Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial
To determine the effect of a standardized program for family participation in essential care activities in the ICU on symptoms of anxiety, depression, posttraumatic stress and satisfaction among relatives, and perceptions and experiences of ICU healthcare providers (HCPs). Multicenter stepped-wedge...
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| Veröffentlicht in: | Critical care medicine 2024-03, Vol.52 (3), p.420-431 |
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| creator | Dijkstra, Boukje M Rood, Paul J T Teerenstra, Steven Rutten, Anne M F Leerentveld, Crista Burgers-Bonthuis, Dominique C Festen-Spanjer, Barbara Klarenbeek, Toine Van Den Boogaard, Mark Ewalds, Esther Schoonhoven, Lisette Van Der Hoeven, Johannes G Vloet, Lilian C M |
| description | To determine the effect of a standardized program for family participation in essential care activities in the ICU on symptoms of anxiety, depression, posttraumatic stress and satisfaction among relatives, and perceptions and experiences of ICU healthcare providers (HCPs).
Multicenter stepped-wedge cluster randomized controlled trial.
Seven adult ICUs, one university, and six general teaching hospitals.
Three hundred six relatives and 235 ICU HCPs.
A standardized program to facilitate family participation inpatient communication, amusement/distraction, comfort, personal care, breathing, mobilization, and nutrition.
Data were collected through surveys among relatives and ICU HCPs. There were no significant differences in symptoms of anxiety in relatives in the intervention period compared with the control period (median Hospital Anxiety and Depression Scale [HADS] 5 [interquartile range (IQR) 2-10] vs 6 [IQR 3-9]; median ratio [MR] 0.72; 95% CI, 0.46-1.13; p = 0.15), depression (median HADS 4 [IQR 2-6] vs 3 [IQR 1-6]; MR 0.85; 95% CI, 0.55-1.32; p = 0.47) or posttraumatic stress (median Impact of Event Scale-Revised score 0.45 [IQR 0.27-0.82] vs 0.41 [IQR 0.14-1]; MR 0.94; 95% CI, 0.78-1.14; p = 0.54). Reported satisfaction was slightly lower in the intervention period (mean 8.90 [sd 1.10] vs mean 9.06 [sd 1.10], difference -0.60; 95% CI, -1.07 to -0.12; p = 0.01). ICU HCPs perceived that more relatives knew how to participate: 47% in the intervention period versus 22% in the control period (odds ratio [OR] 3.15; 95% CI, 1.64-6.05; p < 0.01). They also reported relatives having sufficient knowledge (41% vs 16%; OR 3.56; 95% CI, 1.75-7.25; p < 0.01) and skills (44% vs 25%; OR 2.38; 95% CI, 1.22-4.63; p = 0.01) to apply family participation.
Application of a standardized program to facilitate family participation did not change mental health symptoms in relatives of ICU patients 3 months after discharge. ICU HCPs reported increased clarity, knowledge, and skills among relatives and ICU HCPs. |
| doi_str_mv | 10.1097/CCM.0000000000006093 |
| format | Article |
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Multicenter stepped-wedge cluster randomized controlled trial.
Seven adult ICUs, one university, and six general teaching hospitals.
Three hundred six relatives and 235 ICU HCPs.
A standardized program to facilitate family participation inpatient communication, amusement/distraction, comfort, personal care, breathing, mobilization, and nutrition.
Data were collected through surveys among relatives and ICU HCPs. There were no significant differences in symptoms of anxiety in relatives in the intervention period compared with the control period (median Hospital Anxiety and Depression Scale [HADS] 5 [interquartile range (IQR) 2-10] vs 6 [IQR 3-9]; median ratio [MR] 0.72; 95% CI, 0.46-1.13; p = 0.15), depression (median HADS 4 [IQR 2-6] vs 3 [IQR 1-6]; MR 0.85; 95% CI, 0.55-1.32; p = 0.47) or posttraumatic stress (median Impact of Event Scale-Revised score 0.45 [IQR 0.27-0.82] vs 0.41 [IQR 0.14-1]; MR 0.94; 95% CI, 0.78-1.14; p = 0.54). Reported satisfaction was slightly lower in the intervention period (mean 8.90 [sd 1.10] vs mean 9.06 [sd 1.10], difference -0.60; 95% CI, -1.07 to -0.12; p = 0.01). ICU HCPs perceived that more relatives knew how to participate: 47% in the intervention period versus 22% in the control period (odds ratio [OR] 3.15; 95% CI, 1.64-6.05; p < 0.01). They also reported relatives having sufficient knowledge (41% vs 16%; OR 3.56; 95% CI, 1.75-7.25; p < 0.01) and skills (44% vs 25%; OR 2.38; 95% CI, 1.22-4.63; p = 0.01) to apply family participation.
Application of a standardized program to facilitate family participation did not change mental health symptoms in relatives of ICU patients 3 months after discharge. ICU HCPs reported increased clarity, knowledge, and skills among relatives and ICU HCPs.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/CCM.0000000000006093</identifier><identifier>PMID: 37934138</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Clinical Investigations</subject><ispartof>Critical care medicine, 2024-03, Vol.52 (3), p.420-431</ispartof><rights>Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c358t-ff8554260bbac558399895eeab8331d712d5f3cd0506bfbac982d0dce94cf5193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37934138$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dijkstra, Boukje M</creatorcontrib><creatorcontrib>Rood, Paul J T</creatorcontrib><creatorcontrib>Teerenstra, Steven</creatorcontrib><creatorcontrib>Rutten, Anne M F</creatorcontrib><creatorcontrib>Leerentveld, Crista</creatorcontrib><creatorcontrib>Burgers-Bonthuis, Dominique C</creatorcontrib><creatorcontrib>Festen-Spanjer, Barbara</creatorcontrib><creatorcontrib>Klarenbeek, Toine</creatorcontrib><creatorcontrib>Van Den Boogaard, Mark</creatorcontrib><creatorcontrib>Ewalds, Esther</creatorcontrib><creatorcontrib>Schoonhoven, Lisette</creatorcontrib><creatorcontrib>Van Der Hoeven, Johannes G</creatorcontrib><creatorcontrib>Vloet, Lilian C M</creatorcontrib><creatorcontrib>from the EFfect of FAMily PARTicipation in essential care (EFFAMPART) Study Group</creatorcontrib><title>Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>To determine the effect of a standardized program for family participation in essential care activities in the ICU on symptoms of anxiety, depression, posttraumatic stress and satisfaction among relatives, and perceptions and experiences of ICU healthcare providers (HCPs).
Multicenter stepped-wedge cluster randomized controlled trial.
Seven adult ICUs, one university, and six general teaching hospitals.
Three hundred six relatives and 235 ICU HCPs.
A standardized program to facilitate family participation inpatient communication, amusement/distraction, comfort, personal care, breathing, mobilization, and nutrition.
Data were collected through surveys among relatives and ICU HCPs. There were no significant differences in symptoms of anxiety in relatives in the intervention period compared with the control period (median Hospital Anxiety and Depression Scale [HADS] 5 [interquartile range (IQR) 2-10] vs 6 [IQR 3-9]; median ratio [MR] 0.72; 95% CI, 0.46-1.13; p = 0.15), depression (median HADS 4 [IQR 2-6] vs 3 [IQR 1-6]; MR 0.85; 95% CI, 0.55-1.32; p = 0.47) or posttraumatic stress (median Impact of Event Scale-Revised score 0.45 [IQR 0.27-0.82] vs 0.41 [IQR 0.14-1]; MR 0.94; 95% CI, 0.78-1.14; p = 0.54). Reported satisfaction was slightly lower in the intervention period (mean 8.90 [sd 1.10] vs mean 9.06 [sd 1.10], difference -0.60; 95% CI, -1.07 to -0.12; p = 0.01). ICU HCPs perceived that more relatives knew how to participate: 47% in the intervention period versus 22% in the control period (odds ratio [OR] 3.15; 95% CI, 1.64-6.05; p < 0.01). They also reported relatives having sufficient knowledge (41% vs 16%; OR 3.56; 95% CI, 1.75-7.25; p < 0.01) and skills (44% vs 25%; OR 2.38; 95% CI, 1.22-4.63; p = 0.01) to apply family participation.
Application of a standardized program to facilitate family participation did not change mental health symptoms in relatives of ICU patients 3 months after discharge. ICU HCPs reported increased clarity, knowledge, and skills among relatives and ICU HCPs.</description><subject>Clinical Investigations</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpdkUFv1jAMhiMEYh-Df4BQjly6JU3TJlzQVG0waRMTbOIYpY3zLShtSpJOGjf-Ofm2MQ18sWW_fmzpRegtJQeUyO6w788PyJNoiWTP0IZyRipSS_YcbQiRpGKNZHvoVUo_CKEN79hLtMc6yRrKxAb9PrYWxoyDxRp_y3o2Ohr3Cww-0ZPzt_hCx-xGt-jswowvYthGPWE343wN-LS_-oCP8PnqiwbmDLEwYFnAVN_BbAH3fk277tcCDtMdtw9zjsH7Ul5Gp_1r9MJqn-DNQ95HVyfHl_3n6uzLp9P-6KwaGRe5slZw3tQtGQY9ci6YlEJyAD0IxqjpaG24ZaMhnLSDLRopakPMCLIZLaeS7aOP99xlHSYwu3ej9mqJbtLxVgXt1L-T2V2rbbhRlIiupV1XCO8fCDH8XCFlNbk0gvd6hrAmVQvRyqamDSnS5l46xpBSBPt4hxK1s08V-9T_9pW1d09_fFz66xf7AynWl-4</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Dijkstra, Boukje M</creator><creator>Rood, Paul J T</creator><creator>Teerenstra, Steven</creator><creator>Rutten, Anne M F</creator><creator>Leerentveld, Crista</creator><creator>Burgers-Bonthuis, Dominique C</creator><creator>Festen-Spanjer, Barbara</creator><creator>Klarenbeek, Toine</creator><creator>Van Den Boogaard, Mark</creator><creator>Ewalds, Esther</creator><creator>Schoonhoven, Lisette</creator><creator>Van Der Hoeven, Johannes G</creator><creator>Vloet, Lilian C M</creator><general>Lippincott Williams & Wilkins</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240301</creationdate><title>Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial</title><author>Dijkstra, Boukje M ; Rood, Paul J T ; Teerenstra, Steven ; Rutten, Anne M F ; Leerentveld, Crista ; Burgers-Bonthuis, Dominique C ; Festen-Spanjer, Barbara ; Klarenbeek, Toine ; Van Den Boogaard, Mark ; Ewalds, Esther ; Schoonhoven, Lisette ; Van Der Hoeven, Johannes G ; Vloet, Lilian C M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c358t-ff8554260bbac558399895eeab8331d712d5f3cd0506bfbac982d0dce94cf5193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Clinical Investigations</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dijkstra, Boukje M</creatorcontrib><creatorcontrib>Rood, Paul J T</creatorcontrib><creatorcontrib>Teerenstra, Steven</creatorcontrib><creatorcontrib>Rutten, Anne M F</creatorcontrib><creatorcontrib>Leerentveld, Crista</creatorcontrib><creatorcontrib>Burgers-Bonthuis, Dominique C</creatorcontrib><creatorcontrib>Festen-Spanjer, Barbara</creatorcontrib><creatorcontrib>Klarenbeek, Toine</creatorcontrib><creatorcontrib>Van Den Boogaard, Mark</creatorcontrib><creatorcontrib>Ewalds, Esther</creatorcontrib><creatorcontrib>Schoonhoven, Lisette</creatorcontrib><creatorcontrib>Van Der Hoeven, Johannes G</creatorcontrib><creatorcontrib>Vloet, Lilian C M</creatorcontrib><creatorcontrib>from the EFfect of FAMily PARTicipation in essential care (EFFAMPART) Study Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dijkstra, Boukje M</au><au>Rood, Paul J T</au><au>Teerenstra, Steven</au><au>Rutten, Anne M F</au><au>Leerentveld, Crista</au><au>Burgers-Bonthuis, Dominique C</au><au>Festen-Spanjer, Barbara</au><au>Klarenbeek, Toine</au><au>Van Den Boogaard, Mark</au><au>Ewalds, Esther</au><au>Schoonhoven, Lisette</au><au>Van Der Hoeven, Johannes G</au><au>Vloet, Lilian C M</au><aucorp>from the EFfect of FAMily PARTicipation in essential care (EFFAMPART) Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>52</volume><issue>3</issue><spage>420</spage><epage>431</epage><pages>420-431</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><abstract>To determine the effect of a standardized program for family participation in essential care activities in the ICU on symptoms of anxiety, depression, posttraumatic stress and satisfaction among relatives, and perceptions and experiences of ICU healthcare providers (HCPs).
Multicenter stepped-wedge cluster randomized controlled trial.
Seven adult ICUs, one university, and six general teaching hospitals.
Three hundred six relatives and 235 ICU HCPs.
A standardized program to facilitate family participation inpatient communication, amusement/distraction, comfort, personal care, breathing, mobilization, and nutrition.
Data were collected through surveys among relatives and ICU HCPs. There were no significant differences in symptoms of anxiety in relatives in the intervention period compared with the control period (median Hospital Anxiety and Depression Scale [HADS] 5 [interquartile range (IQR) 2-10] vs 6 [IQR 3-9]; median ratio [MR] 0.72; 95% CI, 0.46-1.13; p = 0.15), depression (median HADS 4 [IQR 2-6] vs 3 [IQR 1-6]; MR 0.85; 95% CI, 0.55-1.32; p = 0.47) or posttraumatic stress (median Impact of Event Scale-Revised score 0.45 [IQR 0.27-0.82] vs 0.41 [IQR 0.14-1]; MR 0.94; 95% CI, 0.78-1.14; p = 0.54). Reported satisfaction was slightly lower in the intervention period (mean 8.90 [sd 1.10] vs mean 9.06 [sd 1.10], difference -0.60; 95% CI, -1.07 to -0.12; p = 0.01). ICU HCPs perceived that more relatives knew how to participate: 47% in the intervention period versus 22% in the control period (odds ratio [OR] 3.15; 95% CI, 1.64-6.05; p < 0.01). They also reported relatives having sufficient knowledge (41% vs 16%; OR 3.56; 95% CI, 1.75-7.25; p < 0.01) and skills (44% vs 25%; OR 2.38; 95% CI, 1.22-4.63; p = 0.01) to apply family participation.
Application of a standardized program to facilitate family participation did not change mental health symptoms in relatives of ICU patients 3 months after discharge. ICU HCPs reported increased clarity, knowledge, and skills among relatives and ICU HCPs.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>37934138</pmid><doi>10.1097/CCM.0000000000006093</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Clinical Investigations |
| title | Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial |
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