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other·critical care, internal medicine, research methods, family medicine·PMC10170368

The Caregiver Pathway, a Model for the Systematic and Individualized Follow-up of Family Caregivers at Intensive Care Units: Development Study

JMIR Formative Research · 6 authors, 10 centres

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TL;DR

This study used a participatory co-design approach to develop 'The Caregiver Pathway', a four-step model for structuring the follow-up of family caregivers of ICU patients from admission to post-discharge. The model is based on stakeholder input emphasizing the need for caregivers to be present, receive adequate information, and get emotional care.

Full summary

544 CHARS

The study aimed to develop a model for the follow-up of family caregivers of critically ill patients. A participatory co-design approach was used in a two-phase iterative process. The preparation phase included stakeholder meetings, a literature search, and interviews with eight former family caregivers. The literature review underscored the overwhelming situation for caregivers. The study is limited by the single-center context and the first author's prior relationships with participants, which could affect generalizability and analysis.

STUDY TYPE

other

SPECIALTY

critical care

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10170368

The Caregiver Pathway, a Model for the Systematic and Individualized Follow-up of Family Caregivers at Intensive Care Units: Development Study

JMIR Formative Research

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ABSTRACT

Background Family caregivers of patients who are critically ill have a high prevalence of short- and long-term symptoms, such as fatigue, anxiety, depression, symptoms of posttraumatic stress, and complicated grief. These adverse consequences following a loved one’s admission to an intensive care unit (ICU) are also known as post–intensive care syndrome-family. Approaches such as family-centered care provide recommendations for improving the care of patients and families, but models for family caregiver follow-up are often lacking. Objective This study aims to develop a model for structuring and individualizing the follow-up of family caregivers of patients who are critically ill, starting from the patients’ ICU admission to after their discharge or death. Methods The model was developed through a participatory co-design approach using a 2-phased iterative process. First, the preparation phase included a meeting with stakeholders (n=4) for organizational anchoring and planning, a literature search, and interviews with former family caregivers (n=8). In the subsequent development phase, the model was iteratively created through workshops with stakeholders (n=10) and user testing with former family caregivers (n=4) and experienced ICU nurses (n=11). Results The interviews revealed how being present with the patient and receiving adequate information and emotional care were highly important for family caregivers at an ICU. The literature search underlined the overwhelming and uncertain situation for the family caregivers and identified recommendations for follow-up. On the basis of these recommendations and findings from the interviews, workshops, and user testing, The Caregiver Pathway model was developed, encompassing 4 steps: within the first few days of the patient’s ICU stay, the family caregivers will be offered to complete a digital assessment tool mapping their needs and challenges, followed by a conversation with an ICU nurse; when the patient leaves the ICU, a card containing information and support will be handed out to the family caregivers; shortly after the ICU stay, family caregivers will be offered a discharge conversation by phone, focusing on how they are doing and whether they have any questions or concerns; and within 3 months after the ICU stay, an individual follow-up conversation will be offered. Family caregivers will be invited to talk about memories from the ICU and reflect upon the ICU stay, and they will also be able to talk about their current situation and receive information about relevant support. Conclusions This study illustrates how existing evidence and stakeholder input can be combined to create a model for family caregiver follow-up at an ICU. The Caregiver Pathway can help ICU nurses improve family caregiver follow-up and aid in promoting family-centered care, potentially also being transferrable to other types of family caregiver follow-up.

CITATION EXPORT

Solbjørg Watland, Lise Solberg Nes, Elizabeth Hanson et al.. The Caregiver Pathway, a Model for the Systematic and Individualized Follow-up of Family Caregivers at Intensive Care Units: Development Study. JMIR Formative Research. (2023). https://doi.org/10.2196/46299

AUTHORS

6 · 10 CENTRES

Solbjørg Watland, Lise Solberg Nes, Elizabeth Hanson, Mirjam Ekstedt, Una Stenberg, Elin Børøsund

1 Department of Digital Health Research Division of Medicine Oslo University Hospital Oslo Norway
2 Medicine Intensive Care Unit, Department of Acute Medicine Division of Medicine Oslo University Hospital Oslo Norway
3 Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
4 Department of Psychiatry and Psychology College of Medicine and Science Mayo Clinic Rochester, MN United States
5 Department of Health and Caring Sciences Linnaeus University Kalmar Sweden
6 Swedish Family Care Competence Centre Kalmar Sweden
7 Department of Learning Informatics Management and Ethics Karolinska Institutet Stockholm Sweden
8 Norwegian National Advisory Unit on Learning and Mastery in Health Oslo University Hospital Oslo Norway
9 Frambu Resource Center for Rare Disorders Ski Norway
10 Department of Nursing and Health Sciences Faculty of Health and Social Sciences University of South-Eastern Norway Drammen Norway

EDITOR / REVIEWER

Amaryllis Mavragani, Anne Ågård, Geri Baumblatt