TY - JOUR
T1 - A family information brochure and dedicated website to improve the ICU experience for patients’ relatives
T2 - an Italian multicenter before-and-after study
AU - Mistraletti, Giovanni
AU - Umbrello, Michele
AU - Mantovani, Elena Silvia
AU - Moroni, Benedetta
AU - Formenti, Paolo
AU - Spanu, Paolo
AU - Anania, Stefania
AU - Andrighi, Elisa
AU - Di Carlo, Alessandra
AU - Martinetti, Federica
AU - Vecchi, Irene
AU - Palo, Alessandra
AU - Pinna, Cristina
AU - Russo, Riccarda
AU - Francesconi, Silvia
AU - Valdambrini, Federico
AU - Ferretti, Enrica
AU - Radeschi, Giulio
AU - Bosco, Edda
AU - Malacarne, Paolo
AU - Iapichino, Gaetano
AU - The, Http://Www Intensiva It Investigators
PY - 2016/11/9
Y1 - 2016/11/9
N2 - Purpose: Good communication between ICU staff and patients’ relatives may reduce the occurrence of post-traumatic stress disorder, anxiety or depression, and dissatisfaction with clinicians. An information brochure and website to meet relatives’ needs were designed to explain in technical yet simple terms what happens during and after an ICU stay, to legitimize emotions such as fear, apprehension, and suffering, and to improve cooperation with relatives without increasing staff workload. The main outcomes were improved understanding of prognosis and procedures, and decrease of relatives’ anxiety, depression, and stress symptoms. Methods: In this prospective multicenter before-and-after study, a self-administered questionnaire was used to investigate relatives’ understanding of prognosis, treatments, and organ dysfunction, families’ satisfaction, and symptoms of anxiety, depression, and post-traumatic stress. Results: A total of 551 relatives received questionnaires in nine Italian ICUs; 332 (60%) responded, 144 before and 179 after implementation of the brochure and website. Of the 179 relatives who responded after, 131 (73%) stated they had read the brochure and 34 (19%) reported viewing the website. The intervention was associated with increased correct understanding of the prognosis (from 69 to 84%, p = 0.04) and the therapeutic procedures (from 17 to 28%, p = 0.03). Multivariable analysis, together with non-modifiable factors (relative’s gender, education level, relationship to patient, and patient status at ICU discharge), showed the intervention to be significantly associated with a lower incidence of post-traumatic stress symptoms (Poisson coefficient = −0.29, 95% CI −0.52/−0.07). The intervention had no effect on the prevalence of symptoms of anxiety and depression. Conclusion: An information brochure and website designed to meet relatives’ needs improved family members’ comprehension and reduced their prevalence of stress symptoms.
AB - Purpose: Good communication between ICU staff and patients’ relatives may reduce the occurrence of post-traumatic stress disorder, anxiety or depression, and dissatisfaction with clinicians. An information brochure and website to meet relatives’ needs were designed to explain in technical yet simple terms what happens during and after an ICU stay, to legitimize emotions such as fear, apprehension, and suffering, and to improve cooperation with relatives without increasing staff workload. The main outcomes were improved understanding of prognosis and procedures, and decrease of relatives’ anxiety, depression, and stress symptoms. Methods: In this prospective multicenter before-and-after study, a self-administered questionnaire was used to investigate relatives’ understanding of prognosis, treatments, and organ dysfunction, families’ satisfaction, and symptoms of anxiety, depression, and post-traumatic stress. Results: A total of 551 relatives received questionnaires in nine Italian ICUs; 332 (60%) responded, 144 before and 179 after implementation of the brochure and website. Of the 179 relatives who responded after, 131 (73%) stated they had read the brochure and 34 (19%) reported viewing the website. The intervention was associated with increased correct understanding of the prognosis (from 69 to 84%, p = 0.04) and the therapeutic procedures (from 17 to 28%, p = 0.03). Multivariable analysis, together with non-modifiable factors (relative’s gender, education level, relationship to patient, and patient status at ICU discharge), showed the intervention to be significantly associated with a lower incidence of post-traumatic stress symptoms (Poisson coefficient = −0.29, 95% CI −0.52/−0.07). The intervention had no effect on the prevalence of symptoms of anxiety and depression. Conclusion: An information brochure and website designed to meet relatives’ needs improved family members’ comprehension and reduced their prevalence of stress symptoms.
KW - Communication strategies
KW - Critically ill patients
KW - ICU families
KW - Post-traumatic stress disorder
KW - Website
UR - http://www.scopus.com/inward/record.url?scp=84994397473&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84994397473&partnerID=8YFLogxK
U2 - 10.1007/s00134-016-4592-0
DO - 10.1007/s00134-016-4592-0
M3 - Article
AN - SCOPUS:84994397473
SP - 1
EP - 11
JO - Intensive Care Medicine
JF - Intensive Care Medicine
SN - 0342-4642
ER -