Abstract
Hospitalization in the cardiac intensive care unit can be a stressful experience for
patients and families. Family members often feel overwhelmed by the severity of their
loved one’s illness, powerless to affect their care, and struggle to comprehend information
regarding their loved one’s current health status and treatment plan. Consequently,
up to half of family members might develop psychological symptoms (depression, generalized
anxiety, and post-traumatic stress disorder) and a syndrome of enduring psychological,
cognitive, or emotional disturbances. Patient and family engagement (PFE) is an emerging
approach that empowers family members to become essential and active partners in care
delivery and research. In the patient care context, the goal of PFE is to improve
the care experience and achieve better outcomes for patients and family members. As
a result of societal trends, family members increasingly wish to directly participate
in their relative’s care and be informed and involved in decision-making. There is
growing evidence that engaging family members in care improves patient- and family-important
outcomes after acute and critical illness. Although the role for PFE in care and research
has been explored in the general critical care context, efforts to inform clinicians
who manage patients with acute cardiovascular disease about the relevance of PFE are
limited. In this review, we describe opportunities for PFE in the cardiac intensive
care unit, outline the current evidence base for PFE in patient care, identify barriers
to PFE and how to overcome them, and highlight knowledge gaps and areas for future
investigations.
Résumé
L’hospitalisation dans une unité de soins intensifs de cardiologie peut être une expérience
stressante pour les patients et leurs familles. Les membres de la famille se sentent
souvent dépassés par la gravité de la maladie de leur proche et impuissants à affecter
leur soin, et ils ont parfois du mal à comprendre l’information qui leur est transmise
sur l’état de santé du patient et sur son plan de traitement. En conséquence, près
de la moitié des proches des patients peuvent présenter des symptômes d’ordre psychologique
(dépression, anxiété généralisée et trouble de stress post-traumatique) et un syndrome
de troubles psychologiques, cognitifs ou émotionnels persistants. Le modèle de participation
du patient et de la famille (PPF) est une nouvelle approche visant à donner aux membres
de la famille les moyens d’être des partenaires essentiels et actifs dans la prestation
des soins et dans la recherche. Dans le contexte des soins au patient, la PPF vise
à améliorer l’expérience des soins et à favoriser l’obtention de meilleurs résultats
pour les patients et pour leurs proches. De nos jours, les membres de la famille souhaitent
de plus en plus participer directement aux soins, être informés des décisions et y
prendre part. Les données recueillies tendent de plus en plus à montrer que la participation
des membres de la famille aux soins peut améliorer les résultats qui sont importants
pour le patient et ses proches après une maladie aiguë et grave. Bien que le rôle
de la PPF en matière de soins et de recherche ait été étudié dans le contexte des
soins intensifs généraux, les initiatives visant à sensibiliser les cliniciens qui
prennent en charge des patients atteints d’une maladie cardiovasculaire aiguë à l’importance
de la PPF sont limitées. Nous présentons donc ici les possibilités de PPF dans les
unités de soins intensifs de cardiologie, les grandes lignes des données probantes
actuelles sur l’importance de la PPF dans les soins aux patients, les obstacles à
la PPF et les façons de les surmonter, ainsi que les lacunes des connaissances et
les questions qui mériteraient d’être explorées.
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Article info
Publication history
Published online: March 31, 2020
Accepted:
March 14,
2020
Received:
January 20,
2020
Footnotes
See page 1038 for disclosure information.
Identification
Copyright
© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
