Debay Vanessa, Hallot Sophie, Calderone Alexander, Goldfarb Michael
McGill Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Department of Internal Medicine, McGill University, Montreal, Quebec, Canada.
CJC Open. 2023 May 16;5(8):619-625. doi: 10.1016/j.cjco.2023.05.002. eCollection 2023 Aug.
Observational studies have shown an association between family participation in intensive care unit (ICU) rounds and better family-centred outcomes. However, evidence from randomized studies on the impact of family participation in ICU rounds is lacking. The objective of this pilot study was to evaluate the feasibility of a randomized trial for family participation in ICU rounds and obtain preliminary estimates of effect to inform a future effectiveness trial.
Family members of patients in the cardiovascular ICU at an academic tertiary-care hospital were randomized to the intervention (participation in rounds) or usual-care group. Following ICU discharge, family member participants completed the family satisfaction (Family Satisfaction in the Intensive Care Unit Survey [FS-ICU]). Feasibility metrics were recruitment (≥ 10 participants per month), uptake (≥ 80%), and follow-up (≥ 80%). Effectiveness was measured by between-group differences in survey score at follow-up.
A total of 27 participants were recruited over 8 weeks. A total of 44% of family members (27 of 61) who were approached agreed to participate. Nonparticipation was due most commonly to lack of interest (N = 20; 64%). All family members randomized to the intervention (N = 16) were present for rounds (100% uptake). Follow-up data were available for 23 participants (85%). Family members who participated in rounds had a higher level of satisfaction with care, compared to the usual-care group (87.3 vs 74.7, = 0.03, respectively).
Family participation in cardiovascular ICU rounds is feasible and effective at improving family satisfaction. Our findings will inform the design of a planned, larger, multicentre study to evaluate the effectiveness of family participation in ICU rounds to improve family-centred outcomes. Trial registration number: NCT05528185.
观察性研究表明,家庭参与重症监护病房(ICU)查房与更好的以家庭为中心的结果之间存在关联。然而,关于家庭参与ICU查房影响的随机研究证据不足。这项试点研究的目的是评估家庭参与ICU查房随机试验的可行性,并获得效果的初步估计,为未来的有效性试验提供依据。
一家学术三级护理医院心血管ICU患者的家庭成员被随机分为干预组(参与查房)或常规护理组。ICU出院后,家庭成员参与者完成家庭满意度调查(重症监护病房家庭满意度调查[FS-ICU])。可行性指标包括招募(每月≥10名参与者)、参与率(≥80%)和随访率(≥80%)。有效性通过随访时两组调查得分的组间差异来衡量。
在8周内共招募了27名参与者。共有44%(61名中的27名)被邀请的家庭成员同意参与。未参与最常见的原因是缺乏兴趣(N = 20;64%)。所有随机分配到干预组的家庭成员(N = 16)都参与了查房(参与率100%)。23名参与者(85%)有随访数据。与常规护理组相比,参与查房的家庭成员对护理的满意度更高(分别为87.3和74.7,P = 0.03)。
家庭参与心血管ICU查房是可行的,并且能有效提高家庭满意度。我们的研究结果将为一项计划中的、更大规模的多中心研究提供设计依据,以评估家庭参与ICU查房对改善以家庭为中心的结果的有效性。试验注册号:NCT05528185。