Gro Frivold. Associate Professor, Intensive Care Nurse,PhD Faculty of Helath and Sport Sciences University of Agder 2017

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1 Gro Frivold Associate Professor, Intensive Care Nurse,PhD Faculty of Helath and Sport Sciences University of Agder 2017

2 From Norway and my home town Grimstad Denne teksten redigeres i 'Topptekst og Bunntekst' 2

3 Denne teksten redigeres i 'Topptekst og Bunntekst' 3

4 Co Authors: Åshild Slettebø, PhD, RN, Professor, University of Agder, Faculty of Health and Sport Sciences, Norway Bjørg Dale, PhD, RN, Associate Professor, University of Agder, Faculty of Health and Sport Sciences Centre for Caring Research, Southern Norway, Denne teksten redigeres i 'Topptekst og Bunntekst' 4

5 Background Relatives- an important recourse ( Friedman et al,2003; Mitchell et al,2009; Engström et al,2007). Relatives of intensive care patients often suffer from long lasting consequences like anxiety and depression after returning home - Strong impressions (Azoulay et al,2005) - Emotional reactions (Baumhover & may,2013; Anderson et al,2008, Choi et al,2016; Fumis et al,2014) - Care burdens (Desai & Needham,2011; Choi et al,2014). Denne teksten redigeres i 'Topptekst og Bunntekst' 5

6 The aim of the study To illuminate relatives experiences of everyday life after a loved one s stay in an Intensive Care Unit Denne teksten redigeres i 'Topptekst og Bunntekst' 6

7 1. Survey including 123 relatives 2. Interview study with thirteen relatives. Methods A phenomenological hermeneutical method, inspired by Ricoeur, was used to explore family members lived experiences upon returning home after their loved one s stay in the Intensive Care Unit. Denne teksten redigeres i 'Topptekst og Bunntekst' 7

8 Result from the quantitative study Post-ICU follow-up: Mostly re-visits to the ICU with the patient and telephone calls from the ICU after the death of a patient. Relatives of non-survivors experienced significantly more follow-up than relatives of survivors. 17 % reported follow-up needs after the ICU stay. Women, and relatives of patients with longer ICU stays, were more likely to report needs for follow-up after the ICU stay. Cooperation between the hospitals and the community health services related to the follow-up needs of relatives seems to be missing. Denne teksten redigeres i 'Topptekst og Bunntekst' 8

9 Findings Living as before Changes in roles and relationships A different life Denne teksten redigeres i 'Topptekst og Bunntekst' 9

10 Findings Changes in responsibility -New challenges -New skills -Unpredictability and uncertainty Denne teksten redigeres i 'Topptekst og Bunntekst' 10

11 Findings Emotional reactions: -Deep despair when experiencing changes -Guilt -anger -frustration -uncertainty -memory loss -Isolation -Sadness -Worries Denne teksten redigeres i 'Topptekst og Bunntekst' 11

12 Emotional reactions «That is what it s all about: You have to be strong, and thus you end up neglecting much of your own feelings; what is bothering you is neglected. I have put it away, and I have to deal with it litle by little» Denne teksten redigeres i 'Topptekst og Bunntekst' 12

13 The new knowledge: «So, I feel grateful, but it doesn t seem like my husband does. At the same time, I admit that he didn t kno how ill he actually had been..» Denne teksten redigeres i 'Topptekst og Bunntekst' 13

14 Findings Quality of information and care during the ICU stay seemes to be important also after the ICU stay -comprehensibility -self efficacy Denne teksten redigeres i 'Topptekst og Bunntekst' 14

15 How did they cope? Personal strength Help and support from others Professional support Denne teksten redigeres i 'Topptekst og Bunntekst' 15

16 Conclutions and recommendations for pracsis, education and research Trust in the health care system and the ICU : stay family -Quality in information and care during the -Inclusion and ability of staying together as a discharge -A contact person in the ICU also after -Re-visit for those who have needs A range of internal and external factors are affecting relatives reactions after the ICU stay. Denne teksten redigeres i 'Topptekst og Bunntekst' 16

17 Unity gives strenght Denne teksten redigeres i 'Topptekst og Bunntekst' 17

18 References Anderson WG, Arnold RM, Angus DC, Bryce CL. Posttraumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Intern Med. 2008;23(11): doi: Choi J, Donahoe MP, Hoffman LA. Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies. J Korean Acad Nurs. 2016;46(2): doi: Engström Å, Söderberg S. Receiving power through confirmation: the meaning of close relatives for people who have been critically ill. J Adv Nurs. 2007;59(6): doi: Denne teksten redigeres i 'Topptekst og Bunntekst' 18

19 References Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, et al. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005;171(9): doi: OC [pii] Baumhover NC, May KM. A vulnerable population: Families of patients in adult critical care. AACN Adv Crit Care. 2013;24(2): doi: 9e Denne teksten redigeres i 'Topptekst og Bunntekst' 19

20 References Desai SV, Law TJ, Needham DM. Long-term complications of critical care.crit Care Med. 2011;39(2): Doi: 6e5Friedman MR, Bowden VR, Jones EG. Family nursing: Reseach, theory and practice. 5.th, editor. Stamford: Appleton & Lange; 2003 Frivold, G., Slettebo, A., & Dale, B. (2016). Family members' lived experiences of everyday life after intensive care treatment of a loved one: a phenomenological hermeneutical study. Journal of Clinical Nursing, 25(3-4), Doi: Denne teksten redigeres i 'Topptekst og Bunntekst' 20

21 Fumis RR, Ranzani OT, Faria PP, Schettino G. Anxiety, depression, and satisfaction in close relatives of patients in an open visiting policy intensive care unit in Brazil. J Crit Care doi: Denne teksten redigeres i 'Topptekst og Bunntekst' 21