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Family Health Conversations Versus Support Group Conversations When a Family Member Has Been Critically Ill: A Mixed Methods Study
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.ORCID iD: 0000-0001-5132-0045
Linnaeus Univ, Sweden.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-1588-135X
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Thoracic and Vascular Surgery.
2021 (English)In: Families, Systems & Health, ISSN 1091-7527, E-ISSN 1939-0602, Vol. 39, no 2, p. 293-305Article in journal (Refereed) Published
Abstract [en]

Introduction: When a family member has been critically ill and cared for at an intensive care unit the individual family member as well as the family system are affected and in need of support. The aim of this study was to compare and contrast the responses from 2 different types of follow-up interventions for families of critically ill persons, focusing on individual hopes, health-related quality of life, family functioning and ability to cope with challenges. Method: Adult family members from 3 hospitals attended 1 of 2 interventions 2 months after intensive care. The family health conversation included the family. The support group conversation included just family members and not the patient who had experienced intensive care. Data were collected via self-reported questionnaires and follow-up interviews with family members. Quantitative and qualitative data were first analyzed separately, and the results were then integrated through mixed methods analysis. Results: A total of 38 family members took part in the interventions. Family members in the 2 intervention groups talked about how they had more hope for the future, and about how talking within the family and the group had helped them justify their feelings, which empowered them in the transition toward a healthier quality of life. Comparisons of the interventions show a higher significance of family function and hope in the family health conversation. Discussion: The article illustrates a disparity between how family members function and the needs they have for follow-up. We discuss what kind of follow-up these persons need.

Place, publisher, year, edition, pages
EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC , 2021. Vol. 39, no 2, p. 293-305
Keywords [en]
family members; family nursing; family relations; intensive care; mixed methods
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-178966DOI: 10.1037/fsh0000607ISI: 000687054400012PubMedID: 34410772OAI: oai:DiVA.org:liu-178966DiVA, id: diva2:1591826
Note

Funding Agencies|Health Research Council in the Southeast of Sweden [FORSS 466311]; Department of Anesthesiology and Intensive Care, Norrkoping, Sweden; Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden

Available from: 2021-09-07 Created: 2021-09-07 Last updated: 2022-11-10
In thesis
1. Being cared for in an Intensive Care Unit – family functioning and support
Open this publication in new window or tab >>Being cared for in an Intensive Care Unit – family functioning and support
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

When COVID-19 came as an uninvited guest into our everyday lives, nursing in intensive care was affected and thus the studies contain data from both before and during the COVID-19 pandemic.

Before the pandemic, most intensive care units, which care for patients with critical illness in a technical setting, allowed family members to visit the patient 24 hours a day. The intensive care unit is a stressful and frightening environment for both the patient and their family. They can be affected both mentally and physically, showing symptoms such as difficulty sleeping, stress and depression. The intensive cared patient often does not remember anything from the time they were cared for in the intensive care unit, and the family needs to explain and recount this unconscious time. During the pandemic, this changed, with restrictions and limited opportunities to visit the hospital and patient due to virus outbreaks. Family members received information about the patient's medical condition by phone from a physician.   

The overall aim of this thesis was to explore and conceptualise the family functioning of families with a family member treated in the intensive care unit. There was also an intention to describe and evaluate how an intervention affects the family and individual family members in families where a family member received intensive care.

In these studies, qualitative, quantitative, as well as mixed methods were utilised. Participants were adult intensive cared patients from seven intensive care clinics, and their families. The results examined between families are based on the patient and family characteristics.   

The results from study I show that families who have experienced COVID-19 and with a family member who was cared for in an intensive care unit, have existential thoughts.   

Study II shows no major impact on family function between families, but the answers differ within the families who experienced intensive care.   

In study III, concerning families experiencing intensive care and attending family health conversations, there was an awareness of family function. The conversations brought the family closer together, through improved understanding of each other.  

In study IV family functioning, hope and sense of coherence were com-pared among the participants in two intervention groups: Family health conversations and support group conversations. Family functioning and hope were higher in the group that participated in the family health conversations and comprehensibility, meaningfulness and vitality were higher among the participants in the support group conversation.  

By exploring how family function affects the individual family member and the family as a unit during critical illness and intensive care, new ways of working can be strengthened in the care of patients and their families.    

Abstract [sv]

När COVID - 19 kom in som en objuden gäst i vår vardag, har omvårdnad inom intensivvården påverkats, och gjort att studierna innehåller data både före och under COVID-19 pandemin.   

Före pandemin erbjöd de flesta intensivvårdsavdelningar, som tar hand om patienter med kritisk sjukdom i en teknisk miljö, familjemedlemmar att besöka patienten dygnet runt. Detta är en stressig och skrämmande miljö för både patienten och dennes familj. De kan påverkas mentalt och fysiskt med bland annat symtom som sömnsvårigheter, stress och depression. Intensivvårdspatienten kommer ofta inte ihåg något från tiden de vårdats på intensiven och familjen behöver förklara och återberätta den förlorade tiden. Under pandemin förändrades detta, med restriktioner och begränsad möjlighet att besöka sjukhuset och patienten på grund av virusutbrott. Familjemedlemmar fick information om patientens sjukdomstillstånd, per telefon av en läkare.   

Det övergripande syftet med denna avhandling var att undersöka familjefunktionen hos familjer med en familjemedlem som vårdats på intensivvårdsavdelning. Det fanns också en avsikt att beskriva och utvärdera hur en intervention påverkar familjen och enskilda familjemedlemmar i familjer där en familjemedlem fick intensivvård.  

I dessa studier användes kvalitativa, kvantitativa och mixad metod. Deltagarna var vuxna intensivvårdspatienter från sju intensivvårdskliniker och deras familjer. Resultaten som undersöks mellan familjer baseras på patient- och familjekarakteristika.  

Resultatet i studie I, visar att familjer som erfarit COVID - 19 sjukdom och vårdats på intensivvårdsavdelning, har existentiella funderingar.   

Studie II visar ingen större påverkan på familjefunktion mellan familjerna, men svaren skiljer sig inom familjen som erfarit intensivvård.

I studie III där familjer som upplever intensivvård och deltagit i hälsostödjande familjesamtal visar en medvetenhet om familjefunktion. Samtalen för familjen närmare varandra, genom förbättrad förståelse av varandra.   

I studie IV jämfördes familjefunktion, hopp om framtiden och känsla av sammanhang bland deltagarna i två interventionsgrupper: Hälsostödjande familjesamtal och stödgruppssamtal. Familjefunktion och hopp om fram-tiden var högre i gruppen som deltog i hälsostödjande familjesamtalen och begriplighet, meningsfullhet och vitalitet var högre bland deltagarna i stödgruppssamtalet.  

Genom att utforska hur familjens funktion påverkar, den enskilde familjemedlemmen och familjen som enhet, av kritisk sjukdom och intensivvård kan nya arbetssätt stärkas i omvårdnaden av patienter och deras anhöriga.  

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2022. p. 80
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1820
Keywords
Critical Care Nursing, Family, Family Members, Family Nursing, Family Relation, Intensive Care Units, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-189871 (URN)10.3384/9789179294359 (DOI)9789179294342 (ISBN)9789179294359 (ISBN)
Public defence
2022-12-16, Berzeliussalen, Building 463, Campus US, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2022-11-10 Created: 2022-11-10 Last updated: 2022-11-10Bibliographically approved

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