Lack of family visitation in the ICU can have long-term consequences on patients in the ICU after discharge. The effect of family visitation on the incidence of patient psychiatric disorders is ...unknown.
What is the association between family visitation in the ICU and incidence of psychiatric outcomes in patients in the ICU 1 year after hospital discharge?
This study assessed a population-based retrospective cohort of adult patients admitted to the ICU from January 1, 2014, through May 30, 2017, surviving to hospital discharge with ICU length of stay of ≥ 3 days. To be eligible, patients needed to have minimum of 5 years of administrative data before ICU admission and a minimum of 1 year of follow-up data after hospital discharge. An internally validated algorithm that interpreted natural language in health records determined patients with or without in-person family (ie, relatives, friends) visitation during ICU stay. The primary outcome was risk of an incidence of psychiatric disorder (composite outcome), including anxiety, depressive, trauma- and stressor-related, psychotic, and substance use disorders, identified using coding algorithms for administrative databases. Propensity scores were used in inverse probability weighted logistic regression models, and average treatment effects were converted to risk ratios (RRs) with 95% CIs. Secondary outcomes were incidences of diagnoses by type of psychiatric disorder.
We included 14,344 patients with (96% n = 13,771) and without (4.0% n = 573) in-person family visitation who survived hospital discharge. More than one-third of patients received a diagnosis of any psychiatric disorder within 1 year after discharge (34.9%; 95% CI, 34.1%-35.6%). Patients most often received diagnoses of anxiety disorders (17.5%; 95% CI, 16.9%-18.1%) and depressive disorders (17.2%; 95% CI, 16.6%-17.9%). After inverse probability weighting of 13,731 patients, in-person family visitation was associated with a lower risk of received a diagnosis of any incident psychiatric disorder within 1 year after discharge (RR, 0.79; 95% CI, 0.68-0.92).
ICU family visitation is associated with a decreased risk of psychiatric disorders in critically ill patients up to 1 year after hospital discharge.
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Expressions of gratitude by leaders tend to yield positive effects in the workplace. Leaders, however, are not solely bestowers of gratitude but also recipients of it. Although leaders are often ...studied for their influence on others in the workplace, it is crucial to acknowledge that they are also complete individuals with personal lives outside of work that can spill over and affect their feelings and leadership behaviors at work. To advance research on leadership and gratitude, we take a whole-person view of leaders to understand the interpersonal crossover and intrapersonal spillover of gratitude. By integrating the moral affect theory of gratitude and savoring interventions research, we investigate how an intervention involving reflecting on gratitude received from family members at home motivates leaders to be more helpful and empowering toward their followers at work. We studied these ideas across three daily field experiments with 103 full-time managers from high schools, 116 leader-follower dyads from a variety of industries, and 109 leaders across various industries. Our findings demonstrate that when leaders reflected on receiving gratitude from family members at home, they felt higher prosocial impact at home, which in turn fulfilled their basic daily needs, consequently motivating them to engage in more helping and empowering behavior toward their followers at work. We also found some evidence that leaders higher in trait negative affect benefited the least from reflecting on receiving gratitude at home. We discuss how our findings provide extensions to literatures on gratitude, leadership, and work-family issues. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Drawing on upper echelons theory, this study examines how the traditionality of family chief executive officers (CEOs) influences the selection of their successors, and how this relationship is ...moderated by two dimensions of socioemotional wealth. Recognizing the central role of CEOs in determining successors, we show that a family CEO’s cultural values regarding traditionality have a significant positive effect on the probability that a family member is chosen as successor. We find that this relationship is strengthened by the family members’ identification with the firm and weakened by the family members’ sense of dynasty. Our contributions to theory and practice are discussed.
Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family ...members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice.
The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission.
A qualitative study was carried out. Semi-structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited.
Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available.
Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours.
Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes.
Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement.
COREQ guidelines.
Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Family members perceive additional value from the use of video calls on hospital wards. For family, use of video calls needs to be facilitated with clear instruction materials and support.
Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560).
The aim of this study was to explore the experiences of family members of patients admitted to the intensive care unit (ICU) for COVID-19 during the first and second waves of the pandemic in ...Switzerland.
A qualitative descriptive approach was used in this study.
Face-to-face in-depth semistructured interviews were used to explore the experiences of family members of surviving COVID-19 patients, who were admitted to the ICU. Interviews were transcribed verbatim and wereanalysed using Braun and Clarke thematic analysis. In our context, family visits were prohibited during the first and second waves of the pandemic.
Fifteen family members participated. Interviews were conducted between October 2020 and March 2021. Data analysis identified three main themes: (i) becoming a pillar of support for all; (ii) dealing with uncertainty; and (iii) a trajectory of emotions. Five subthemes are reported within these themes. The primary concern was the need for information due to visitation restrictions. This led to stress as many became the main communication source for other family members and friends. Coping strategies to support the ongoing uncertainty included daily routines, work, and prayer. The inability to visit and the lack of information led to a range of conflicting emotions, such as feeling of helplessness, which were countered by the gratitude that their loved ones had survived.
This study highlights the profound impact of the COVID-19 pandemic on the family members of ICU patients. It emphasises their struggle for information, adaptation to new roles, and coping mechanisms amidst uncertainty. Although they experienced predominantly negative emotions, the recovery and return of their loved ones triggered a sense of gratitude. This study sheds light on the crucial role of social support. Such findings may have implications for nursing practice in effectively addressing the concerns and priorities of family members in similar emergency situations, thereby improving clinical outcomes.
Purpose
Post-traumatic stress disorder (PTSD) can affect family members of patients admitted to the intensive care unit (ICU). Easily accessible patient’s and relative’s information may help develop ...accurate risk stratification tools to direct relatives at higher risk of PTSD toward appropriate management.
Methods
PTSD was measured 90 days after ICU discharge using validated instruments (Impact of Event Scale and Impact of Event Scale-Revised) in 2374 family members. Various supervised machine learning approaches were used to predict PTSD in family members and evaluated on an independent held-out test dataset. To better understand variables’ contributions to PTSD predicted probability, we used machine learning interpretability methods on the best predictive algorithm.
Results
Non-linear ensemble learning tree-based methods showed better predictive performances (Random Forest—area under curve, AUC = 0.73 0.68–0.77 and XGBoost—AUC = 0.73 0.69–0.78) than regularized linear models, kernel-based models, or deep learning models. In the best performing algorithm, most important features that positively contributed to PTSD’s predicted probability were all non-modifiable factors, namely, lower patient’s age, longer duration of ICU stay, relative’s female sex, lower relative’s age, relative being a spouse/child, and patient’s death in ICU. A sensitivity analysis in bereaved relatives did not alter the algorithm’s predictive performance.
Conclusion
We propose a machine learning-based approach to predict PTSD in relatives of ICU patients at an individual level. In this model, PTSD is mostly influenced by non-modifiable factors.
Background: Conventional or hospital treatment such as surgery, chemotherapy, or radiotherapy is widely recommended by health care providers for treating breast cancer. Early decision in conventional ...treatment is a complex phenomenon that requires careful consideration of the medical condition, available information, potential risk, financial, job, and involvement of family members. However, there is an inadequate understanding of early decisions about conventional treatment in Malaysia. Purpose: This study aimed to explore the early decisions about breast cancer treatment among women and their family members.Methods: This study employed a qualitative, narrative approach. Purposive and snowball sampling were applied, and 28 participants were recruited for this study. The participants took part in in-depth, face-to-face, and audio-recorded one-time interviews. All interviews were subsequently transcribed verbatim and analysed using narrative analysis.Results: This study identified two themes regarding early decisions about breast cancer treatment: (1) women and family members who accepted immediate conventional treatment, and (2) women and family members who refused immediate conventional treatment. This study discovered that some women and family members agreed to undergo conventional treatment immediately due to following doctors’ advice, influence by other patients with breast cancer, personal attitude, and appropriate knowledge concerning breast cancer. Meanwhile, other women refused it due to fear, not ready to undergo treatment, influenced by other people and socio-culture template. The unique finding in this study is the presence of specific socio-cultural templates related to breast cancer.Conclusion: This study highlights that health care providers can assist women who decline breast cancer treatment by offering education about conventional treatment options. This can be achieved by providing accurate information about the treatment, addressing treatment-related fears, providing emotional support, and encouraging open communication regarding the reasons for refusing conventional treatment.
Returning human remains to family members after a loved one's death is thought to support grief adaptation. However, no known research has examined the effects that notifications of fragmented ...remains have on bereaved family members. We examined the number of notifications received, continuing questions about the death, grief severity, and posttraumatic stress (PTS) in family members bereaved by the September 11, 2001 attacks (N = 454). One notification was associated with fewer continuing questions compared to zero notifications, p = .037, or two or more notifications, p = .009. A model using notifications and continuing questions to predict grief severity showed there was no difference between receiving one and zero notifications, p = .244; however, receipt of two or more notifications was associated with higher grief severity compared to zero notifications, p = .032. A similar model demonstrated that receipt of any notifications was associated with PTS, ɳp2 = .026, p = .006. Having continuing questions was associated with grief severity, ɳp2 = .170, p < .001; and PTS, ɳp2 = .086, p < .001. Additionally, participants who received one notification and chose not to receive more had fewer continuing questions compared to all other participants, and participants who received two or more notifications and chose no future notifications had higher PTS levels compared to all other participants. The results indicate that human remains notification is not associated with reduced grief severity but is associated with PTS. These findings should inform notification policy and guide families’ notification choice after traumatic deaths.
Adopting an interpretive grounded theory approach, we find that key events in the early lives of next-generation family members fuel a sense of belonging and identity, which lies at the heart of ...their socioemotional wealth. As next-generation family members interact more with the family business, they interpret nonfinancial aspects of the firm as an answer to a larger variety of affective needs, which broadens and strengthens their interactive socioemotional wealth frame of mind. In line with our life course theory lens, we observe how key events that build up socioemotional wealth greatly influence the life paths of next-generation family members.
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