Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized...

Area of Science:

• Critical Care Medicine
• Patient and Family Centered Care
• Psychological Outcomes

Background:

• Family participation in intensive care unit (ICU) essential care activities is increasingly recognized.
• Understanding the impact of structured family involvement on relatives' psychological well-being and healthcare providers' (HCPs) perceptions is crucial.

Purpose of the Study:

• To evaluate a standardized program for family participation in ICU care.
• To assess the program's effect on relatives' anxiety, depression, posttraumatic stress, and satisfaction.
• To explore ICU HCPs' perceptions and experiences regarding family participation.

Main Methods:

• A multicenter, stepped-wedge cluster randomized controlled trial was conducted across seven adult ICUs.
• The study involved 306 relatives and 235 ICU HCPs.
• A standardized program facilitated family involvement in communication, comfort, personal care, and clinical activities.

Main Results:

• No significant differences were observed in relatives' anxiety, depression, or posttraumatic stress symptoms between intervention and control periods.
• Relatives reported slightly lower satisfaction in the intervention period compared to the control period.
• ICU HCPs reported significantly increased perceived knowledge and skills among relatives for participation in the intervention period.

Conclusions:

• The standardized family participation program did not improve mental health symptoms in relatives of ICU patients.
• ICU HCPs perceived enhanced clarity, knowledge, and skills among both relatives and themselves regarding family participation.
• Further research may be needed to optimize family-centered care interventions in the ICU setting.