Pemenuhan Kebutuhan Keluarga Pasien Kritis dengan Perawatan Paliatif di Intensive Care Unit: Studi di Yogyakarta

https://doi.org/10.22146/jkkk.71433

Sri Setiyarini(1*), Eri Yanuar Akhmad(2), Happy Indah Kusumawati(3)

(1) Departemen Keperawatan Dasar dan Emergensi Universitas Gadjah Mada
(2) Departemen Keperawatan Dasar dan Emergensi, Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada
(3) Departemen Keperawatan Dasar dan Emergensi, Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: Regarding the severity of disease, death occur at high rates in ICU, with mortality rate reaches 25%. Hospitalization in ICU has significant impact for patient’s family, therefore meeting needs of family is crucial part in the ICU.
Objective: To determine family needs of critically ill patients who need palliative care from nurses and familes perspective.
Method: This was descriptive study which conducted in three ICU facilities in Yogyakarta. The subjects were 31 nurses and 76 family members who completed the Critical Care Family Needs Inventory (CCFNI), Meeting Needs Inventory (MNI) instruments and open questions. Data were analyzed quantitatively used mean (± SD) and percentage.
Result: The mean (± SD) score of inventory needs (CCFNI) subscale from nurse perception vs. family perception were as follows: assurance (3,488 ± 0,386 vs. 3,602 ± 0,362), proximity and accessibly (3,308 ± 0,363 vs. 3,484 ± 0,739), information (3,207 ± 0,630 vs. 3,334 ± 0,422). The mean (± SD) score of meeting needs (MNI) subscale from perception of nurses vs family were as follows: assurance (3,160 ± 0,371 vs. 3,137 ± 0,556), proximity and accessibly (3,151 ± 0,405 vs. 2,998 ± 0,531), information (2,775 ± 0,399 vs. 2,512 ± 0,630).
Conclusion: The most important family need and meeting need, according to nurses and families, is assurance subscale.

ABSTRAK

Latar belakang: Beratnya jenis penyakit pasien di ICU, membuat ICU menjadi tempat kematian yang umum bagi pasien, dengan angka kematian sekitar 25%. Hospitalisasi di ICU cukup berdampak pada keluarga, sehingga memenuhi kebutuhan keluarga menjadi hal yang penting di ICU.
Tujuan: Untuk mengidentifikasi pemenuhan kebutuhan keluarga pasien kritis yang membutuhkan perawatan paliatif, dari persepsi perawat dan keluarga.
Metode: Penelitian ini merupakan penelitian deskriptif yang dilakukan di tiga ICU di Yogyakarta. Terdapat 31 sampel perawat dan 76 sampel keluarga pasien yang mengisi instrumen The Critical Care Family Needs Inventory (CCFNI), Meeting Needs Inventory (MNI), dan beberapa pertanyaan terbuka. Data dianalisis secara kuantitatif menggunakan rerata (± SD) dan persentase.
Hasil: Skor rerata pentingnya kebutuhan keluarga pasien dari persepsi perawat dan keluarga pada 3 subskala tertinggi, adalah: jaminan 3,488 (± 0,386) dan 3,602 (± 0,362); kedekatan dan akses 3,308 (± 0,363) dan 3,484 (± 0,739); informasi 3,207 (±0,630) dan 3,334 (± 0,422). Rerata terpenuhinya kebutuhan keluarga pasien dari persepsi perawat dan keluarga pada 3 subskala tertinggi, adalah: jaminan 3,160 (± 0,371) dan 3,137 (± 0,556); kedekatan dan akses 3,151(± 0,405) dan 2,998 (± 0,531), informasi 2,775 (± 0,399) dan 2,512 (± 0,630),
Kesimpulan: Baik kebutuhan maupun pemenuhan kebutuhan, yang dianggap paling penting menurut perawat dan keluarga adalah jaminan.


Keywords


CCFNI; ICU; keluarga; kebutuhan; perawatan paliatif

Full Text:

PDF


References

  1. Center of Advanced Palliative Care. Intensive Care Unit [Internet]. Available from: http://www.capc.org/about-capc/copyright/
  2. Curtis JR. Caring for Patients with Critical Illness and Their Families: The Value of The Integrated Clinical Team - PubMed. Respir Care [Internet]. 2008; 53(4): 480–7. Available from: https://pubmed.ncbi.nlm.nih.gov/18364061/
  3. Truog RD, Campbell ML, Curtis JR, Haas CE, Luce JM, Rubenfeld GD, et al. Recommendations for End-of-Life Care in The Intensive Care Unit: a Consensus Statement by The American College [corrected] of Critical Care Medicine. Crit Care Med [Internet]. 2008; 36(3): 953–63. DOI: 10.1097/CCM.0B013E3181659096. Available from: https://pubmed.ncbi.nlm.nih.gov/18431285/
  4. Söderström IMK, Saveman BI, Hagberg MS, Benzein EG. Family Adaptation in Relation to A Family Member’s Stay in ICU. Intensive Crit care Nurs [Internet]. 2009 Oct; 25(5): 250–7. DOI: 10.1016/J.ICCN.2009.06.006. Available from: https://pubmed.ncbi.nlm.nih.gov/19628390/
  5. Linnarsson JR, Bubini J, Perseius KI. A Meta-Synthesis of Qualitative Research into Needs and Experiences of Significant Others to Critically Ill or Injured Patients. J Clin Nurs [Internet]. 2010; 19(21–22): 3102–11. DOI: 10.1111/J.1365-2702.2010.03244.X. Available from: https://pubmed.ncbi.nlm.nih.gov/20738453/
  6. Harvey MA. Evidence-Based Approach to Family Care in The Intensive Care Unit: Why Can’t We Just be Decent? Crit Care Med [Internet]. 2004 Sep; 32(9): 1975–6. DOI: 10.1097/01.CCM.0000139616.58132.89. Available from: https://journals.lww.com/ccmjournal/Fulltext/2004/09000/Evidence_based_approach_to_family_care_in_the.31.aspx.
  7. Azoulay E, Pochard F, Chevret S, Lemaire F, Mokhtari M, Le Gall JR, et al. Meeting The Needs of Intensive Care Unit Patient Families: A Multicenter Study. Am J Respir Crit Care Med [Internet]. 2001; 163(1): 135–9. DOI: 10.1164/AJRCCM.163.1.2005117. Available from: https://pubmed.ncbi.nlm.nih.gov/11208638/
  8. Verhaeghe S, Defloor T, Van Zuuren F, Duijnstee M, Grypdonck M. The Needs and Experiences of Family Members of Adult Patients in An Intensive Care Unit: A Review Of The Literature. J Clin Nurs [Internet]. 2005 Apr; 14(4): 501–9. DOI: 10.1111/J.1365-2702.2004.01081.X. Available from: https://pubmed.ncbi.nlm.nih.gov/15807758/
  9. Roberti SM, Fitzpatrick JJ. Assessing Family Satisfaction with Care of Critically Ill Patients: A Pilot Study. Crit Care Nurse [Internet]. 2010; 30(6): 18–26. DOI: 10.4037/CCN2010448. Available from: https://pubmed.ncbi.nlm.nih.gov/21123230/
  10. Auerbach SM, Kiesler DJ, Wartella J, Rausch S, Ward KR, Ivatury R. Optimism, Satisfaction with Needs Met, Interpersonal Perceptions of The Healthcare Team, and Emotional Distress in Patients’ Family Members During Critical Care Hospitalization. Am J Crit Care [Internet]. 2005; 14(3): 202–10. Available from: https://pubmed.ncbi.nlm.nih.gov/15840894/
  11. Bouch CD, Thompson JP. Severity Scoring Systems in The Critically Ill. Contin Educ Anaesth Crit Care Pain [Internet]. 2008 Oct 1; 8(5): 181–5. DOI: 10.1093/BJACEACCP/MKN033. Available from: https://academic.oup.com/bjaed/article/8/5/181/268370
  12. Iribarren-Diarasarri S, Aizpuru-Barandiaran F, Muñoz-Martínez T, Loma-Osorio Á, Hernández-López M, Ruiz-Zorrilla JM, et al. Health-Related Quality of Life as A Prognostic Factor of Survival in Critically Ill Patients. Intensive Care Med [Internet]. 2009 May; 35(5): 833–9. DOI: 10.1007/S00134-009-1418-3. Available from: https://pubmed.ncbi.nlm.nih.gov/19183948/
  13. Maxwell KE, Stuenkel D, Saylor C. Needs of Family Members of Critically Ill Patients: A Comparison of Nurse and Family Perceptions. Heart Lung [Internet]. 2007 Sep; 36(5): 367–76. DOI: 10.1016/J.HRTLNG.2007.02.005. Available from: https://pubmed.ncbi.nlm.nih.gov/17845883/
  14. Leske JS. Needs of Adult Family Members After Critical Illness: Prescriptions for Interventions. Crit Care Nurs Clin North Am. 1992 Dec 1; 4(4): 587–96. DOI: 10.1016/S0899-5885(18)30606-3.
  15. Takman C, Severinsson E. A Description of Healthcare Providers’ Perceptions of The Needs of Significant Others in Intensive Care Units in Norway and Sweden. Intensive Crit care Nurs [Internet]. 2006 Aug; 22(4): 228–38. DOI: 10.1016/J.ICCN.2005.10.003. Available from: https://pubmed.ncbi.nlm.nih.gov/16388948/
  16. American College of Critical Care Medicine. Clinical Practice Guidelines for Support of The Family in The Patient-Centered Intensive Care Unit: American College of Critical Care Medicine Task Force 2004-2005. Crit Care Med [Internet]. 2007 Feb; 35(2): 605–22. DOI: 10.1097/01.CCM.0000254067.14607.EB. Available from: https://pubmed.ncbi.nlm.nih.gov/17205007/
  17. Lam P, Beaulieu M. Experiences of Families in The Neurological ICU: A “Bedside Phenomenon” - PubMed. J Neurosci Nurs [Internet]. 2004; 36(3): 142–6. Available from: https://pubmed.ncbi.nlm.nih.gov/15233414/
  18. El-Masri MM, Fox-Wasylyshyn SM. Nurses’ Roles with Families: Perceptions of ICU Nurses. Intensive Crit Care Nurs [Internet]. 2007 Feb; 23(1): 43–50. DOI: 10.1016/J.ICCN.2006.07.003. Available from: https://pubmed.ncbi.nlm.nih.gov/16971125/
  19. Olsen KD, Dysvik E, Hansen BS. The Meaning of Family Members’ Presence during Intensive Care Stay: A Qualitative Study. Intensive Crit Care Nurs [Internet]. 2009 Aug; 25(4): 190–8. DOI: 10.1016/J.ICCN.2009.04.004. Available from: https://pubmed.ncbi.nlm.nih.gov/19497746/
  20. Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, et al. Clinical Practice Guidelines for Support of The Family in The Patient-Centered Intensive Care Unit: American College of Critical Care Medicine Task Force 2004-2005. Crit Care Med [Internet]. 2007 Feb; 35(2): 605–22. DOI: 10.1097/01.CCM.0000254067.14607.EB. Available from: https://pubmed.ncbi.nlm.nih.gov/17205007/
  21. Hardicre J. Meeting The Needs of Families of Patients in Intensive Care Units - PubMed. Nurs Times [Internet]. 2003; 99(27): 26–7. Available from: https://pubmed.ncbi.nlm.nih.gov/12882048/
  22. Ros I, Depasse B, Schroeder M, Dumont J, Vincent JL. Information Needs of The ICU Patient: A Belgian Experience. http://dx.doi.org/103109/tcic1111317 [Internet]. 2011;11(1):13–7. DOI: 10.3109/TCIC.11.1.13.17. Available from: https://www.tandfonline.com/doi/abs/10.3109/tcic.11.1.13.17
  23. Osse BHP, Vernooij-Dassen MJFJ, Schadé E, Grol RPTM. Problems Experienced by The Informal Caregivers of Cancer Patients and Their Needs for Support. Cancer Nurs [Internet]. 2006 Sep;29(5):378–88. DOI: 10.1097/00002820-200609000-00005. Available from: https://pubmed.ncbi.nlm.nih.gov/17006111/
  24. Kosco M, Warren NA. Critical Care Nurses’ Perceptions of Family Needs as Met. Crit Care Nurs Q [Internet]. 2000;23(2):60–72. DOI: 10.1097/00002727-200008000-00008. Available from: https://pubmed.ncbi.nlm.nih.gov/11853028/
  25. Kleinpell RM, Powers MJ. Needs of Family Members of Intensive Care Unit Patients. Appl Nurs Res. 1992 Feb 1; 5(1): 2–8. DOI: 10.1016/S0897-1897(05)80076-X.
  26. Davidson JE. Family-Centered Care: Meeting The Needs of Patients’ Families and Helping Families Adapt to Critical Illness. Crit Care Nurse [Internet]. 2009 Jun; 29(3): 28–34. DOI: 10.4037/CCN2009611. Available from: https://pubmed.ncbi.nlm.nih.gov/19487778/



DOI: https://doi.org/10.22146/jkkk.71433

Article Metrics

Abstract views : 1408 | views : 2682

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Sri Setiyarini, Eri Yanuar Akhmad, Happy Indah Kusumawati



Jurnal Keperawatan Klinis dan Komunitas (Clinical and Community Nursing Journal) 
collaborates with DPW PPNI DIY

Lisensi Creative Commons  

Jurnal Keperawatan Klinis dan Komunitas (Clinical and Community Nursing Journal) is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.