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Background: In the intensive care unit (ICU), delirium in patients and long-term mental health challenges in both patients and their family members are highly prevalent. To address these issues, patient- and family-centered care has been recommended to alleviate the burdens associated with critical illness and ICU admission. We have developed the patient- and FAMily-centered care in the adult ICU intervention (FAM-ICU intervention). This multi-component intervention comprises several concrete and manageable components and operationalizing patient- and family-centered care principles in clinical practice. In this protocol, we describe a study aiming to evaluate the feasibility and acceptability of the FAM-ICU intervention in the adult ICU setting, including the feasibility of collecting relevant patient- and family-member outcome data.
Referenc: Bohart et al. 2024. Acta Anaesthesiol Scand
. 2025 Jan;69(1):e14539. doi: 10.1111/aas.14539. Epub 2024 Oct 24. Method: We will conduct a pre-/post two-group study design. We plan to recruit 30 adult ICU patients and their close family members at Herlev University Hospital in Denmark. The pre-group (n = 15) will receive usual care and the post-group (n = 15) will receive the FAM-ICU intervention. The FAM-ICU intervention involves interdisciplinary training of the ICU team and a systematic approach to information sharing and consultations with the patients and their family. Feasibility outcomes will include recruitment and retention rates, intervention fidelity, and the feasibility of participant outcome data collection. Acceptability will be assessed through questionnaires and interviews with clinicians, patients, and family members. Data collection is scheduled to begin in January 2025.
Discussion: This study will assess the feasibility and acceptability when implementing the FAM-ICU intervention and the feasibility of conducting a main trial to investigate its effectiveness on delirium in patients and the mental health of patients and family members. The data from the feasibility study will be used to guide sample size calculations, trial design, and final data collection methods for a subsequent stepped-wedge randomized controlled trial.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| usual care | No Intervention | The group receives usual care. | |
| FAM-ICU intervention | Experimental | The group receives the FAM-ICU intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FAM-ICU | Other | This multi-component intervention comprises several concrete and manageable components and operationalizing patient- and family-centered care principles in clinical practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility, recruitment rate | Number of approached participants who consent to participate. | during ICU admission. |
| Feasibility, Retention rate | The number of non-responders to the self-reported questionnaires at 6 months. | 1 month post ICU admission |
| Feasibility, Fidelity | The frequency and resource use of intervention delivery. Free text describing experienced barriers and facilitators for completing/not completing an intervention component. | during ICU admission. |
| Acceptability, Adherence | Willingness to follow the intervention (Including barriers and facilitators). | during ICU admission. |
| Acceptability, Appropriateness | Perception of how suitable the intervention is for the target population, | during ICU admission. |
| Acceptability, Convenience | The intervention intrusiveness (how easy is it to apply) | during ICU admission. |
| Acceptability, effectiveness | Perception of whether the intervention helps manage the problem. | during ICU admission. |
| Measure | Description | Time Frame |
|---|---|---|
| Free of delirium | Number of delirium free days assessed by Confusion assessment method ICU (CAM-ICU) | during ICU admission. |
| Anxiety, patients | Symptoms of anxiety, using Hospital Anxiety and Depression Scale |
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Patients are eligible if they are:
Family members are eligible if they are:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Søs Bohart, PhD | Contact | 0045 38 68 91 86 | soes.bohart@regionh.dk |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39445615 | Result | Bohart S, Waldau T, Andreasen AS, Moller AM, Thomsen T. Patient- and family-centered care in adult ICU (FAM-ICU): A protocol for a feasibility study. Acta Anaesthesiol Scand. 2025 Jan;69(1):e14539. doi: 10.1111/aas.14539. Epub 2024 Oct 24. |
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We will conduct a pre-/post two-group study design.
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| 1 month post ICU admission |
| Depression, patients | Symptoms of depression using Hospital Anxiety and Depression Scale. | 1 month post ICU admission |
| PTSD, patients | Symptoms of PTSD using Harvard Trauma Questionnaire part 4 (HTQ-lV). | 1 month post ICU admission |
| Health-related quality of life, patients | Assessed using EQ-5D | 1 month post ICU admission |
| Free of life support | Days without mechanical ventilation, receiving vasopressors and undergoing dialysis. | during ICU admission. |
| Survival | Days alive. | 1 month post ICU admission |
| Employment status, patient | Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired. | 1 month post ICU admission |
| Cognitive function | Assessed using Mini Montreal Cognitive Assessment (Mini MoCA). | 1 month post ICU admission |
| Out of hospital | Number of days out of hospital | 1 month post ICU admission |
| Anxiety, family | Symptoms of anxiety using HADS | 1 month post ICU admission |
| Depression, family | Symptoms of depression using HADS | 1 post ICU admission |
| PTSD, family | Symptoms of PTSD using HTQ | 1 month post ICU admission |
| Satisfaction, family | Survey for family-members regarding satisfaction. | At ICU discharge. |
| Employment status, family | Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired. | 1 month post ICU admission |
| Anxiety, patients | Symptoms of anxiety, using Hospital Anxiety and Depression Scale | 6 months post ICU |
| Depression, patients | Symptoms of depression using Hospital Anxiety and Depression Scale. | 6 months post ICU |
| PTSD, patients | Symptoms of PTSD using Harvard Trauma Questionnaire part 4 (HTQ-lV). | 6 months post ICU |
| Health-related quality of life, patients | Assessed using EQ-5D | 6 months post ICU |
| Survival | Days alive. | 6 months post ICU |
| Employment status, patient | Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired. | 6 months post ICU |
| Cognitive function | Assessed using Mini Montreal Cognitive Assessment (Mini MoCA). | 6 months post ICU |
| Anxiety, family | Symptoms of anxiety using HADS | 6 months post ICU |
| Depression, family | Symptoms of depression using HADS | 6 months post ICU |
| PTSD, family | Symptoms of PTSD using HTQ | 6 months post ICU |
| Employment status | Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired. | 6 months post ICU |
| Employment status, family | Employment as full-time, part-time, unemployed, self-employed, (paid/unpaid) on leave, student, or retired. | 6 months post ICU |
| Out of hospital | Number of days out of hospital | 6 months post ICU |
| ID | Term |
|---|---|
| D003693 | Delirium |
| D001008 | Anxiety Disorders |
| D003863 | Depression |
| D013313 | Stress Disorders, Post-Traumatic |
| D010146 | Pain |
| ID | Term |
|---|---|
| D003221 | Confusion |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
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