Barriers to families' regaining control in ICU: Disconnectedness

Area of Science:

• Critical care nursing
• Family studies
• Qualitative research

Background:

• Interactions between healthcare professionals and families significantly impact critical illness experiences and outcomes.
• A lack of theoretical frameworks may hinder patient- and family-centered care in intensive care units (ICUs).

Purpose of the Study:

• To understand families' experiences with healthcare professional interactions during unexpected intensive care unit admissions in Australia.
• To generate a substantive theory guiding critical care nursing practice for family interactions.

Main Methods:

• Grounded theory methodology.
• In-depth interviews with 25 family members of 21 critically ill patients in an Australian metropolitan tertiary-level ICU.
• Data collected between 2009 and 2013.

Main Results:

• A core category of 'regaining control' was identified.
• Disconnectedness, stemming from emotional/physical disengagement and insensitive interactions, increases vulnerability and hinders regaining control.
• Staff disengagement and lack of hope-promoting interactions were key factors in family disconnection.

Conclusions:

• Findings provide an in-depth understanding of staff engagement's impact on families' ability to regain control in the ICU.
• A novel theoretical framework was developed, integrating categories to represent family resilience within the Australian ICU context.
• The study supports the implementation of patient- and family-centered care interventions in ICUs.