of spiritual care interventions for adult patients in ICU according to JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The inclusion criteria will be informed by the types of participants, concept and context, and types of evidence sources. Quantitative, qualitative and mixed methods studies, editorials, opinion papers and gray literature will be included. Databases such as PubMed (National Library of Medicine), CINAHL, Academic Search Complete, Psychology and Behavioral Sciences Collection, APA PsycINFO, Cochrane Central Register of Controlled Trials (via EBSCOhost), Scopus and Web of Science Core Collection will be searched. No date limit will be set. Titles and abstracts that meet the inclusion criteria, full texts of eligible studies and reference lists of all selected sources will be screened by 2 independent reviewers. Data will be extracted using customized tools, presented in diagrammatic or tabular format and summarized in a final narrative synthesis report. This research represents the first effort to develop a comprehensive overview of the characteristics of spiritual care interventions exclusively targeting adult patients in ICU settings. The findings will offer a thorough review of these interventions, including their main attributes, providers, resources, associated outcomes and assessment tools. Consequently, this knowledge can enhance the spiritual dimension of patient-centered care in the ICU, thereby promoting a shift from the traditional biomedical model to a more holistic perspective and establishing a new standard in critical care.

Investigation of the relationship between spiritual care needs of relatives of patients hospitalized in intensive care unit and intensive care satisfaction in Turkey

BACKGROUND

Relatives of patients admitted to the intensive care unit (ICU) play a crucial role in the care of their loved ones. After a patient's admission to the ICU, family members may be vulnerable to conditions such as depression, anxiety or post-traumatic stress disorder, which can lead to moral concerns.

AIM

The aim of this study was to determine the relationship between the spiritual care needs of family members of patients hospitalized in the ICU and their satisfaction with the ICU.

STUDY DESIGN

In this study, a cross-sectional and correlational design was used. The study was conducted with 291 patient relatives who could be reached by face-to-face questionnaire. Data were collected using the 'Personal Information Form', 'Family Satisfaction Scale in Intensive Care Unit (FS-ICU-24)' and 'Spiritual Care Needs Inventory'.

RESULTS

Spiritual Care Needs Inventory (SCNI) total score was determined as 58.00 ± 15.91. The mean total score of FS-ICU-24 was 86.38 ± 7.12. No significant correlation was found between the mean SCNI total score and the FS-ICU-24 total score (r = .084; p > .05).

CONCLUSIONS

As a result of this research, it was determined that the spiritual care needs of the patients' relatives were at a medium level and their satisfaction with intensive care was high.

RELEVANCE TO CLINICAL PRACTICE

Institutions should establish spiritual care support units for individuals with patients in ICUs and examine the effects of this on individuals.

The spectrum of psychological disorders in family members of patients suffering from delirium associated with critical illness: a prospective, observational study

During intensive care unit admission, relatives of critically ill patients can experience emotional distress. The authors hypothesized that families of patients who are diagnosed with intensive care unit (ICU) delirium experience more profound depression and anxiety disorders related to stress than do families of patients without delirium. We performed a prospective observational single-center study including families of adult patients (age above 18 years) hospitalized in a 17-bed ICU of a university hospital for at least 48 h who completed research questionnaires at day 2 after admission and day 30 after initial evaluation using dedicated questionnaires (HADS, CECS, IES, PTSD-C). A total of 98 family members of patients hospitalized in the ICU were included in the final analysis (50 family members whose relatives were CAM-ICU positive (DEL+), and 48 family members of patients without delirium (DEL-)). No statistically significant differences in demographics and psychosocial data were found between the groups. In the follow-up 30 days after the first conversation with a family member, the mean PTSD score for the relatives of patients with delirium was 11.02 (Me = 13.0; SD = 5.74), and the mean score for nondelirious patients' family members was 6.42 (Me = 5.5; SD = 5.50; p < 0.001). A statistically significant increase in IES scores for family members of patients with delirium was observed for total PTSD (p = 0.001), IES-intrusion (p < 0.001), and IES-hyperarousal (p = 0.002). The prevalence of anxiety symptoms, depression, and posttraumatic stress disorder (PTSD) was higher in families of patients diagnosed with ICU delirium within 48 h of admission to the ICU. No factors increasing the depth of these disorders in family members of patients with ICU delirium were identified. Taking appropriate actions and thus providing families with appropriate support will contribute to the understanding of unfavorable emotional states, including anxiety, stress, depression, anger, agitation, or avoidance.