Understanding crisis needs among family caregivers of patients in critical care: A qualitative analysis

Abstract

Background

Family caregivers often experience shock and disorientation when a patient is admitted to critical care. Developing interventions to assist caregivers during this crisis requires a more in-depth understanding of their needs.

Objective

Our aim was to understand family caregivers' needs during a patient's critical care admission and early hospitalisation and differences in needs by caregiver anxiety level.

Methods

We conducted a descriptive mixed-method study. Forty semistructured interviews were conducted with family caregivers of mechanically ventilated critical care patients. The Hospital Anxiety and Depression Scale was also administered. Crisis theory was used to guide this analysis. The data were analysed by content analysis and then stratified by anxiety level to examine differences across groups. Consolidated Criteria for Reporting Qualitative Research were followed.

Setting

Two intensive care units at a large, tertiary academic medical centre were a part of this study.

Findings

Caregivers at all anxiety levels described needs involving information and emotional processing, social support, and self-care, with differences across anxiety groups. Caregivers with anxiety and borderline anxiety expressed limited capacity to think past the current moment, whilst caregivers with low anxiety actively used information to consider next steps and prepare others. Emotional processing appeared more limited in the anxiety and borderline-anxiety groups. Whilst most caregivers reported receiving some degree of social support, some caregivers with anxiety noted family tension, whilst caregivers with borderline and low anxiety had a wider variety of supportive relationships. Caregivers with anxiety reported distress influenced their self-care, whilst caregivers with borderline and low anxiety received tangible help from other family members for self-care.

Conclusion

Family caregivers of critical care patients experience needs during early hospitalisation, although the specific needs differ by caregiver anxiety level.