Survey into bereavement of family members of patients who died in the intensive care unit

Introduction

The death of a family member in the ICU is often sudden and unexpected and may have a strong impact. The care provided in the ICU differs from other hospital settings, resulting in special needs for family members of the dying patient. We studied the characteristics of bereavement, the need for follow-up bereavement service and to determine whether the information and care in the ICU is sufficient for relatives of deceased ICU patients.

Methods

A structured telephone interview was conducted in a 10-bed mixed medical-surgical ICU. Patients and respondents were selected according to four criteria: (1) the patient had died between June 2008 and June 2009 in the ICU, (2) there had to be at least one relative, who (3) was involved during the ICU stay preceding death and (4) had sufficient knowledge of the Dutch language. For each deceased patient, one family member was identified as eligible for study participation. All eligible family members were first contacted by an ICU nurse to ask for agreement with the study. Furthermore, the structured interview was then emailed or sent to the family members so they would be able to read the questionnaire prior to the actual telephone interview. Three weeks after the initial telephone call by the nurses, the respondents were contacted for the structured telephone interview with specific attention to the use of new medication, work-related problems, resuming normal activities, money problems and sleeping problems.

Results

A substantial portion of the respondents (37%) complained about sleeping problems. A majority (77%) was satisfied with the provided ICU care and the information provided. Almost all of the respondents (90%) understood the fatal sequence of events during the dying process. Most common complaints concerned communication and the information provided. The need for a follow-up bereavement service was reported by 35% of the respondents. Reasons for such a service were firstly to deal with the death of the family member and secondly to answer remaining questions.

Conclusions

This study demonstrates that most relatives had resumed their normal activities. In addition, there was a high level of satisfaction with the care provided in the ICU, although many considered a followup bereavement service potentially useful. The most frequent persisting bereavement characteristic was related to sleeping problems.