A Qualitative Research On The Impact Factors Of ICU Patients’ Family Members

Objectives The aims of the research were to explore the uncertainty in illness of thepatients’ family members in intensive care unit, and discuss the major influencingfactors.It would provide the foundation of interventions to reduce the level of uncertaintyin illness, and in order to give a better support to the family members and improve therehabilitation of the patients.Methods A hermeneutic phenomenological approach of qualitative research was used inthis study. Using purposeful sampling, seventeenth family members of ICU patients in ageneral teaching hospital of Wuhan were semi-structural interviewed. To explore theexperience of uncertainty in illness, then the findings were transcribed and analyzed to findthe themes and sub-themes.Results The impact factors of family members’ uncertainty in illness were classified intofour themes.1Theme one: The patients’ condition of the illness1.1Complicated conditions of illness of the patientComplicated illness is not only increased the difficulty of treatment and informationunderstand, but also increase the family members’psychological burden.1.2Patients’illness change processThe disease change of ICU patients is very urgent and fast, every change of the diseaseto the family member is a stress.1.3Patients’ psychological conditionsFamily members were very worried about the patients’ psychological conditions, theyworried if the patients don’t have a good state of mind which would influence thecompliance and the effect of treatment.2Theme two: Lack of medical knowledge and the limit ability of understand2.1Lack of medical knowledge Having no much medical knowledge influenced family members’ ability to understandpatient’s illness.2.2Ability of understandingBecause of the limit of Cultural level, family members couldn’t get effectiveinformation from the doctor.3Theme three: Worry about the outcome of the patient was a very important influencefactor to the family members’illness uncertainty.3.1The sequelae of the patient3.2The recurrence of the patient3.3The specialist’ treatment of the patient3.4Uncertainty in illness after transfer from intensive care4Theme four: Social factors4.1Financial burdenRespondents general expressed that ICU medical expenses was very high, the financialburden was very heavy，especially for the rural family members.4.2Information support: In this research, a large proportion of the family membersreflected that there weren’t a sufficient communication between family members with themedical staff, they didn’t get the sufficient information support.4.3The level of medical care serviceLack of the experience, family members expressed their concern whether the patient couldget quality care and humanistic care from the nurses.4.4Visiting systemAlthough most respondents understood and supported the ICU visiting system and the noaccompanying system, visiting system as a double-edged sword objective impacted familymembers’illness uncertainty.4.5The ICU environment4.5.1The instruments and the equipment Unfamiliar equipment could cause family members make incorrect guesses, they didn’tknow whether it is the need of treatment or the sign of aggravation.4.5.2Environmental layoutWhen families visiting the ICU, they could have a rough idea and based on theirunderstanding to make a judgment whether the ICU environment was benefit for thepatient’s treatment.Conclusion: This findings provided elaborate data for nurses deeper understanding of theinfluencing factors of family members’ illness uncertainty, it will be able to give the ICUadministrators and nursing staff beneficial consult, and can promote the familiessatisfaction，so promote the rehabilitation of the patient in the end.