Wong, P., Liamputtong, P., Koch, S., and Rawson, H. (2019). Searching for meaning: A grounded theory of family resilience in adult ICU. Journal of Clinical Nursing, 28(5-6), 781–791. https://doi.org/10.1111/jocn.14673
When family members are supported during their relative’s admission to the ICU, they are better able to make sense of the situation, feel valued, and offer critical expertise to the health care team resulting in better health care for the patient.
Using a constructivist grounded theory, this study aimed to understand the multiple perspectives of family members’ experiences as they interacted in the ICU, and to provide an explanatory framework for their interactions. 25 adult family members of 21 patients, who were unexpectedly admitted to a generalized ICU in metropolitan Australia, were interviewed by a registered nurse on their experiences during their relative’s ICU stay. Data were collected in three coding phases: initial, focused, and theoretical.
The authors conclude that the unexpected hospitalization often causes family members to feel they have lost control which in turn contributes to greater feelings of anxiety and distress. This, then, interferes with the family members’ ability to contribute to decision-making and advocacy on behalf of the patient. As families regain control, often by discerning some meaning in the situation or for their role, they build resilience as well as the potential to better meet their family members’ needs.
Uncertainty about a critically ill relative’s health status leads family members to seek out information in various ways in order to make sense of the situation and find meaning. Family members cite needing to piece together information from various health care staff and sometimes still not being able to make sense of the bigger picture. This increases the potential for families to develop postintensive care syndrome (PICS-F), marked by anxiety, depression, and posttraumatic stress disorder.
By clearly communicating and engaging family members in patient care, the health care team can lessen the potential for PICS-F and help family members find meaning in the experience, in turn building resilience and better helping their family member.