Development and psychometric evaluation of the family intensive care units syndrome inventory.

BACKGROUND: Family members of patient in the intensive care unit (ICU) experience a set of problems which are entitled Family Intensive Care Units Syndrome (FICUS). OBJECTIVES: The aim of this study was to develop and psychometrically evaluate the FICUS Inventory (FICUSI) in Iran. METHODS: This sequential exploratory mixed method study was conducted in 2020 in two main phases. In the first phase, FICUSI was developed based on the results of an integrative review and a qualitative study. In the second phase, the psychometric properties of FICUSI, namely, face, content, and construct validity, reliability, responsiveness, interpretability, and scoring, were evaluated. The sample for the construct validity evaluation consisted of 283 ICU family members. RESULTS: The primary item pool of FICUSI had 144 items and was reduced to 65 items or omitting overlapping and similar items. The scale-level content validity index of FICUSI was 0.89. In the construct validity evaluation through exploratory factor analysis, 31 items with factor loading values more than 0.3 were loaded on two factors (namely psychological symptoms and nonpsychological symptoms) which explained 68.45% of the total variance. The Cronbach's alpha and the test-retest intraclass correlation coefficient of FICUSI were 0.95 and 0.97, respectively. CONCLUSION: FICUSI is a valid and reliable instrument which can be used in clinical settings and studies for FICUS assessment. Further studies for the cross-cultural adaptation of FICUSI in other contexts are recommended. RELEVANCE TO CLINICAL PRACTICE: Health care providers in clinical settings can use FICUSI to assess FICUS among the family caregivers of patients in ICU. Health care providers' better understanding of FICUS helps them understand the quality of their own services for the family members of patients in ICU.

The family intensive care unit syndrome: A qualitative content analysis.

BACKGROUND: Hospitalization of patients in an intensive care unit (ICU) is associated with a series of psychological problems for their family members called family intensive care unit syndrome (FICUS). Nonetheless, family members of patients in ICU often receive little attention from health care providers. Exploring family members' experiences of their patients' hospitalization in ICU helps health care providers focus more clearly on their problems. AIMS AND OBJECTIVES: This study aimed to explore FICUS-related experiences among the family members of patients in ICU. DESIGN: This was a qualitative content analysis study. METHODS: This qualitative study was conducted in 2019. Participants were 14 family members of patients in ICU who were purposively selected from three hospitals in Tehran, Iran. Data were collected using semi-structured interviews and were analyzed using qualitative content analysis. RESULTS: Participants' experiences of FICUS fell into four categories, that is, threat to psychological well-being (with four subcategories), threat to physical health (with three subcategories), threat to social health (with three subcategories), and change in spiritual orientation (with two subcategories). The 12 subcategories of these categories were emotional disturbances, hopelessness, changes in sleep pattern, mood changes, physical symptoms, aggravation of the existing illnesses, negligence towards personal health, alteration in social interactions, alteration in the burden of responsibility, alternation in the life process, resort to spiritual beliefs, and spiritual conflict, respectively. CONCLUSION: FICUS symptoms are not limited to psychological problems, rather they include a wide range of psychological, physical, social, and spiritual problems, which can affect the different aspects of family members' lives. Along with care delivery to patients in ICU, health care providers should provide care and support to patients' family members. RELEVANCE TO CLINICAL PRACTICE: FICUS is a major threat to health among the family members of patients in ICU. Careful assessment of these family members helps identify family members who are at risk for FICUS and identify FICUS effects on their decisions and health status.

Family Intensive Care Unit Syndrome: An Integrative Review.

BACKGROUND: Hospitalization in the Intensive Care Unit (ICU) brings about psychological and physical symptoms in patients' family members. Family Intensive Care Unit Syndrome (FICUS) is a term used to explain the psychological symptoms of the family of a patient in response to the patient's admission to the ICU. The purpose of this study was to define FICUS along with its symptoms and predictors. MATERIALS AND METHODS: The Web of Science, PubMed, Scopus, Google Scholar, and SID databases were searched for literature published in 2005-2018 with the keywords "FICUS," "intensive care unit," "family," "caregivers," "anxiety," "depression," and "post-traumatic stress disorder" in their title and abstract. The strategy for conducting an integrative review provided by Whittemore and Knafl (2005) was used in this study. RESULTS: Twenty articles were included in the final data analysis. Following the patient's admission to the ICU, family members experience multiple psychological symptoms such as FICUS. The most commonly reported symptoms were anxiety, depression, post-traumatic stress disorder (PTSD), complicated grief, sleep disorder, stress, and fatigue. The low education level, having a critically-ill spouse, adequate support, financial stability, preference for decision-making, understanding of the disease process, anxiety, depression, or previous acute stress were predictors of FICUS. CONCLUSIONS: On the basis of the results, families also experience physical symptoms, so the FICUS is not limited to the occurrence of psychological symptoms. This study found that there is no universal definition for the term "FICUS" in the research literature. Thus, further research is needed to explore FICUS in the health field.

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome.

Introduction: Many patients in coronary care unit (CCU) suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS). Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67) years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups) during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.