The focus of family members' functioning in the acute phase of traumatic coma: part two: Protecting from suffering and protecting what remains to rebuild life.

AIMS The identification and description of the basic psychological process linked with the focus of family members' functioning during the acute phase of traumatic coma. BACKGROUND Earlier research learned that hope is a core category in coping with traumatic coma. Hope seems to be the drive to keep family members going and to enable them to fulfil their main task, namely protecting. In the two articles on the focus of family members functioning, this task is defined and the process linked with it is described. DESIGN A qualitative approach according to the 'grounded theory' method. METHOD Twenty-four in-depth interviews with 22 family members of 16 patients with traumatic coma. RESULTS Family members describe the period after the confrontation with traumatic coma as a battle. During this battle, they feel the urge to protect their relative in coma, other family members and themselves. They go through three phases: protecting life, protecting from suffering, protecting what remains to rebuild life. In this article (Part Two) we describe the phase of protecting from suffering and protecting what remains to rebuild life. CONCLUSIONS All relatives go through the three phases. Family members who have already overcome previous set-backs get through the process slightly more quickly and experience less extreme emotions. RELEVANCE TO CLINICAL PRACTICE Understanding the process of protecting in different phases may help health care professionals to do anything in their power to avoid unnecessary suffering, to ease the pain and to support family members in their task of protecting.

[1]  T. Defloor,et al.  The focus of family members' functioning in the acute phase of traumatic coma: part one: The initial battle and protecting life. , 2010, Journal of clinical nursing.

[2]  T. Turan,et al.  Effect of nursing interventions on stressors of parents of premature infants in neonatal intensive care unit. , 2008, Journal of clinical nursing.

[3]  Engström Åsa,et al.  Close relatives in intensive care from the perspective of critical care nurses. , 2007 .

[4]  T. Defloor,et al.  How does information influence hope in family members of traumatic coma patients in intensive care unit? , 2007, Journal of clinical nursing.

[5]  T. Defloor,et al.  The Process and the Meaning of Hope for Family Members of Traumatic Coma Patients in Intensive Care , 2007, Qualitative health research.

[6]  D. Asch,et al.  Epidemiology and prognosis of coma in daytime television dramas , 2005, BMJ : British Medical Journal.

[7]  T. Defloor,et al.  Stress and coping among families of patients with traumatic brain injury: a review of the literature. , 2005, Journal of clinical nursing.

[8]  J. Cutcliffe,et al.  Adapt or adopt: developing and transgressing the methodological boundaries of grounded theory. , 2005, Journal of advanced nursing.

[9]  Tom Defloor,et al.  The needs and experiences of family members of adult patients in an intensive care unit: a review of the literature. , 2005, Journal of clinical nursing.

[10]  F. Fothergill-Bourbonnais,et al.  Family assessment tools: a review of the literature from 1978-1997. , 2000, Heart & lung : the journal of critical care.

[11]  L. Gelling The role of hope for relatives of critically ill patients: a review of the literature. , 1999, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[12]  D. Dawson,et al.  On the receiving end: experiences of being a relative in critical care. Part 1. , 1999, Nursing in critical care.

[13]  G. Burr,et al.  Contextualizing critical care family needs through triangulation: an Australian study. , 1998, Intensive & critical care nursing.

[14]  N. Warren,et al.  Perceived and Unmet Needs of Critical Care Family Members , 1998, Critical care nursing quarterly.

[15]  F. Wester,et al.  In the Shadow: The Impact of Chronic Illness on the Patient's Partner , 1998, Qualitative health research.

[16]  G. Burr The family and critical care nursing: a brief review of the literature. , 1997, Australian critical care : official journal of the Confederation of Australian Critical Care Nurses.

[17]  M. Bott,et al.  The experiences of families with a relative in the intensive care unit. , 1996, Heart & lung : the journal of critical care.

[18]  Susan K. Johnson,et al.  Perceived changes in adult family members' roles and responsibilities during critical illness. , 1995, Image--the journal of nursing scholarship.

[19]  J. Morse,et al.  Preserving self: from victim, to patient, to disabled person. , 1995, Journal of advanced nursing.

[20]  N. Warren The phenomena of nurses' caring behaviors as perceived by the critical care family , 1994, Critical care nursing quarterly.

[21]  S. Davis-Martin Perceived needs of families of long-term critical care patients: a brief report. , 1994, Heart & lung : the journal of critical care.

[22]  Maureen Engli,et al.  Needs of Family Members of Critically III Patients With and Without Acute Brain Injury , 1993, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[23]  L. Chappel-Aiken,et al.  Traumatic Brain Injury: A Family Experience , 1992, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[24]  M. Powers,et al.  Needs of family members of intensive care unit patients. , 1992, Applied nursing research : ANR.

[25]  T. Freichels Needs of family members of patients in the intensive care unit over time , 1991, Critical care nursing quarterly.

[26]  E. Rukholm,et al.  Needs and anxiety levels in relatives of intensive care unit patients. , 1991, Journal of advanced nursing.

[27]  M. Hickey What are the needs of families of critically ill patients? A review of the literature since 1976. , 1990, Heart & lung : the journal of critical care.

[28]  S. Thorne,et al.  Guarded alliance: health care relationships in chronic illness. , 1989, Image--the journal of nursing scholarship.

[29]  C. H. Campbell Needs of Relatives and Helpfulness of Support Groups in Severe Head Injury , 1988, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[30]  A. Bellinger,et al.  Need satisfaction levels of family members of critical care patients and accuracy of nurses' perceptions. , 1988, Heart & lung : the journal of critical care.

[31]  J. Leske Needs of relatives of critically ill patients: a follow-up. , 1986, Heart & lung : the journal of critical care.

[32]  L. Norris,et al.  Investigation of selected psychosocial needs of family members of critically ill adult patients. , 1986, Heart & lung : the journal of critical care.

[33]  L. Daley,et al.  The perceived immediate needs of families with relatives in the intensive care setting. , 1984, Heart & lung : the journal of critical care.

[34]  Stillwell Sb Importance of visiting needs as perceived by family members of patients in the intensive care unit. , 1984 .

[35]  M. Mathis Personal Needs of Family Members of Critically Ill Patients With and Without Acute Brain Injury , 1984, Journal of neurosurgical nursing.

[36]  Molter Nc Needs of relatives of critically ill patients: a descriptive study. , 1979, Heart & lung : the journal of critical care.

[37]  S. Hampe Needs of the Grieving Spouse in a Hospital Setting , 1975, Kango kenkyu. The Japanese journal of nursing research.

[38]  P. Ferdinande,et al.  Needs of relatives of critical care patients: perceptions of relatives, physicians and nurses , 2001, Intensive Care Medicine.

[39]  J. Kreutzer,et al.  Family needs after traumatic brain injury: a factor analytic study of the Family Needs Questionnaire. , 1997, Brain injury.

[40]  K. Buckwalter,et al.  Emotional responses of family members during a critical care hospitalization. , 1994, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[41]  M. Titler,et al.  Impact of adult critical care hospitalization: perceptions of patients, spouses, children, and nurses. , 1991, Heart & lung : the journal of critical care.

[42]  D. Forrester,et al.  Critical care family needs in an urban teaching medical center. , 1991, Heart & lung : the journal of critical care.

[43]  J. Jacono,et al.  Comparison of perceived needs of family members between registered nurses and family members of critically ill patients in intensive care and neonatal intensive care units. , 1990, Heart & lung : the journal of critical care.

[44]  D. Forrester,et al.  Critical care family needs: nurse-family member confederate pairs. , 1990, Heart & lung : the journal of critical care.

[45]  M. Koch,et al.  Informational needs of families of intensive care unit patients. , 1986, QRB. Quality review bulletin.