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Open Access Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

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Background:

During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process.

Methods:

A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission.

Results:

Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia.

Conclusion:

Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.
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Keywords: Family perception; critical illness; intensive care unit; long-term acute care; perception in ICU; stress in ICU; transition of care; understanding critical care illness

Document Type: Research Article

Affiliations: 1: From Aventura Hospital and Medical Center, Pulmonary Department, Aventura, Florida; 2: Oregon Health Science University Hospital, Critical Care Medicine, Portland, Oregon; and 3: Kindred Hospital, Pulmonary Medicine, Hollywood, Florida

Publication date: December 1, 2019

More about this publication?
  • The Journal of Precision Respiratory Medicine (JPRM) is a peer reviewed publication dedicated to distributing timely information regarding cutting edge advancements in the knowledge and practice of respiratory medicine. Its primary readership extends to all medical providers with an interest in respiratory diseases.

    The incorporation of the term, 'precision medicine' in its title serves to direct the journal's focus on this revolutionary approach to disease prevention and treatment that takes into account the individual differences which result from the interplay of lifestyle, environment and human biology/genetics.

    JPRM seeks to publish articles characterized by both a predominant clinical focus and by having the potential to directly impact the quality of patient care. JPRM welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Pulmonary Conference (EPC) JPRM will publish content from EPC poster sessions as well as review articles derived from EPC lectures.

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