Objective: The purpose of this study was to construct the perception model of nurses on family needs of critically ill patients by using the Critical Care Family Needs Inventory - Japanese Version (CCFNI-J).
Methods: We conducted a questionnaire survey of 590 nurses working for ICU, CCU, and medical emergency center in the Kansai area. A questionnaire consisted of questions on the CCFNI-J and demographic data. The nurse’s perception of family needs of critically ill patients consisted of the perceptions of importance and of satisfaction on family needs. We relied on Structural Equation Modeling (SEM) for testing our hypotheses on it. Amos18 was used for statistical analysis of measured values.
Results: 360 questionnaires were returned (response rate 61.0%), among which 336 were valid (valid response rate 93.3%). The perception model of nurses was structured with the perceptions of importance and of satisfaction on family needs. Both perceptions consisted of patient-related needs - the best care for patients, face-to-face contacts with patients, and communication with healthcare providers, and family-related needs - reception of family, family environment, and supporters. The hypothetic model analyzed by SEM fit well with data (χ²=37.508, p=.086, CFI=0.995,RMSEA=0.034). The coefficient from the perception of importance on family-related needs to the perception of satisfaction on patient-related needs was -0.61 while other coefficients from the perception of important to the perception of satisfaction were 0.68 and 0.35.
Conclusions: We constructed the perception model of nurses on family needs of critically ill patients. This model revealed that the perception of importance on family needs affects the perception of satisfaction on family needs. These findings would contribute to the development of nursing practice for meeting family needs.

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This study examined specific nursing care activities done by ICU nurses for family members of dying patients. A qualitative study was conducted using semi-structured interviews. Inclusion criteria were over 5 years of clinical experience, over 3 years of ICU clinical experience and currently assuming leadership roles. Twenty ICU nurses who met the inclusion criteria and gave their written consent were asked about the nursing care activities they had done for the family members of patients greeting death in the ICU. Analysis revealed 10 categories: assisting them to perceive patient conditions as they are; understanding their critical psychological distress and helping them to cope with the unforeseen situation; assisting them in spending time with the unconscious patient; building relationships with them during a short period of time; conveying a sense of security to them; supporting them not to regret the death of the patient in the ICU; making the ICU a suitable place for attending the patient’s deathbed; protecting patient dignity; making arrangements among family members; and acting as advocates on behalf of them. The findings suggest that ICU nurses take measures appropriate to the situation and devise ways to deal with difficulties they may encounter in the ICU, and that the nursing care activities identified be verbalized, shared with other nurses and integrated into practice.

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[in Japanese]

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