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Nunez ER, Villa G, McFadden R, et al. Differences in Family Involvement in the Bedside Care of Patients in the ICU Based on Self-Identified Race. Crit Care Explor. 2021;3(3):e0365doi: 10.1097/CCE.0000000000000365.
Nunez, E. R., Villa, G., McFadden, R., Palmisciano, A., Lanini, I., O'Mahony, S., Curtis, J. R., Levy, M. M., & Amass, T. (2021). Differences in Family Involvement in the Bedside Care of Patients in the ICU Based on Self-Identified Race. Critical care explorations, 3(3), e0365. https://doi.org/10.1097/CCE.0000000000000365
Nunez, Eduardo R, et al. "Differences in Family Involvement in the Bedside Care of Patients in the ICU Based on Self-Identified Race." Critical care explorations vol. 3,3 (2021): e0365. doi: https://doi.org/10.1097/CCE.0000000000000365
Nunez ER, Villa G, McFadden R, Palmisciano A, Lanini I, O'Mahony S, Curtis JR, Levy MM, Amass T. Differences in Family Involvement in the Bedside Care of Patients in the ICU Based on Self-Identified Race. Crit Care Explor. 2021 Mar 15;3(3):e0365. doi: 10.1097/CCE.0000000000000365. eCollection 2021 Mar. PMID: 33786441; PMCID: PMC7994041.
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Crit Care Explor. 2021 Mar 15;3(3):e0365. doi: 10.1097/CCE.0000000000000365. eCollection 2021 Mar.

Differences in Family Involvement in the Bedside Care of Patients in the ICU Based on Self-Identified Race.

Critical care explorations

Eduardo R Nunez, Gianluca Villa, Rory McFadden, Amy Palmisciano, Iacopo Lanini, Sean O'Mahony, J Randall Curtis, Mitchell M Levy, Timothy Amass

Affiliations

  1. The Pulmonary Center, Boston University School of Medicine, Boston, MA.
  2. Department of Health Sciences, Section of Anesthesiology, Intensive Care and Pain Medicine, University of Florence, Florence, Italy.
  3. Department of Internal Medicine, Palliative Medicine Section, Rush University Medical Center, Chicago, IL.
  4. Rhode Island Hospital, Research Division of Pulmonary, Critical Care & Sleep, Providence, RI.
  5. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA.
  6. Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Brown University, Providence, RI.
  7. Department of Medicine, Division of Pulmonary Sciences & Critical Care, University of Colorado Denver, Denver, CO.
  8. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO.

PMID: 33786441 PMCID: PMC7994041 DOI: 10.1097/CCE.0000000000000365

Abstract

OBJECTIVES: Being a caregiver for a patient in the ICU can place emotional burden on families and engaging families in caregiving can reduce psychological distress. Our goal was to observe support methods used by families in the ICU and identify differences between race/ethnicity.

DESIGN: A secondary analysis of a multicenter before-and-after clinical trial.

SETTING: Three hospitals in Chicago, Providence, and Florence, Italy.

PARTICIPANTS: Family members of patients admitted to the ICU.

INTERVENTIONS: In the primary study, an intervention was designed to engage families in seven domains that were based on the five physical senses (taste, touch, sight, smell, and sound), personal care, and spiritual care of the patient. During the control phase, nursing staff observed and recorded if they witnessed families participating in support methods unprompted.

MEASUREMENTS AND MAIN RESULTS: We compared the use of support methods among families from different races, categorized by race as either White, Black, or other using generalized estimating equation population-averaged logistic regression analysis. A total of 133 patients and 226 family members were enrolled in the control arm of the primary study, with patients being 71.2% White, 17% Black, and 11.8% other. Compared with Whites, families who identified their race Black or other may be more likely to participate in support methods that included personal care, touch, or spiritual care. Families who identified as Black may also be more likely to incorporate audio or sound. There were no differences in the categories of sight, smell, or taste.

CONCLUSIONS: Our study identifies racial differences in the use of bedside support methods in the ICU. Guiding families in a culturally congruent and open-minded manner may have the potential to decrease family distress and improve the experience for families in the ICU.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Keywords: family engagement; intensive care unit caregiving; racial differences

Conflict of interest statement

Dr. Amass’s institution received funding from the National Heart, Lung, and Blood Institute (grant T32 HL134625). The remaining authors have disclosed that they do not have any potential conflicts of

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