Optimism, satisfaction with needs met, interpersonal perceptions of the healthcare team, and emotional distress in patients' family members during critical care hospitalization

Stephen M Auerbach, Donald J Kiesler, Jennifer Wartella, Sarah Rausch, Kevin R Ward, Rao Ivatury
American Journal of Critical Care 2005, 14 (3): 202-10

BACKGROUND: Families of critical care patients experience high levels of emotional distress. Access to information about patients' medical conditions and quality relationships with healthcare staff are high-priority needs for these families.

OBJECTIVES: To assess satisfaction with needs met, signs and symptoms of acute stress disorder, interpersonal perception of healthcare staff, level of optimism, and the relationships among these variables in patients' family members.

METHODS: Family representatives of 40 patients were administered a brief version of the Critical Care Family Needs Inventory, the Acute Stress Disorder Scale, the Brief Symptom Inventory, the Impact Message Inventory, and the Life Orientation Test shortly after admission of the patients to the intensive care unit and after discharge.

RESULTS: Levels of dissociative symptoms associated with acute stress disorder were elevated in family members just after admission but decreased significantly after discharge. Needs the families thought were least satisfactorily cared for after admission involved lack of information. Interpersonally, attending physicians were viewed as more controlling than bedside nurses at admission; nurses were viewed as more affiliative than physicians both at admission and after discharge. At admission, higher optimism of the family members was strongly related to greater satisfaction with needs met, to perceptions of affiliation from physicians, and to perceptions of not being controlled by physicians.

CONCLUSIONS: More interpersonal contact with medical staff can help meet the information needs of patients' families. Nurses may aid in families' adjustment by fostering a sense of optimism in family members and encouraging them to participate in the patients' care.

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