K Hönig1, H Gündel2. 1. Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. Klaus.Hoenig@uniklinik-ulm.de. 2. Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
Abstract
BACKGROUND: Relatives of patients in intensive care units (ICU) have important supportive care needs which are often unrecognized and rarely satisfactorily met. OBJECTIVES: Description of stress factors and strains as well as supportive care needs, assessment of care needs, empirical evidence for care needs, satisfaction of care needs, options and efficacy of psychosocial support and communication recommendations for this special situation. MATERIAL AND METHODS: Evaluation of literature review articles, discussion of basic qualitative and quantitative research findings, meta-analyses and expert recommendations. RESULTS: Relatives of ICU patients report a number of cognitive, emotional, social and pragmatic support needs. Important needs, such as maintenance of hope and security as well as sincere and needs-adjusted communication often remain unrecognized and are rarely satisfactorily met. The weighting and prioritization of support needs are modulated by sociodemographic and cultural factors. Psychoeducative interventions reduce the psychosocial distress of family members. Communicative strategies of healthcare professionals reduce the risk of posttraumatic stress disorders for family members, reduce anxiety and depression and improve participative decision making. CONCLUSION: Healthcare professionals in ICUs should be sensitized to the specific characteristics of these special situations. For healthcare professionals it is equally important to improve self-awareness regarding their own defense mechanisms and to refine communicative competence on accessibility and adequately address the reality of subjective experiences of family members. Psychosocial support services should be recommended and utilization should be encouraged.
BACKGROUND: Relatives of patients in intensive care units (ICU) have important supportive care needs which are often unrecognized and rarely satisfactorily met. OBJECTIVES: Description of stress factors and strains as well as supportive care needs, assessment of care needs, empirical evidence for care needs, satisfaction of care needs, options and efficacy of psychosocial support and communication recommendations for this special situation. MATERIAL AND METHODS: Evaluation of literature review articles, discussion of basic qualitative and quantitative research findings, meta-analyses and expert recommendations. RESULTS: Relatives of ICU patients report a number of cognitive, emotional, social and pragmatic support needs. Important needs, such as maintenance of hope and security as well as sincere and needs-adjusted communication often remain unrecognized and are rarely satisfactorily met. The weighting and prioritization of support needs are modulated by sociodemographic and cultural factors. Psychoeducative interventions reduce the psychosocial distress of family members. Communicative strategies of healthcare professionals reduce the risk of posttraumatic stress disorders for family members, reduce anxiety and depression and improve participative decision making. CONCLUSION: Healthcare professionals in ICUs should be sensitized to the specific characteristics of these special situations. For healthcare professionals it is equally important to improve self-awareness regarding their own defense mechanisms and to refine communicative competence on accessibility and adequately address the reality of subjective experiences of family members. Psychosocial support services should be recommended and utilization should be encouraged.
Entities:
Keywords:
Caregiver; Communication; Intensive care unit; Social support; Suffering
Authors: K E Covinsky; L Goldman; E F Cook; R Oye; N Desbiens; D Reding; W Fulkerson; A F Connors; J Lynn; R S Phillips Journal: JAMA Date: 1994-12-21 Impact factor: 56.272