The identification of family members' contribution to patients' care in the intensive care unit: a naturalistic inquiry.

The admission of a patient to an intensive care unit (ICU) is recognized as being a stressful experience for their families. Many studies have focused on the needs of families within ICU, but few have highlighted the unique contribution that family members make towards patient care and recovery. Using a naturalistic approach, data were collected through observation, video recording, in-depth interviewing and reflective video analysis to explore the processes and factors underpinning families' contribution to patient care. The findings can be grouped into three themes: getting to know the patient through the family, family contribution to care and the nurses' role in supporting families of ICU patients. Families can have a very positive influence on the patient's care and recovery from ICU, but both the family members, and in turn the nursing staff, need to be supported appropriately if this valuable contribution to patient care is to be maximized and maintained.

[1]  J. Hardicre.  Meeting the needs of families of patients in intensive care units. , 2003, Nursing times.

[2]  C. Crocker.  Nurse led weaning from ventilatory and respiratory support. , 2002, Intensive & critical care nursing.

[3]  G. Wojnicki-Johansson.  Communication between nurse and patient during ventilator treatment: patient reports and RN evaluations. , 2001, Intensive & critical care nursing.

[4]  A. Green.  An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit. , 1996, Intensive & critical care nursing.

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

[6]  P. Stern.  Grounded theory methodology: its uses and processes. , 1980, Image.

[7]  L. Lee,et al.  Immediate needs of adult family members of adult intensive care patients in Hong Kong. , 2003, Journal of clinical nursing.

[8]  P. Wilkinson.  A qualitative study to establish the self-perceived needs of family members of patients in a general intensive care unit. , 1995, Intensive & critical care nursing.

[9]  H. Laitinen.  Patients' experience of confusion in the intensive care unit following cardiac surgery. , 1996, Intensive & critical care nursing.

[10]  S Russell,et al.  An exploratory study of patients' perceptions, memories and experiences of an intensive care unit. , 1999, Journal of advanced nursing.

[11]  Lynne Harrison,et al.  Families, nurses and intensive care patients: a review of the literature. , 2002, Journal of clinical nursing.

[12]  L. Menzel.  Ventilated Patients’ Self-Esteem during Intubation and after Extubation , 1999, Clinical nursing research.

[13]  C. Tanner,et al.  The phenomenology of knowing the patient. , 1993, Image--the journal of nursing scholarship.

[14]  A. Price.  Intensive care nurses' experiences of assessing and dealing with patients' psychological needs. , 2004, Nursing in critical care.

[15]  P. Munhall.  Ethical Considerations in Qualitative Research , 1988, Western journal of nursing research.

[16]  J. Jenny,et al.  Knowing the patient: one aspect of clinical knowledge. , 1992, Image--the journal of nursing scholarship.

[17]  Issues concerning the familiarity of researchers with the research setting. , 1994, Journal of advanced nursing.

[18]  P. Benner,et al.  Clinical judgment: how expert nurses use intuition. , 1987, The American journal of nursing.

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

[20]  M. Coulter.  The needs of family members of patients in intensive care units. , 1989, Intensive care nursing.

[21]  Factors influencing the patient during weaning from mechanical ventilation: a national survey. , 2002, Intensive & critical care nursing.

[22]  Sally Brown,et al.  A bereavement after-care service for intensive care relatives and staff: the story so far. , 2003, Nursing in critical care.

[23]  A comparison of patients' communication-related responses during intubation and after extubation. , 1997, Heart & lung : the journal of critical care.

[24]  I Bergbom-Engberg,et al.  Assessment of patients' experience of discomforts during respirator therapy , 1989, Critical care medicine.

[25]  J. Chevrolet,et al.  Influence of the quality of nursing on the duration of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease. , 1995, Critical care medicine.

[26]  Rita Seeger Jablonski,et al.  The Experience of Being Mechanically Ventilated , 1994 .

[27]  M. Topf,et al.  Effects of critical care unit noise on the subjective quality of sleep. , 1996, Journal of advanced nursing.

[28]  D. Lundberg,et al.  Acute confusion and unreal experiences in intensive care patients in relation to the ICU syndrome. Part II. , 1999, Intensive & critical care nursing.

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

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

[31]  S. Eisendrath,et al.  Families in the intensive care unit: their effect on staff. , 1983, Heart & lung : the journal of critical care.

[32]  R Behi,et al.  Triangulation: the best of all worlds? , 1995, British journal of nursing.

[33]  F. Hammond.  Involving families in care within the intensive care environment: a descriptive survey. , 1995, Intensive & critical care nursing.

[34]  Douglas Harper,et al.  The visual ethnographic narrative 1 , 1987 .

[35]  D. Lundberg,et al.  Patients' experience of being critically ill or severely injured and cared for in an intensive care unit in relation to the ICU syndrome. Part I. , 1998, Intensive & critical care nursing.