Abstract and Introduction
Abstract
Background: Factors such as the thought of losing the patient, the uncertainty of the course of the disease, and the inability to obtain sufficient information about the patient are frightening and alarming for relatives of patients in the intensive care unit.
Objectives: To determine the quality of life and the style of coping with stress of the relatives of patients hospitalized in the intensive care unit during the COVID-19 pandemic.
Methods: This study was descriptive and cross-sectional. A personal information form, the Styles of Coping With Stress Scale, and the 36-Item Short Form Health Survey were used to collect data.
Results: The sample size of the study was 162 relatives of patients in the intensive care unit. There was a highly significant (P = .001) positive correlation between the Styles of Coping With Stress mean scores of the participants and their quality of life (as shown by the 36-Item Short Form Health Survey).
Conclusions: In addition to the uncertainty and fear associated with the COVID-19 pandemic, it is very distressing to have a relative who is a patient in the intensive care unit. In this context, it is especially important to improve the level of coping with stress of the relatives of patients in the intensive care unit and to increase their quality of life.
Introduction
Intensive care units (ICUs) are technologically complex to support the vital functions of critically ill patients. Patients in the ICU require a lot of attention, and the professional ICU care team administers specialized life-saving treatments.[1,2] The ICU team must also monitor and keep up with constantly changing information and technologies. Although ICU mortality rates vary depending on the underlying disease, they are generally high.
For relatives of patients, the feeling of being separated from their relative creates stress, and additional sources of stress can include anxiety about losing their loved one, the inability to access sufficient information about the patient, and negative behaviors of hospital personnel. The absence of relatives in the ICU; awareness of the seriousness of the disease; fear of death, treatment, and procedures; fear caused by the environment and complex equipment in the ICU; and noise caused by working health professionals or devices can all be considered frightening and alarming. For both patients and their relatives, a stay in the ICU can be a frightening and alarming experience.[3,4]
For a variety of reasons, such as ensuring patient safety, these units operate differently and have different rules than other services. There are closed areas and restricted areas, which are separate sources of stress and anxiety for patients and their loved ones. All these negative factors affect the patients' family members and have a negative impact on the family members' quality of life.[5] In ICUs, the attention is mostly focused on the patient and the patient's illness. If the relatives of the patient have fear or anxiety while a patient is being provided care in an ICU, this situation can lead to the medical staff ignoring the patient's family members, who are unable to be with the patient during treatment. According to research, patients' family members who were dissatisfied with the care their relative received in the ICU reported higher levels of depression and anxiety than did family members who were satisfied with their relative's care.[6]
Patients' relatives become irate and anxious if no attempt is made to understand their feelings and if they are ignored. The hospitalization of a patient in critical condition is a traumatic experience for the family.[7,8] Admission of a person to the ICU because of a critical illness results in a crisis for both the patient and the patient's family.[9] Family members of patients may even neglect their own needs while they are in the hospital, especially during lengthy treatment processes, which may result in emotional and financial difficulties.[10]
In these situations, the patients' family members' routines are disturbed and they become less interested in other family members and other activities; as a result, their quality of life suffers.[11] The COVID-19 pandemic raises the level of stress that people experience as well as the harmful effects of stress.[12] When faced with a situation with an unpredictable outcome, such as a pandemic, it is considered natural for people to display protection and avoidance behavior with fear and panic.[13] The emotional and psychosocial effects of the uncertainty and crisis that have emerged these days as the pandemic continues and how they are managed or dealt with are important in terms of the individual and society.[14] Results of a study conducted by Alsharari in 2019 indicate that relatives of patients admitted to ICUs have a high need for trust, closeness, and information and the lowest level of need for comfort and support.[15]
Patients in ICUs and their loved ones are having a difficult time during the pandemic.[16] One of the responsibilities of the intensive care team in this pandemic, particularly the nurses, is to support the patient and their family members while also providing the care and treatment that the patient deserves.[17] In this circumstance, it is unavoidable for the family members of patients to go through severe stress because of both the fact that their loved ones are receiving intensive care and the negative effects of the pandemic on their quality of life. The most fundamental responsibility of a professional nurse is to consider the patient's level of stress while making plans holistically, regardless of the primary paradigm of professional care.[18]
This study looked at the stress levels and quality of life of the family members of patients who were being treated in ICUs during the COVID-19 pandemic.
Am J Crit Care. 2023;32(3):205-215. © 2023 American Association of Critical-Care Nurses
