Factors that Influence the Counselling of Family Members in Out-of-Hospital Emergency Medical Care

Abstract

Background: Counselling family members of acutely ill patients has not been studied from the perspective of out-of-hospital emergency care. The purpose of this study was to fill the research gap by describing care providers’ experiences of factors that influence counselling and supporting family members in out-of-hospital emergency care. Methods: The data were collected by semi-structured interviews of emergency care providers (N=15) in Finland in 2014 and analysed using content analysis. Results: Factors that influence the counselling aimed at family members in out-of-hospital emergency care can depend on the patient, family member, emergency care provider or context. Patient-dependent factors involve the patient’s personality, severity of physical and psychological symptoms, criticality of the situation, the patient’s memory, responses, behaviour and cognitive abilities and emotional resources. Family member-dependent factors include the family members’ needs and responses, fears, anxiety, feelings of not having control, needs for support, cognitive and emotional preparedness to commit themselves to help and support the patient and willingness to engage in supporting the patient. Care provider-dependent factors include the care provider’s personality, clinical expertise, theoretical and practical competence, work and life experience and attitudes. Context-dependent factors include time, degree of urgency, safety of the environment and the circumstances. Conclusions: Care providers must gain an overall idea of the family’s function and their ability to endure stress in acute situations, so that counselling can be founded on the family’s strengths and limitations regarding the patient’s follow-up care and coping at home. Ability to differentiate between various factors in counselling situations helps care providers concentrate on factors that they can affect. The results can be used in the education of health carestudents and professionals and in developing the quality of counselling.