Author: Leung, Nga-yee
Title: Attitudes of healthcare staff and patients' family members towards family presence during resuscitation in adult critical care units
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Medical personnel -- Attitudes.
Critical care medicine -- Psychological aspects.
Critical care medicine -- Moral and ethical aspects.
Critically ill -- Family relationships.
Department: School of Nursing
Pages: x, 117 leaves : ill. ; 30 cm.
Language: English
Abstract: Background: The practice of Family Presence During Resuscitation (FPDR) means allowing the patients' family members to be present at the bedside when the patient is being resuscitated by healthcare staff. Currently, this is not a common practice in Hong Kong hospitals. The benefits and drawbacks of this practice have been discussed worldwide. However, the attitudes of healthcare staff and patients' family members towards this practice in Hong Kong are not well known. It is crucial to investigate their views and the factors that contribute to this practice so appropriate healthcare policies can be developed. Aim: The aim of the study is to examine the attitudes of healthcare staff and patients' family members in Hong Kong adult critical care units towards the practice of FPDR and to explore the factors that influence their acceptance or disapproval of this practice. Design: The study was an exploratory study with cross-sectional survey design. A survey in the form of a questionnaire was used to collect opinions of healthcare staff and patients' family members towards FPDR in critical care units. Outcome measures: The outcome measures are the level of agreement among healthcare staff and patients' family members about various aspects of FPDR practice. Results: 163 healthcare staff and 69 family members of patients who were hospitalized in critical care units were recruited to participate in the study. About 13% of healthcare staff and 80% of patients' family members supported the practice of FPDR. For the healthcare staff, their previous FPDR experience and education level were significantly correlated with acceptance of the FPDR practice. The regression analysis identified several factors predicting the attitudes of healthcare staff towards FPDR. These factors include strong emotional disturbance to the healthcare staff (p<0.001), the availability of extra support from bereavement service (p<0.001), witnessing FPDR is a traumatic experience for families (p<0.001), family members could share the patients' dying moment with them (p<0.001), adequate training to staff to support family members (p=0.008), difficult to stop resuscitation if the family members present at the bedside disagreed (p=0.013) and concerns about adequate staffing to support families during FPDR (p=0.026). For the patients' family members, the regression analysis identified five predictive factors towards FPDR. They include the domain of health belief (p<0.001), domain of cues and triggers (p<0.001), domain of behavioral control (p<0.001), family members' occupation (p=0.003) and education level (p=0.03). There was no significant difference in the attitudes of doctors and nurses towards FPDR. The results revealed that there was significant difference in the attitudes of healthcare staff and patients' families towards FPDR (p<0.001). Conclusion: The results of this study provide information for the healthcare professionals on development of FPDR programs for patients and their family members. By a thorough collaboration with our multidisciplinary team, the effective and safe implementation of FPDR practice can be enhanced.
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