Investigating the Impact of the Family Interaction Model on the Anxiety and Mental Well-Being of Patients During Visit Restrictions in Intensive Care Units: A Mixed-Methods Study.

Abstract

Background: Patients hospitalised in the intensive care unit (ICU) often experience feelings of isolation and a sense of profound loneliness. These individuals frequently report symptoms of anxiety, depression and other psychiatric disorders.

Aim: The aim of this study was to examine the impact of the family interaction model on the anxiety and mental well-being of patients during the visit restrictions in the ICUs. Additionally, the experiences of intensive care patients and their relatives regarding this process were investigated.

Study design: This research utilised a parallel design mixed-methods approach, incorporating both quantitative and qualitative designs. A qualitative research design was employed in the quasi-experimental framework to examine post-intervention experiences. The research sample consisted of 47 patients in the intervention group.

Results: The intervention group, that received videos and messages from their relatives, exhibited a decrease in anxiety over time. In contrast, the control group demonstrated an increase in anxiety over time. The results indicated that 77% of these changes were due to the group variable (CI: -38.627 to -30.902; p < 0.05). Mental well-being scores demonstrated an increase over time in the intervention group, while a decrease was observed in the control group. The analysis revealed that 83.4% of this change could be attributed to the group variable (CI: 29.178-35.048; p < 0.05). In the interviews, three themes were obtained from both patients and the relatives of the patients in the intervention group. In the control group, four themes were found. In the qualitative interviews conducted with the patients in the intervention group, the subthemes regarding their feelings about the disease process and intensive care experience included fear, uncertainty and anxiety, and hopelessness and longing, while after the patients were shown the video, themes that overlapped with positive feelings were found. These subthemes were determined as happiness, excitement and hope. In the control group, the subthemes regarding their experiences of the disease process were determined as death anxiety, hopelessness and helplessness, uncertainty, agitation and physical discomfort (pain and fatigue).

Conclusions: The results of this study demonstrated that using remote communication methods to facilitate interaction between patients and their families was linked to reduced anxiety in patients, improved mental well-being and increased satisfaction among their relatives.

Relevance to clinical practice: The primary strength of the study is its pioneering role in facilitating communication between intensive care patients and their relatives at the public hospital level during the pandemic period. Additionally, it has shed light on the emotional outcomes associated with this communication. Moreover, the project facilitated the transmission of the patient's final statements to their relatives, effectively serving as a verbal testament to the bond between the patient and their family. Primarily, communicating the final statements of deceased patients is of paramount humanitarian importance. The results of this study prove that intensive care nurses have an important role in enabling patients to connect with their loved ones in their final stages. Thus, nurses can support recovery, increase communication and ensure farewells.