ICU family communication and health care professionals: A qualitative analysis of perspectives.

OBJECTIVES: Although ineffective communication is known to influence patient and family satisfaction with care in intensive care unit [ICU] settings, there has been little systematic analysis of the features of the perceived problem from a communication theory perspective. This study was undertaken to understand perceptions of miscommunication and the circumstances in which they present. RESEARCH METHODOLOGY AND DESIGN: Semi-structured interviews were conducted with 22 health care professionals [HCPs] in five adult ICUs at an academic medical centre in the United States. FINDINGS: From qualitative analysis of the transcribed interviews, four themes emerged, each containing multiple subthemes. Person factors are problems that originate within individuals, related to education, cultural background and emotion. Structural factors are associated with boundaries and coordination of institutional roles. Information management problems result from social and psychological processes by which HCPs and family members seek, distribute and understand information. Relationship management problems arise from difficulties in interpersonal interactions. CONCLUSIONS: Ineffective communication is not a single problem, but rather several distinct problems that exist at different levels of abstraction and vary in over-time stability. These findings provide a framework for designing interventions to improve the well-being of patients and family members.

The use of psychological first aid (PFA) training among nurses to enhance population resiliency.

Disaster mental health research has found that psychological casualties from a given disaster can be expected to far outnumber physical casualties. Amidst a shortage of mental health professionals and against the backdrop of natural disasters, continued terrorism, and pandemic influenza, there is a striking need to expand and operationalize available human resources to enhance the psychological resiliency of those affected. Through the utilization of psychological first aid (PFA) as an early crisis intervention tool, and by virtue of their occupation and experience, nurses are particularly well-suited to assume a leadership role in expanding the disaster mental health presence beyond the existing cadre of mental health clinicians. Here, we characterize the importance of integrating PFA in the context of other nursing functions, to augment mental health surge capacity in disaster settings.