‘Hearing nothing from those caring for my patient is depressing’: Family members’ perception of their needs in intensive care unit at Kamuzu Central Hospital, Malawi

doi:10.21203/rs.3.rs-2498430/v1

Download PDF

Research Article

‘Hearing nothing from those caring for my patient is depressing’: Family members’ perception of their needs in intensive care unit at Kamuzu Central Hospital, Malawi

https://doi.org/10.21203/rs.3.rs-2498430/v1

This work is licensed under a CC BY 4.0 License

Journal Publication

published 21 Aug, 2023

Read the published version in BMC Nursing →

You are reading this latest preprint version

Background

Family members are the first people that recognize satisfactory care provided to their patients regardless of the outcome. However, little is known about the perceptions of family members regarding their needs when a relative is admitted to the Intensive Care Unit (ICU). We explored family members’ perceptions of their needs in the ICU at Kamuzu Central Hospital in Lilongwe, Malawi.

Study Designs and Methods

The study used a qualitative descriptive design. We purposively selected 12 participants from immediate family members of patients hospitalized for 48 hours or more in ICU and adult HDU at Kamuzu Central Hospital. Data were collected through in-depth interviews. Data analysis followed the steps of conventional content analysis.

Findings

The following four themes were identified: perceived information, physical, and psychosocial needs, and coping mechanisms of the family members. The findings indicated that family members need to access information about their patient’s progress to lessen their anxiety as a priority compared to other needs such as comfort, and foodstuffs among others.

Conclusion

This study suggests that there should be a collaborative relationship between the ICU team and family members in order to meet their needs. Health professionals should be aware of how strong family members need information about their patients. The findings affirm the need to offer the basic guidelines or standards developed by both health professionals and family members on their needs and support when they have a patient in ICU.

Intensive care Units

Family perceptions

family needs

Hospitals

Malawi.

Family members' experiences of the crisis brought by the critical illness of their loved ones in the intensive care unit (ICU) may differ especially if their needs are not met by the health personnel. Nurses and doctors need to be aware of family members’ needs that are associated with hospitalization of a critically ill relative ¹. Lack of attention to family members is often overlooked in the healthcare environment as families are not given high priority. When assessing the quality of patient care in healthcare systems around the world, these perceived needs and satisfaction are crucial ². Therefore, healthcare providers should aim at addressing healthcare beneficiaries’ needs through enhanced healthcare delivery. This provides a reflection of the quality of critical care provided by them especially at tertiary hospitals hence satisfying the family members’ needs. This is in line with a study done by³ who highlighted that satisfaction of family members is of great importance in evaluating the quality of patient care in the health systems globally. Furthermore identifying and meeting the needs of the family members does not only improve the quality of healthcare, but also reduces the negative emotions experienced by healthcare beneficiaries⁵

Healthcare professionals should be aware of family members’ perception of their needs through interacting with them during their visit to the unit. However, most family members are not allowed to express themselves. This is consistent with findings of a study by³⁵ which pointed out that there was limited information explored on perceptions of family members concerning their needs when a relative was admitted to the ICU at the hospital where the study was conducted. In addition, the researcher observed that family members are not engaged during their visit to the unit. Therefore, this study aimed at exploring the family members' perceptions of their needs in the intensive care unit at Kamuzu Central Hospital in Lilongwe, Malawi.

Study approach and design

This study utilized a qualitative descriptive design. The design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation ⁴. It is underpinned by the assumptions of naturalism or constructivism in which reality is not a fixed entity but rather a construction of the individuals participating in a study ⁵.

Study setting

The study was conducted in ICU and adult HDU at Kamuzu Central Hospital (KCH) in Lilongwe. The hospital is one of the country's public referral hospitals located in the central region of Malawi. It is also a teaching hospital for different health professionals including nurses and midwives, clinicians, doctors, and other allied health professionals. It has one general ICU with a capacity of eight beds but mostly only five beds are used because of limited resources. HDU which is adjacent to ICU, it has 10 beds and all of them are used to admit patients. In both units, one or two family members per patient are allowed to visit their patients three times in a day as follow; 7:00 to 7:30am, 12:00 and 1:00 pm and 5:00 to 6:00 pm

Participants

Purposeful sampling technique was used on 12 immediate family members of 12 patients hospitalized in the ICU or HDU. An immediate family member is defined as a guardian or next of kin of the patient during his or her admission to the ICU/HDU ⁶. The inclusion criteria was an immediate family member; (spouse, father, mother, sister or brother, and child older than 18 years of age). All under 18 years old and not immediate family members were excluded from this study. The selected participants comprised eight females and four males with ages ranging from 35 to 64 years. Half of the participants, 50% (n = 6) dropped out of school at the primary level, while the other half had secondary and tertiary education qualifications.

Data collection

Data were gathered through face-to-face in-depth interviews using a semi-structured interview guide. Each interview was audio-recorded and notes were taken to ensure that no piece of information was missed. Preventive measures for COVID-19 were followed during the data collection which included hand washing with soap, use of face masks, and social distancing of one meter apart when the researcher was conducting the interview. In addition, shaking hands was avoided. The interviews were transcribed verbatim. The interview was in Chichewa to some participants who were not comfortable with English and in English to those who were proficient in the language. Translation was done and the transcripts were checked for accuracy by re-listening to the audio and comparing them with the transcripts.

Data analysis

The data were analyzed manually utilizing the steps of conventional content analysis as proposed by Hsieh and Shannon (2005). The steps for the analysis were as follows; preparation, organizing derived codes, making notes, labeling for codes, emergent categories, cluster formation, definitions development, and reporting the findings. The analysis was done simultaneously with data collection until data saturation was achieved.

Ethical consideration

Approval to conduct the study was obtained from the College of Medicine Research and Ethics Committee (COMREC) of the University of Malawi, reference number P.10/20/3168. Permission was also sought from KCH Research Committee. The study respected the human rights of family members and patients hospitalized in the ICU. The researcher obtained both verbal and written consent from the participants. In order to ensure anonymity, no names were used in the study. The participants were identified with numbers and all information concerning the data was kept confidential, in a locker accessible only to the researcher.

Four themes were identified as follows: perceived information, psychosocial, physical needs and coping mechanisms. The study had included 12 participants, eight of whom were women (n = 8) and four of whom were males (n = 4). The participants ranged in age from 35 to 64 years old. Half of the participants (n = 6) dropped out of primary school, while the other half went on to secondary and higher education.

Perceived information needs

The family members expressed the need for information on the patient's progress. They explained that if they were not updated on their patient’s progress, they became anxious about the patient’s progress. Therefore, they would like to be kept up to date on their patient's condition, as stated by the following participants;

“If healthcare workers were able to update me on the condition of my patient at least my anxiety levels would improve. But hearing nothing from those taking care of my patient is depressing. You wonder what is happening to the patient”. (Participant#8):

“I need to be updated on the progress of the patient regarding management and how he is fairing. Feedback is important to us because when I come to visit, doctors just say come and see your patient, so we don’t get a patient progress report from doctors, so we just make our judgment”. (Participant#6)

Perceived Psychosocial needs

Psychosocial need is any need that is essential to mental health or that is otherwise not a biological necessity. The sub themes include psychological support, reassurance, hope, approachable health workers, staff identity, and proximity to the patients.

Need for support/reassurance.

Some participants stated the need for support or reassurance. One participant said:

“I need to be supported for instance as of now I have called my uncle in the village so that he can be with me sometimes when I come in so that he is the one holding my hand in support as i visit my critically ill brother”. (Participant#10)

Need for hope

The family members expected health professionals to provide encouraging words or explanations that would give hope as expressed by the following participants;

“…just an explanation or a word of giving hope or just to say we are trying but we just put everything in God’s hands, you know that will do a lot to my thinking (Participant#3):

Similarly, another participant said:

“…the way I see things is that hope comes when the medical staff responds to my questions well:” (Participant#4).

Need for approachable health workers

This relates to health personnel’s attitudes toward patients' family members, which should be positive, friendly, and capable of assisting them whenever they require clarification or specific information.

“…I can say that they should be friendly so that maybe we should not be afraid eeeeh…. because sometimes we may want to ask something but because of the unfriendly manner of addressing us, we get afraid, we fail to ask we just keep quiet.” (Participant#9).

Need for staff identity

Some participants were also concerned about health workers’ identities. The family members wanted the health professionals to have name tags or introduce themselves to the family members;

“It is very difficult to tell whether it’s the nursing officer or just an ordinary worker. But all I can say is that one of the workers gives us updates” (Participant#11).

Need for proximity

The need for proximity refers to the frequency with which family members visit their loved ones in ICU/HDU. The family members wanted to visit their patients frequently as expressed by the following participant;

“I would love to see my brother as frequently as possible just to get some fears out of my mind. Even though I come here and stay for hours, I spend my day outside; they don’t allow us inside. This gives me so many worries.” (Participant#5).

Another participant suggested that the visiting protocol be reviewed;

“…the members of staff should meet and look into the ICU protocol especially to review the visiting guidelines. At least for once, they should be allowing important and closest family members to get into the ICU and see their patients. ”. (Participant#11).

Perceived physical needs

Physical needs are things that family members required for the physical health during the admission of their relative. The family members mentioned the need for shelter, financial support, and food supply because the hospital only provides for patients and not guardians. A participant stated that:

“…the supplies I brought are finished like relish, maize flour. I don’t know what to do, I also came with my husband’s nephew. It is tough on us. I am worried.” (Participant#2)

Furthermore, the shelter referred to a space where only family members of critically ill patients could rest and discuss their experiences. The following is an example of their explanation:

“We know this is one of the biggest hospitals in Malawi and we feel they can consider us a room, where we can be put up as guardians of patients in ICU”. (Participant#11):

Another participant shared that:

“…when they chase us I don’t have anywhere to go, so I go outside the gate and stay there waiting for maybe evening staff, so they should help us to at least have a place where we can stay, because they told us to go to the kitchen but looking at the kitchen environment, the surrounding and there is congestion” (Participant# 9)

Some participants were also concerned about financial constraints. This meant the financial burden to family members when they were advised to access other services for their patients such as Computed Tomography (CT) scans for diagnostic investigations from other private hospitals since the hospital had a nonfunctional machine. Participants expressed themselves as follows:

“I am still worried because the doctor recommended that my patient should go for scanning at a private facility, where I am supposed to pay for such services. As I indicated, I am very much worried about where I would get the money from”. (Participant#7)

Coping mechanisms

Coping mechanisms are adaptations made by family members in response to bad experiences and perceived family requirements, as described above. Prayer, acceptance of the circumstance, and hope, were among the coping techniques.

Prayer

Family members' spiritual belief in God was critical in helping them cope with stressful events and bringing consolation into their lives. Belief in prayer gave members of the family hope or expectations. During the visiting period, some participants pray for God's intervention on behalf of their patients as expressed by the following participants:

“I am a spiritual person and at the same time a guardian to …, I take some time praying for him. I can get into the room and pray silently without disturbing other patients in the ICU…. As it is now, I just commit everything in the hands of God to intervene in our situation”. (Participant#1)

Furthermore, another participant said:

“…So, all we ask for is that God should continue using the medical staff to treat and care for our patient and hoping that one day God will descend his healing hand upon our patient. But if anything happens to our patient, we know it’s the will of God. (Participant#12)

Accepting the condition

Some individuals thought the patient's condition was hopeless and simply accepted it. Participants stated the following:

“… But I have just accepted the situation; I know that my child is admitted to that unit for special treatment.” (Participant#1).

Another participant said:

“As it is at the moment, we will welcome anything that will come on our way; to be honest our patient’s condition is worrisome… So, I just accept it and go by their conditions” (Participant#5):

The study findings pointed out some important views of family members that should be handled by health workers. Depending on their situation, different participants articulated their needs according to the experience. The patient's progress information, psychosocial support and physical needs were mentioned during the interviews. Some coping mechanisms which assisted them were among the narratives.

The demographic profile of participants, majority were females, as opposed to males. This suggests that female relatives are expected to be there in the presence of their patients and are the ones closest to providing care. Similarly, ⁹ reported that women are typically considered as the family's primary care givers in the African context. Furthermore, ⁷ observed that more than half of the participants in their study were female care givers. Similarly ⁸ in Malawian setting found that most of family members (Hospital Guardians) who cared for the sick relation are women Almost half of the participants in this study were elementary school dropouts. This may also have an impact on their understanding of their patient's condition and care. According to ⁹, educational level of patients' family members and others is associated with their knowledge and understanding of concerns related to ICU/HDU hospitalization.

The perceptions of these family members are thought to aid health practitioners in considering and improving their care. However, ¹³ reported that families who struggle with the stress of having a loved one in the ICU could often think that they were left alone and that no one would help them. According to the literature, identifying and addressing the perceived needs of family members, does not only lessen the unpleasant emotions felt by relatives of patients, but also improve the hospital's service quality ¹⁰.

Perceived information needs

During their time in the ICU/HDU, family members raised concerns about the information requirements and others. Likewise, ¹⁴ found that the majority of families believed staff missed occasions to share information with them, or explain care processes. The participants said that they needed information about their patient’s progress in the ICU. They highlighted that information on the patient's progress and the care they receive. These findings are corroborated by¹¹, who found that the majority of family members required more information about the patient’s diagnosis and prognosis. Participants indicated that they were not informed of the patient's progress update due to a lack of information. In support of this conclusion, ¹² discovered that many participants in their study said they didn't always get to talk with the doctor or that they had to wait a long time to get the results of a test or operation. The explanation of what is going on instills confidence in the participants and allows them to deal better ¹³. In a study done by ¹⁴, they found very strong connections between evaluations for communication, information, support, and staff competence in their study. Several individuals reported family member needs, indicating that they wanted to be helped in some way. It is critical for health facility workers to detect family requirements, and solutions for satisfying these needs must also be created and executed ¹².

The perceived need for information or a progress report update was reflected by the majority of the participants in this study. Ten of the twelve respondents revealed a desire for explanations of their patient’s progress after being admitted to the ICU/HDU. They demonstrated that when they are told about their patient's health concerns and the treatment that is required, they believe that their hopes are raised. According to ⁷, family members rely greatly on healthcare staff for information on the patient's status and progress. The authors went on to say that nurses must address the requirements of family members because they are advocates for patients who are unable to make decisions about their care due to their critical state. In addition,¹³ discovered that family members reported how they came to an understanding of the patient’s prognosis by combining what they saw with what the nurses and physicians informed them.

Perceived psychosocial needs

Psychosocial needs comprised support, reassurance, hope, approachable health workers, staff identity, and proximity. In this study, the family members were psychologically distressed as a result of the unplanned circumstance they were in and that they needed to be helped by health workers. Findings of ¹³ showed that ICU nurses are positioned uniquely to provide such support because they have the most contact with both patient and family. Psychological distress is one of the most common psychological disorders identified by family members with relatives admitted to the ICU ¹⁵. Healthcare providers are required to provide psychological assistance as part of their care.

Likewise, reassurance, which is a psychological need for family members, was identified as a critical strategy in managing their stressed mood in the ICU/HDU in this study. Reassurance simply means the action of removing someone's doubts or fears ¹⁶. This means that when family members are reassured by healthcare professionals, they gain trust and are relieved of stress. ¹⁷ examined the perceptions of ICU nurses and families regarding the psychosocial needs of families of intensive care patients and reported that the family should be assured by the medical team that their patient is receiving the best possible care. In this study, we noted that the nurses and other healthcare personnel did not give reassurance to the family members, which led to some fear and uncertainty about how well the patient was doing. Similarly, ¹⁸ found that family members' watchful attendance revealed the need for reassurance as well as the need to be close to the patient to create confidence and trust in the healthcare professionals' treatment. This study found that togetherness and reassurance in family members would help relief of stress. In support of this a study done by ³, it was found that Malawian culture strengthens social cohesiveness during critical illness or grief when a family member dies.

Participants in the study were unable to distinguish between staff workers due to the style of dressing or scrub suits they wore. They required an identifier to know with whom they were speaking. Family members describe nurses as a significant source of information about the ICU environment, therapies, and the patient's health state, according to ¹³. This suggests that if the participants identify nurses, they may be a top priority for them to speak with. In support of this ¹⁹ pointed out that nurses’ clinical specialty had a significant influence on their attitudes towards overall. In their study ¹⁹ results suggested that nurses’ prior education in family nursing and clinical specialty determine their ability to work with and engage families in critical care. ICU nurses are well-positioned to assist because they have the greatest contact with both the patient and the family ¹³.

According to the findings, nearly half of the participants desired frequent visits from their relatives, indicating a demand for proximity. ¹¹ found that proximity was important to many family members. This was also in line with the fact that participants in the study clearly emphasized the need to remain near to the patient, as family members felt compelled to track the care that was being delivered ¹⁸. According to ¹⁵, open visiting hours help to decrease anxiety in families since family members may spend more time with the patients and feel safer being there than not being there. In a similar vein, ⁷ discovered that the proximity subscale determined the requirement to see the patient frequently. ²⁰ discovered that more than half of their participants thought that having flexible visiting hours was highly significant and that some of them thought that they should be able to visit at any time.

Perceived Physical needs

Special shelter, food supply, and financial resources were among the physical needs which we identified from participants. The findings of this study revealed that there is a need for at least a pleasant shelter for family members waiting for critically ill loved ones, where they can relax and relieve tension. In Malawian hospitals, such as KCH, at least one family member is permitted to remain on the premises as the admitted patient's guardian. Because many of them have been referred or have traveled a long distance, they require shelter and food to meet their physiological demands. According to the unique shelter's description, they wanted a resting room for family members of critically sick patients in ICU/HDU where they could stay and share comparable experiences, allowing them to empathize and encourage one another. This study found that unlike family members who have patients in other departments, those who have critical patients in ICU/HDU may feel connected and be able to share their experiences and console one another. Encourage family members to chat about themselves and the patient by making eye contact, sitting close, using touch, engaging in small talk, and using humor ¹⁷.

Furthermore, participants noted that the environment of the hospital's guardian's shelter was unsuitable for them. The entire hospital has one common shelter where all guardians from other departments stay, however the participants desired a separate location or room where they could discuss their common experiences and impressions of their needs while waiting for their patients in the ICU/HDU. Similarly, ¹² observed that participants in their study expressed a desire for a better physical atmosphere in the waiting rooms. Other issues, such as the need for more comfortable waiting room furniture and the desire for less stringent visiting hours, may not appear to be important to some, but they are critical if holistic care is to be provided to not only the patient but also the family who is there to support and encourage the patient in their recovery, according to the authors. In support with this, ²¹ noted as a life experience that the family prefers to spend time in the family area, which serves as a home and an extended location in ICUs. Family members choose to stay within the hospital grounds merely to be close to their relatives due to the stress and fear they face in the ICU/HDU. When a family member is admitted to the ICU, most parents and spouses never leave the ICU perimeter ⁷.

Coping Mechanisms of Family members.

Coping mechanisms were noted in the study as a result of family members’ adaption to the ICU/HDU unit setting, which improved control over stressful periods. Good coping mechanisms could make it easier for the participants to adapt to their current situation. Prayer, acceptance of the situation, and hope are some of the coping mechanisms. Nearly half of the participants said they believed in prayer for the betterment of their loved ones in ICU/HDU. They showed faith in God's healing power. This is consistent with the findings of, ²¹ who found that religious-spirituality views were particularly essential in stressful situations such as a patient's admission to the ICU. Many people in this country are Christians, and praying for their relatives gives them hope and strength, believing that their admitted relative in ICU or HDU would have a better outcome.

One of the coping mechanisms we discovered was acceptance of the situation. This was one of the internal motivations that propelled the participants to adapt and move forward, while they were with their families in the ICU/HDU. The results corroborated those of ²² who discovered that family members disturb routine organization and personal life by adjusting to hospital routines. The authors claim that because family members want a break from daily living, sleep patterns are disturbed. To make sense of it all, they experiment with different coping strategies. However, ²³ stated that it takes longer for a patient's family to come to terms with the grim diagnosis. This was because telling the truth was difficult for a variety of reasons, including cultural taboos against talking about death and the importance of family in deciding on care.

The study has shown that perceived information needs, psychological needs, and physical needs were the family members’ needs found as well as their coping mechanisms. The perceived information needs aspects were found to be significant among family members of patients admitted to the ICU/HDU. These findings provide insight for nurses and other healthcare professionals on what family members value in terms of their requirements, and what they should consider for them during the time they have a patient admitted to the ICU/HDU. In addition to that for a collaborative relationship in order to improve the family members expectations.

Acknowledgements

I acknowledge my supervisors for the guidance they gave to me. The study was conducted in fulfilment of the primary author’s Master’s degree at Kamuzu College of Nursing (KCN) which is under Kamuzu University of Health Sciences (KUHEs) with funding from Mr G. and Miss S.H. from Hannover Germany. Additional research funding was provided by the Ministry of Education, through the Directorate of Higher Education for the proposed grant. The authors declare no conflict of interest.

Authors’ contributions

All authors (A.K, .C. M, & R.G) contributed equally towards study conception, study design, data collection, analysis, interpretation, and manuscript preparation. All authors (A.K, .C. M, & R.G) read and approved the manuscript.

Funding

The Malawi Ministry of Education through the Higher Education Research Grants supported this study.

Availability of data and materials

Data is available with the corresponding author and may be made available upon request.

Ethics approval and consent to participate

All methods were performed in accordance with the relevant guidelines and regulations. For example, ethical approval for the study was obtained from the College of Medicine Research and Ethics Committee (COMREC) of the University of Malawi (reference number is P.10/20/3168. Informed consent was read to each participant in the study and written consent or thumbprint was acquired, and participated voluntarily with option to withdraw. To ensure anonymity, participants were assigned codes and names were not used in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no conflict of interest.

Author details

¹Kamuzu University of Health Sciences, P/Bag 1, Lilongwe, Malawi.

² Daeyang University, P.O. Box 30330, Lilongwe, Malawi.

Frivold G, Dale B, Slettebø Ã. Family members’ experiences of being cared for by nurses and physicians in Norwegian intensive care units: A phenomenological hermeneutical study. Intensive Crit Care Nurs. 2015 Aug 1;31(4):232–40.
Jensen HI, Gerritsen RT, Koopmans M, Downey L, Engelberg RA, Curtis JR, et al. Satisfaction with quality of ICU care for patients and families: the euroQ2 project. Crit Care. 2017;21(1):1–10.
Gundo R, Lengu ES, Maluwa A, Mtalimanja O, Chipeta D, Kadyaudzu C. An audit of admissions to intensive care unit at Kamuzu Central Hospital in Malawi.Open J Nurs. 2014;2014.
Bradshaw C, Atkinson S, Doody O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res. 2017;4:1–8.
Creswell JW. Research designs: Qualitative, quantitative, and mixed methods approaches. 3rd ed. Los Angeles: SAGE Publications, Inc; 2009.
Gundo R. Contextual issues that influence preparedness of nurses for critical care nursing practice in Malawi. Malawi Med J. 2019;31(2):138–43.
Hashim F, Hussin R. Family Needs of Patient Admitted to Intensive Care Unit in a Public Hospital. Procedia - Soc Behav Sci. 2012 Jan;1:36:103–11.
Hoffman M, Mofolo I, Salima C, Hoffman I, Zadrozny S, Martinson F, et al. Utilization of family members to provide hospital care in Malawi: the role of hospital guardians. Malawi Med J. 2012;24(4):74–8.
Bandari R, Heravi-Karimooi M, Rejeh N, Mirmohammadkhani M, Vaismoradi M, Snelgrove S. Information and support needs of adult family members of patients in intensive care units: an Iranian perspective. J Res Nurs. 2015 Aug;20(5):401–22.
Elay G, Tanriverdi M, Kadioglu M, Bahar I, Demirkiran O. The needs of the families whose relatives are being treated in intensive care units and the perspective of health personnel. Annals Med Res. 2020;27(3):825–9.
Abdel-Aziz AL, Ahmed SE, Younis GA. Family needs of critically ill patients admitted to the intensive care unit, comparison of nurses and family perception. Am J Nurs Sci. 2017;6(4):333–46.
Nolen KB, Warren NA. Meeting the Needs of Family Members of ICU Patients: Critical Care Nursing Quarterly [Internet]. 2014 [cited 2022 Oct 16]. Available from: https://journals.lww.com/ccnq/Abstract/2014/10000/Meeting_the_Needs_of_Family_Members_of_ICU.6.aspx
Adams JA, Anderson RA, Docherty SL, Tulsky JA, Steinhauser KE, Bailey DE. Nursing strategies to support family members of ICU patients at high risk of dying. Heart Lung. 2014 Sep;43(1):406–15.
Carlson EB, Spain DA, Muhtadie L, McDade-Montez L, Macia KS. Care and caring in the intensive care unit: Family members’ distress and perceptions about staff skills, communication, and emotional support. J Crit Care. 2015 Jun 1;30(3):557–61.
Abdul Halain A, Tang LY, Chong MC, Ibrahim NA, Abdullah KL. Psychological distress among the family members of Intensive Care Unit (ICU) patients: A scoping review. J Clin Nurs. 2022;31(5–6):497–507.
Wong P, Liamputtong P, Koch S, Rawson H. Searching for meaning: A grounded theory of family resilience in adult ICU. J Clin Nurs. 2019;28(5–6):781–91.
Shorofi SA, Jannati Y, Moghaddam HR, Yazdani-Charati J. Psychosocial needs of families of intensive care patients: Perceptions of nurses and families. Niger Med J J Niger Med Assoc. 2016;57(1):10–8.
De Beer J, Brysiewicz P. The needs of family members of intensive care unit patients: A grounded theory study. South Afr J Crit Care. 2016;32(2):44–9.
Zwicky A, Thaqi Q, Hediger H, Naef R. The influence of nurse characteristics on practice skills and attitudes towards working with families in critical care: A regression analysis. Intensive Crit Care Nurs. 2022 Oct 1;72:103261.
Munyiginya P, Brysiewicz P. The needs of patient family members in the intensive care unit in Kigali, Rwanda. South Afr J Crit Care. 2014 Jul;23(1):5–7.
Gaeeni M, Farahani MA, Seyedfatemi N, Mohammadi N. Informational support to family members of intensive care unit patients: the perspectives of families and nurses. Glob J Health Sci. 2015;7(2):8.
Javelona ED. Perceptions and Attitudes of ICU Nurses toward Family Participation in Patient Care: A Descriptive Correlational Study - ProQuest [Internet]. 2021 [cited 2022 Oct 16]. Available from: https://www.proquest.com/openview/3b74b40986e33b7a2046fcf80ce153da/1?pq-origsite=gscholar&cbl=18750&diss=y
Min J, Kim Y, Lee JK, Lee H, Lee J, Kim KS et al. Survey of family satisfaction with intensive care units: a prospective multicenter study.Medicine (Baltimore). 2018;97(32).

No competing interests reported.

Download PDF

Journal Publication

published 21 Aug, 2023

Read the published version in BMC Nursing →

Editorial decision: Major revision
19 Feb, 2023
Reviews received at journal
06 Feb, 2023
Reviewers agreed at journal
26 Jan, 2023
Reviewers agreed at journal
26 Jan, 2023
Reviewers agreed at journal
26 Jan, 2023
Reviewers invited by journal
23 Jan, 2023
Editor assigned by journal
23 Jan, 2023
Editor invited by journal
20 Jan, 2023
Submission checks completed at journal
20 Jan, 2023
First submitted to journal
20 Jan, 2023

You are reading this latest preprint version

‘Hearing nothing from those caring for my patient is depressing’: Family members’ perception of their needs in intensive care unit at Kamuzu Central Hospital, Malawi

Status:

Journal Publication

Version 1

Abstract

Introduction

Methods

Study approach and design

Study setting

Participants

Data collection

Data analysis

Ethical consideration

Results

Perceived information needs

Perceived Psychosocial needs

Need for hope

Need for approachable health workers

Need for staff identity

Need for proximity

Perceived physical needs

Coping mechanisms

Prayer

Accepting the condition

Discussion

Perceived information needs

Perceived psychosocial needs

Perceived Physical needs

Conclusion

Declarations

References

Additional Declarations

Status:

Journal Publication

Version 1