• Boukje M Dijkstra, Paul J T Rood, Steven Teerenstra, RuttenAnne M FAMFDepartment of Intensive Care Medicine, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands., Crista Leerentveld, Dominique C Burgers-Bonthuis, Barbara Festen-Spanjer, Toine Klarenbeek, Mark Van Den Boogaard, Esther Ewalds, Lisette Schoonhoven, Johannes G Van Der Hoeven, VloetLilian C MLCMResearch Department Emergency and Critical Care, School of Health Studies Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands.IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Ni, and from the EFfect of FAMily PARTicipation in essential care (EFFAMPART) Study Group.
• Research Department Emergency and Critical Care, School of Health Studies Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands.
• Crit. Care Med. 2024 Mar 1; 52 (3): 420431420-431.

ObjectivesTo determine the effect of a standardized program for family participation in essential care activities in the ICU on symptoms of anxiety, depression, posttraumatic stress and satisfaction among relatives, and perceptions and experiences of ICU healthcare providers (HCPs).DesignMulticenter stepped-wedge cluster randomized controlled trial.SettingSeven adult ICUs, one university, and six general teaching hospitals.ParticipantsThree hundred six relatives and 235 ICU HCPs.InterventionsA standardized program to facilitate family participation inpatient communication, amusement/distraction, comfort, personal care, breathing, mobilization, and nutrition.Measurements And Main ResultsData were collected through surveys among relatives and ICU HCPs. There were no significant differences in symptoms of anxiety in relatives in the intervention period compared with the control period (median Hospital Anxiety and Depression Scale [HADS] 5 [interquartile range (IQR) 2-10] vs 6 [IQR 3-9]; median ratio [MR] 0.72; 95% CI, 0.46-1.13; p = 0.15), depression (median HADS 4 [IQR 2-6] vs 3 [IQR 1-6]; MR 0.85; 95% CI, 0.55-1.32; p = 0.47) or posttraumatic stress (median Impact of Event Scale-Revised score 0.45 [IQR 0.27-0.82] vs 0.41 [IQR 0.14-1]; MR 0.94; 95% CI, 0.78-1.14; p = 0.54). Reported satisfaction was slightly lower in the intervention period (mean 8.90 [ sd 1.10] vs mean 9.06 [ sd 1.10], difference -0.60; 95% CI, -1.07 to -0.12; p = 0.01). ICU HCPs perceived that more relatives knew how to participate: 47% in the intervention period versus 22% in the control period (odds ratio [OR] 3.15; 95% CI, 1.64-6.05; p < 0.01). They also reported relatives having sufficient knowledge (41% vs 16%; OR 3.56; 95% CI, 1.75-7.25; p < 0.01) and skills (44% vs 25%; OR 2.38; 95% CI, 1.22-4.63; p = 0.01) to apply family participation.ConclusionsApplication of a standardized program to facilitate family participation did not change mental health symptoms in relatives of ICU patients 3 months after discharge. ICU HCPs reported increased clarity, knowledge, and skills among relatives and ICU HCPs.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

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