Abstract

Objective

This study was conducted to determine the opinions of nurses working in surgical intensive care units (S-ICU) about the participation of family members (FM) in the care of patients during the dying process.

Materials and Methods

Ethical approval was obtained before starting the research. The study was conducted in descriptive type with 81 nurses working in the S-ICU of a training and research hospital between 15 March and 15 April 2022. The data were collected through the descriptive information form and the nurse's opinion determination form created by the researcher. STROBE checklist was used in reporting the research. A p<0.05 value was accepted for statistical significance.

Results

The mean age of the nurses participating in the study was 32.39±5.87 years, and the duration of working experience in S-ICUs was 5.69±5.76 years. The rate of nurses wanting the FM of patients in the dying process to participate in the patient care in the intensive care unit is 26%, the rate of not wanting is 57%, and the rate of undecided is 17%. 72.8% of the nurses think that the participation of FM in care is beneficial for the patients, while 27.2% think that it is harmful. It was determined that nurses with working experience had a higher support rate in cases where FMs participated in the care of patients in the dying process (p=0.010) (p<0.05).

Conclusion

Although nurses working in S-ICUs think that the participation of FM in the care of patients in the dying process will be beneficial for patients, the rate of support is low.

Keywords: Patient in the dying process, end of life care, good death, nursing, surgical intensive care

References

  1. White DB, Ernecoff N, Billings JA, Arnold R. Is dying in an ICU a sign of poor quality end-of-life care? Am J Crit Care. 2013;22:263-6.
  2. Goldfarb MJ, Bibas L, Bartlett V, Jones H, Khan N. Outcomes of Patient- and Family-Centered Care Interventions in the ICU: A Systematic Review and Meta-Analysis. Crit Care Med. 2017;45:1751-61.
  3. Toronto CE, LaRocco SA. Family perception of and experience with family presence during cardiopulmonary resuscitation: An integrative review. J Clin Nurs. 2019;28:32-46.
  4. Considine J, Eastwood K, Webster H, Smyth M, Nation K, Greif R, et al. Family presence during adult resuscitation from cardiac arrest: A systematic review. Resuscitation. 2022;180:11-23.
  5. Barreto MDS, Peruzzo HE, Garcia-Vivar C, Marcon SS. Family presence during cardiopulmonary resuscitation and invasive procedures: a meta-synthesis. Rev Esc Enferm USP. 2019;53:e03435.
  6. Bradley C. Family Presence and Support During Resuscitation. Crit Care Nurs Clin North Am. 2021;33:333-42.
  7. Meier EA, Gallegos JV, Thomas LP, Depp CA, Irwin SA, Jeste DV. Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue. Am J Geriatr Psychiatry. 2016;24:261-71.
  8. Tenzek KE, Depner R. Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective. Behav Sci (Basel). 2017;7:25.
  9. Krikorian A, Maldonado C, Pastrana T. Patient’s Perspectives on the Notion of a Good Death: A Systematic Review of the Literature. J Pain Symptom Manage. 2020;59:152-64.
  10. Bandini JI. Beyond the hour of death: Family experiences of grief and bereavement following an end-of-life hospitalization in the intensive care unit. Health (London). 2022;26:267-83.
  11. Breen CM, Abernethy AP, Abbott KH, Tulsky JA. Conflict associated with decisions to limit life-sustaining treatment in intensive care units. J Gen Intern Med. 2001;16:283-9.
  12. Fang ML, Sixsmith J, Sinclair S, Horst G. A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review. BMC Geriatr. 2016;16:107.
  13. Erzincanlı S, Kasar KS. Hemşirelerin yaşam sonu bakıma yönelik tutum ve davranışlarının klinik karar vermeye etkisi. Turk J Intensive Care. 2021;00710.
  14. Kirchhoff KT, Beckstrand RL. Critical care nurses’ perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients. Am J Crit Care. 2000;9:96-105.
  15. Eskigülek Y, KAV S. Palyatif Bakım Hastaları ve Hemşirelerinin Gözünden İtibarlı Bakım. THDD. 2020;1:1-18.
  16. Park M, Giap TT, Lee M, Jeong H, Jeong M, Go Y. Patient- and family-centered care interventions for improving the quality of health care: A review of systematic reviews. Int J Nurs Stud. 2018;87:69-83.
  17. Porter JE, Cooper SJ, Sellick K. Family presence during resuscitation (FPDR): Perceived benefits, barriers and enablers to implementation and practice. Int Emerg Nurs. 2014;22:69-74.
  18. Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York: Lawrence Erlbaum Associates; 1988.
  19. Breen LJ, Aoun SM, O’Connor M, Howting D, Halkett GKB. Family Caregivers’ Preparations for Death: A Qualitative Analysis. J Pain Symptom Manage. 2018;55:1473-9.
  20. Yavuz M, Totur Dikmen B, Altınbaş Y, Aslan Başlı A. Opinions for Family Presence During Cardiopulmonary Resuscitation in Turkey: A Literature Review. Journal of Medical and Surgical Intensive Care Medicine. 2013;:13-7.
  21. Davis LL, Grant JS. Guidelines for using psychometric consultants in nursing studies. Res Nurs Health. 1993;16:151-5.
  22. Emanuel EJ, Wendler D, Killen J, Grady C. What makes clinical research in developing countries ethical? The benchmarks of ethical research. J Infect Dis. 2004;189:930-7.
  23. World Medical Association. Declaration of Helsinki 2008. Available from: URL:http://www.wma.net/e/ethicsunit/helsinki.htm. Accessed December 21, 2022.
  24. Leske JS, McAndrew NS, Brasel KJ, Feetham S. Family Presence During Resuscitation After Trauma. J Trauma Nurs. 2017;24:85-96.
  25. Maxton FJ. Parental presence during resuscitation in the PICU: the parents’ experience. Sharing and surviving the resuscitation: a phenomenological study. J Clin Nurs. 2008;17:3168-76.
  26. Rainsford S, MacLeod RD, Glasgow NJ, Phillips CB, Wiles RB, Wilson DM. Rural end-of-life care from the experiences and perspectives of patients and family caregivers: A systematic literature review. Palliat Med. 2017;31:895-912.
  27. Stajduhar KI, Funk L, Outcalt L. Family caregiver learning--how family caregivers learn to provide care at the end of life: a qualitative secondary analysis of four datasets. Palliat Med. 2013;27:657-64.
  28. Chi NC, Demiris G. Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review. Am J Hosp Palliat Care. 2017;34:470-85.
  29. Olgun Ş, Yavuz Van Giersbergen M. Evidence-based approaches: Nursing care of adults in the last days of life. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2018;34:179-91.
  30. Family presence: visitation in the adult ICU. Crit Care Nurse. 2012;32:76-8.
  31. Pol A, Carter M, Bouchoucha S. Violence and aggression in the intensive care unit: What is the impact of Australian National Emergency Access Target? Aust Crit Care. 2019;32:502-8.
  32. Zhang L, Wang A, Xie X, Zhou Y, Li J, Yang L, et al. Workplace violence against nurses: A cross-sectional study. Int J Nurs Stud. 2017;72:8-14.
  33. Aljohani B, Burkholder J, Tran QK, Chen C, Beisenova K, Pourmand A. Workplace violence in the emergency department: a systematic review and meta-analysis. Public Health. 2021;196:186-97.

How to cite?

1.
Koyuncu A, Eren Y, Yava A. Investigation of Opinions of Nurses Working in Surgical Intensive Care Units about the Participation of Family Members in the Care of Patients during the Dying Process: A Cross-sectional Design. Turk J Intensive Care. 2024;22(3):180-189. https://doi.org/10.4274/tybd.galenos.2023.48344