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Patient- and Family-centred Care in the Adult Intensive Care Unit: a Feasibility Study

Not Applicable
Not yet recruiting
Conditions
Delirium
Post Intensive Care Unit Syndrome
Post Intensive Care Unit Syndrome Family
Depression
Posttraumatic Stress Disorder (PTSD)
Mortality
Length of ICU Stay
Pain
Satisfaction Survey
Anxiety
Registration Number
NCT06974214
Lead Sponsor
Herlev Hospital
Brief Summary

Background: In the intensive care unit (ICU), delirium in patients and long-term mental health challenges in both patients and their family members are highly prevalent. To address these issues, patient- and family-centered care has been recommended to alleviate the burdens associated with critical illness and ICU admission. We have developed the patient- and FAMily-centered care in the adult ICU intervention (FAM-ICU intervention). This multi-component intervention comprises several concrete and manageable components and operationalizing patient- and family-centered care principles in clinical practice. In this protocol, we describe a study aiming to evaluate the feasibility and acceptability of the FAM-ICU intervention in the adult ICU setting, including the feasibility of collecting relevant patient- and family-member outcome data.

Referenc: Bohart et al. 2024. Acta Anaesthesiol Scand

. 2025 Jan;69(1):e14539. doi: 10.1111/aas.14539. Epub 2024 Oct 24. Method: We will conduct a pre-/post two-group study design. We plan to recruit 30 adult ICU patients and their close family members at Herlev University Hospital in Denmark. The pre-group (n = 15) will receive usual care and the post-group (n = 15) will receive the FAM-ICU intervention. The FAM-ICU intervention involves interdisciplinary training of the ICU team and a systematic approach to information sharing and consultations with the patients and their family. Feasibility outcomes will include recruitment and retention rates, intervention fidelity, and the feasibility of participant outcome data collection. Acceptability will be assessed through questionnaires and interviews with clinicians, patients, and family members. Data collection is scheduled to begin in January 2025.

Discussion: This study will assess the feasibility and acceptability when implementing the FAM-ICU intervention and the feasibility of conducting a main trial to investigate its effectiveness on delirium in patients and the mental health of patients and family members. The data from the feasibility study will be used to guide sample size calculations, trial design, and final data collection methods for a subsequent stepped-wedge randomized controlled trial.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Primary Outcome Measures
NameTimeMethod
Acceptability, Adherenceduring ICU admission.

Willingness to follow the intervention (Including barriers and facilitators).

Acceptability, Convenienceduring ICU admission.

The intervention intrusiveness (how easy is it to apply)

Feasibility, Retention rate1 month post ICU admission

The number of non-responders to the self-reported questionnaires at 6 months.

Acceptability, Appropriatenessduring ICU admission.

Perception of how suitable the intervention is for the target population,

Feasibility, Fidelityduring ICU admission.

The frequency and resource use of intervention delivery. Free text describing experienced barriers and facilitators for completing/not completing an intervention component.

Feasibility, recruitment rateduring ICU admission.

Number of approached participants who consent to participate.

Acceptability, effectivenessduring ICU admission.

Perception of whether the intervention helps manage the problem.

Secondary Outcome Measures
NameTimeMethod
Employment status, patient6 months post ICU

Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired.

Cognitive function6 months post ICU

Assessed using Mini Montreal Cognitive Assessment (Mini MoCA).

Out of hospital6 months post ICU

Number of days out of hospital

Anxiety, family6 months post ICU

Symptoms of anxiety using HADS

Depression, family6 months post ICU

Symptoms of depression using HADS

PTSD, family6 months post ICU

Symptoms of PTSD using HTQ

Satisfaction, familyAt ICU discharge.

Survey for family-members regarding satisfaction.

Employment status, family6 months post ICU

Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired.

Employment status6 months post ICU

Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired.

PTSD, patients6 months post ICU

Symptoms of PTSD using Harvard Trauma Questionnaire part 4 (HTQ-lV).

Health-related quality of life, patients6 months post ICU

Assessed using EQ-5D

Free of life supportduring ICU admission.

Days without mechanical ventilation, receiving vasopressors and undergoing dialysis.

Survival6 months post ICU

Days alive.

Free of deliriumduring ICU admission.

Number of delirium free days assessed by Confusion assessment method ICU (CAM-ICU)

Anxiety, patients6 months post ICU

Symptoms of anxiety, using Hospital Anxiety and Depression Scale

Depression, patients6 months post ICU

Symptoms of depression using Hospital Anxiety and Depression Scale.

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