Impact of an advanced practice family nurse-led support intervention for families of critically ill persons: A mixed method study
Creators: name: Naef, Rahel
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences

description: Background: Families are both important to the well-being and recovery of critically ill persons, and profoundly affected by the critical illness itself. Research reports that around 30% of family members experience adverse post-intensive-care mental health outcomes, which are, among other factors, associated with poor communication, insufficient shared decision-making as well and lack of emotional support by intensive care staff. To increase the quality of family care, a family support intervention is introduced in one ICU, which aims to better address families’ needs for proactive engagement, consistent and constant communication, and emotional and practical support during critical illness Objective: First, to examine the impact of a nurse-led family support intervention on family members’ satisfaction with ICU care, sense of well-being, and post-ICU psychological distress. Second, to investigate families’ and health professionals’ experience with a nurse-led family support intervention in intensive care. Third, to explore health professionals’ attitudes towards and proficiency in working with families before and after implementation of the family support intervention. Design: Mixed method design with a qualitative study embedded in a quasi-experimental before and after study. Setting: A twelve-bed surgical ICU in a 900-bed University Hospital in Switzerland. Participants: A consecutive sample of family members of patients treated in ICU is used. All health professionals working on the study ICU are invited to take part. Intervention: The family support intervention consists of an interprofessional family support pathway and a new role of an advanced practice family nurse. Intervention component include relational family engagement over time, nurse-therapeutic family conversations, and liaison and facilitation of communication between the family and the ICU team. Methods: Data iscollected in two sequential phases, before (control phase, 6 months) and after introduction of the nurse-led family support intervention (intervention phase, 10 months). Data from family members are collected with a written questionnaire (Family Satisfaction in ICU-24 Survey, Hospital Anxiety Depression Scale, Impact of Event Scale-Revised-6) within the first three months post-ICU, and with qualitative interviews (intervention group only). Intervention delivery is recorded in a structured log. Data from ICU staff is obtained through an online survey (Families’ Importance in Nursing Care – Nurse Attitudes, Family Nursing Practice Scale) before and after the implementation of the family support intervention, and through focus group interviews after implementation. Quantitative family member data are analysed using linear mixed-effect models, and two-sided independent t-test for health professional data. Alpha level was set at p &lt; .05. content analysis strategies are used to analyse qualitative data. Relevance and impact: The study generates research-based knowledge about the impact of a nurse-led and interprofessionally-delivered family support intervention in ICU on family members’ satisfaction with ICU care and their psychosocial health. The study will also provide insight into the acceptability, feasibility and benefit of such an intervention from family members’ and health professionals’ perspective. Such knowledge is needed to ensure that the considerable proportion of family members affected by critical illness of a close other who face a high risk for adverse mental health receive effective care and support.