A randomised controlled trial of a nurse facilitator to promote communication for family members of critically ill patients.
Intensive Care Med
; 50(5): 712-724, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38573403
ABSTRACT
PURPOSE:
Suboptimal communication with clinicians, fragmented care and failure to align with patients' preferences are determinants of post intensive care unit (ICU) burden in family members. Our aim was to evaluate the impact of a nurse facilitator on family psychological burden.METHODS:
We carried out a randomised controlled trial in five ICUs in France comparing standard communication by ICU clinicians to additional communication and support by nurse facilitators. We included patients > 18 years, with expected ICU length of stay > 2 days, chronic life-limiting illness, and their family members. Facilitators were trained to help families to secure care in line with patient's goals, beginning in ICU and continuing for 3 months. Assessments were made at baseline and 1, 3 and 6 months post-randomisation. Primary outcome was the evolution of family symptoms of depression over 6 months using a linear mixed effects model on the depression subscale of the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes included HADS-Anxiety, Impact of Event Scale-6, goal-concordant care and experience of serious illness (QUAL-E).RESULTS:
385 patients and family members were enrolled. Follow-up at 1-, 3- and 6-month was completed by 284 (74%), 264 (68.6%) and 260 (67.5%) family members respectively. The intervention was associated with significantly more formal meetings between the ICU team and the family (1 [1-3] vs 2 [1-4]; p < 0.001). There was no significant difference between the intervention and control groups in evolution of symptoms of depression over 6 months (p = 0.91), nor in symptoms of depression at 6 months [0.53 95% CI (- 0.48; 1.55)]. There were no significant differences in secondary outcomes.CONCLUSION:
This study does not support the use of facilitators for family members of ICU patients.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Relações Profissional-Família
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Família
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Estado Terminal
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Comunicação
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Unidades de Terapia Intensiva
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Intensive Care Med
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Intensive care med
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Intensive care medicine
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França