Yinet Literature Review Paper
Critical illness denotes a severe condition that is usually fatal (McAdam, Fontaine, White, Dracup, & Puntillo, 2012). Therefore, critical illness signifies a condition, disease, or sicknesses such as cancer, renal disorder, heart surgery, myocardial infarction, coma, stroke, loss of sight, transplant of a major organ, and different kinds of surgeries to mention a few. Fundamentally, medical practitioners comprehend the worth of offering some kind of aid in the stressful experiences of family members by reflecting on how they would desire being assisted if in a comparable state. This literature review employs reputable peer-reviewed journals from credible sources such as Google and online libraries that encompass EBSCOhost and Emerald. At first, the search yielded over 100 journals that were narrowed down to ten of the best, which were used in this study.
In which way do the family members and the critically ill patients diagnosed with critical conditions and diseases cope with the suffering and hospitalization at the intensive care unit during the period of care provision?
The intensive (critical) care unit (ICU) could be a challenging setting for the family members of patients, particularly when the loved ones are at an immense risk of death. The patients in the intensive care unit are critically ill, sedated, and with numerous intricate interventions, usually making them unable to take part in their care (Pattison, Carr, Turnock, & Dolan, 2013). The anticipation that the family members will act as surrogate judgment makers and supporters of the patients while still making preparations for the possible loss of their loved one overburdens them. Critical illness, as well as hospitalization in the ICU, is a distressing occurrence that could result in considerable mayhem not just for the patients but also for the people close to them.
The magnitude of the Problem
Critical care settings offer medical attention to patients who have life-threatening sicknesses and conditions, which call for intensive attention, close examination, and backing of specialized equipment and medications to make sure that normal bodily operations are in order. Critical care settings are staffed by greatly trained professionals with specialization in the care of patients with critical illnesses (Petrinec, Mazanec, Burant, Hoffer, & Daly, 2015). They are different from the normal hospital units in that they must have more nurse-to-patient proportions and availability of sophisticated medical equipment not usually accessible in any other ward in a health facility. Patients might be referred to a critical care setting from an emergency unit if necessary, from any other ward when their condition exceedingly deteriorates, or immediately following a major surgery that is invasive where the patients have a risk of complexities.
Because medical practitioners are traditionally trained to tackle the necessities of the patients, they could disregard the requirements of the family members. The ill-fated actuality is that the members of the family of the critically ill usually face enhanced occurrence of psychological and physical health concerns, and are not likely to prioritize their necessities. The majority of family members mainly experience depression, anxiety, and stress (Brysiewicz & Bhengu, 2010). On this note, critical care nurses should adequately assist family members through the provision of coping and psychological support via communication, referrals, and encouragement. Critical care nurses ought to collaborate with other stakeholders such as social workers to offer personalized care for patients and their family members.
The family of a critically ill entails his/her spouse, children, parents, siblings, and other close relatives such as grandparents, aunts, uncles, and cousins to mention a few (Adams et al., 2014). Though several family members of critically ill patients successfully deal with the stressors of the critical condition, many demand coping mechanisms and some could be unsuccessful to a point of even interfering with the recovery of the patient. Nurses and other health professionals in the critical care setting can facilitate positive coping policies of family members and make efforts to ensure their effectiveness. The term coping signifies the means of dealing with the stressors of critical illness reasonably irrespective of the unavoidable challenges, psychological, and physical disturbance with which family members have to come to terms.
The family members of the patients in critical care settings face augmented psychological and physical problems (Davidson, Jones, & Bienvenu, 2012). The admission in critical care settings seems to be an extremely unfamiliar and daunting environment for the family members. It mostly occurs unexpectedly and the members of the family think of the possibility of their loved one dying or being severely disabled (Foster, Whitehead, & Maybee, 2016). Coping with the stressors of critical illness requires the engagement of family members in decision-making concerning the care of the patient. Family members could help in giving end-of-life determinations and ideas concerning the application of life-sustaining therapies to mention a few hence taking a significant role in the care of their loved ones. To boost the coping mechanisms of the family members, health professionals have accountability for fostering a setting that caters to the psychological and physical challenges.
If well prepared by the nurses, the family members could act as a buffer against the deterioration of the condition of the patients and operate as helpful support resources for the patients (Clissett, Porock, Harwood, & Gladman, 2013). Nonetheless, if the nurses leave the family members to suffer depression, anxiety, and stress, they could be incapable of supporting the patients effectively. Therefore, it is vital for critical care nurses to discover the requirements of the family members and meet them by offering suitable interventions. In this regard, critical care nurses have a role to play in the identification of the needs of the family members and establishing the best means of responding to such requirements. To succeed in this role, nurses should take into consideration the cultural competence, support, and flexibility of the family members of critically ill patients. Cultural competence will enable the nurses to be cautious with interventions and offer the most appropriate ones (Iverson et al., 2014). Facilitating flexibility will assist family members in coping with possible stressors through tailored approaches. Additionally, through supporting the family members, their needs will be satisfied entirely, which as well reduces depression, anxiety, and stress, and improves coping.
Through advocating for the participation of other stakeholders, critical care nurses successfully instigate coping mechanisms for family members early during the stay of their loved ones in the critical care setting. Initiating the coping mechanisms early goes a long way to prevent the worsening of the conditions of the patients, improving communication between the health professionals and the family members, and promoting the family members’ satisfaction with the provided care; all these assists in reducing the depressive symptoms of the family members.
Moreover, critical care nurses should engage in communication with family members to assess the occurrence of symptoms such as stress, depression, and anxiety. To do this effectively, critical care nurses should seek the frequent involvement of the family members in decision-making and other aspects of care for critically ill patients. The regular interrelations give nurses the capacity to establish connections and confidence with family members while being watchful of any variation in the behavior of the family members. In severe conditions of the depressive symptoms, critical care nurses should help family members to obtain spiritual care, counseling, and assistance from support groups (Timmins & Neill, 2013).
Critical care nurses have a significant role in satisfying the needs of the family members of the patients in critical care settings to ensure considerable influence on the well-being of the patients. Interventions are necessary to address the depression and anxiety faced by the family members when a patient is hospitalized at a critical care unit, and they assist in the enhancement of coping mechanisms. Critical care nurses are supposed to work together with other stakeholders such as social workers to ensure the wellbeing of patients and their family members. Moreover, they should seek the regular participation of the family members in the making of decisions and other facets of care for the patients.
Adams, J. A., Anderson, R. A., Docherty, S. L., Tulsky, J. A., Steinhauser, K. E., & Bailey, D. E. (2014). Nursing strategies to support family members of ICU patients at high risk of dying. Heart & Lung: The Journal of Acute and Critical Care, 43(5), 406-415.
Brysiewicz, P., & Bhengu, B. R. (2010). The experiences of nurses in providing psychosocial support to families of critically ill trauma patients in intensive care units: A study in the Durban metropolitan area. Southern African Journal of Critical Care, 26(2), 42-51.
Clissett, P., Porock, D., Harwood, R. H., & Gladman, J. R. (2013). Experiences of family carers of older people with mental health problems in the acute general hospital: A qualitative study. Journal of Advanced Nursing, 69(12), 2707-2716.
Davidson, J. E., Jones, C., & Bienvenu, O. J. (2012). Family response to critical illness: Postintensive care syndrome–family. Critical Care Medicine, 40(2), 618-624.
Foster, M., Whitehead, L., & Maybee, P. (2016). The parents’, hospitalized child’s, and health care providers’ perceptions and experiences of family-centered care within a pediatric critical care setting: A synthesis of quantitative research. Journal of Family Nursing, 22(1), 6-73.
Iverson, E., Celious, A., Kennedy, C. R., Shehane, E., Eastman, A., Warren, V., & Freeman, B. D. (2014). Factors affecting stress experienced by surrogate decision makers for critically ill patients: Implications for nursing practice. Intensive and Critical Care Nursing, 30(2), 77-85.
McAdam, J. L., Fontaine, D. K., White, D. B., Dracup, K. A., & Puntillo, K. A. (2012). Psychological symptoms of family members of high-risk intensive care unit patients. American Journal of Critical Care, 21(6), 386-394.
Pattison, N., Carr, S. M., Turnock, C., & Dolan, S. (2013). ‘Viewing in slow motion’: Patients’, families’, nurses’ and doctors’ perspectives on end‐of‐life care in critical care. Journal of Clinical Nursing, 22(9-10), 1442-1454.
Petrinec, A. B., Mazanec, P. M., Burant, C. J., Hoffer, A., & Daly, B. J. (2015). Coping strategies and posttraumatic stress symptoms in post-ICU family decision makers. Critical Care Medicine, 43(6), 1205.
Timmins, F., & Neill, F. (2013). Teaching nursing students about spiritual care–A review of the literature. Nurse Education in Practice, 13(6), 499-505.