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American Journal of Critical Care. 2009;18: 200-209 doi:10.4037/ajcc2009252
Copyright © 2009 by the American Association of Critical-Care Nurses.
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CE Article

Symptoms Experienced by Family Members of Patients in Intensive Care Units

By Jennifer L. McAdam, RN, PhD and Kathleen Puntillo, RN, DNSc. Jennifer L. McAdam is an assistant professor of nursing at the School of Nursing at Dominican University of California, San Rafael. Kathleen Puntillo is a professor of nursing in the Department of Physiological Nursing, School of Nursing, University of California, San Francisco.

Corresponding author: Jennifer L. McAdam, RN, PhD, Department of Nursing, Dominican University of California, 50 Acacia Ave, San Rafael, CA 94901(e-mail: jennifer.mcadam{at}dominican.edu).

Concern for the family members of patients who are at high risk of dying in intensive care units is both a necessary and integral part of providing holistic nursing care. When patients are at high risk of dying, their families experience burdens such as decision making and treatment choices that can cause the families psychological and physical symptoms, most commonly stress, anxiety, and depression. These symptoms in turn can affect family members’ general well-being. Since the late 1990s, several quantitative and qualitative studies have been done to assess symptoms in such family members. In this review of the literature, the current state of the science on symptoms experienced by family members of patients in the intensive care unit is reviewed and critiqued. Risk factors associated with an increase in symptoms experienced are discussed. Overall, surveys that use self-report measures were the most common study design. Limitations of the studies include convenience sampling, small sample sizes, and a lack of description of patients’ characteristics, all of which make comparison and use of findings difficult. Recommendations to address gaps in the literature are highlighted, and future research goals are discussed.

Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Determine symptoms experienced by family members of patients in the intensive care unit.
  2. Examine interventions to reduce symptoms families are experiencing.
  3. Evaluate what further research is needed.
To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue." No CE test fee for AACN members.




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