Nurse-Led Educational Intervention for Caregivers of ICU Patients (Nurses For Family - N4F)

Official title

Feasibility And Acceptability of a Nurse-Led Educational Intervention for Caregivers of ICU Patients (Nurses For Family - N4F): Pilot Study

Overview

Admission of a loved one to the intensive care unit (ICU) is a highly stressful experience for family members and caregivers. Many caregivers report increased levels of anxiety, stress, and depressive symptoms, often due to uncertainty about the patient's condition and difficulties in understanding medical information. Improving communication and providing clear, structured information may help reduce this psychological burden. This study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of a nurse-led educational intervention called "Nurses for Family" (N4F), designed to support caregivers of ICU patients. The study will include adult caregivers (aged 18 years or older) of patients admitted to the ICU for more than 24 hours. Participants must provide informed consent and be able to complete questionnaires independently. A total of 20 participants will be enrolled and allocated to one of two groups: an intervention group (receiving nurse-led educational support) or a control group (receiving standard care). Data will be collected at two time points during the ICU stay. At baseline (24-48 hours after ICU admission), participants will complete the Hospital Anxiety and Depression Scale (HADS), which measures symptoms of anxiety and depression. At follow-up (7 days later), participants will complete the HADS again, along with the Family Satisfaction in the ICU (FSICU-24) questionnaire. Feasibility will be assessed based on recruitment and retention rates, adherence to the study protocol, and completeness of data collection. Acceptability will be evaluated through interviews conducted with participants from the control group. This pilot study is expected to determine whether the N4F intervention is feasible and acceptable in a clinical setting and to provide preliminary evidence regarding its potential to reduce psychological distress and improve satisfaction among caregivers of ICU patients.

Detailed description

Aim: This study was designed to investigate the feasibility, acceptability, and preliminary efficacy of a nurse-led educational intervention for caregivers of ICU patients (Nurses for Family - N4F).

Design: This pilot study will use a single-center, prospective, non-randomized, quasi-experimental design.

Method: Caregivers of adult patients hospitalized in the ICU for more than 24 hours will be included in the study. Participants will be persons aged ≥18 years who meet the definition of a caregiver, provide informed consent to participate in the study, and are able to complete the questionnaires independently. Caregivers under the age of 18, with cognitive impairments, who do not consent to participate in the study, or who are unable to complete the questionnaires will be excluded from the study. Participants will be allocated either to the intervention group and receive the nurse-led educational intervention or to the control group and receive usual care. The acceptability of the intervention will be assessed based on interviews with participants in the control group, and feasibility will be evaluated according to criteria including recruitment, retention, protocol adherence, and data completeness (≥80% recruitment and completion rates, ≥90% protocol adherence, ≤15% missing data). Data will be collected at two time points during the patient's ICU stay. At T1 (24-48 hours after admission), participants will complete the Hospital Anxiety and Depression Scale (HADS), a validated questionnaire measuring psychological distress. At T2 (7 days after the intervention), participants will complete both the HADS and the FSICU-24 questionnaire. The data collection procedure will include standardized methods, such as clinical information, questionnaires, and interviews with patients' families (control group), in accordance with the study protocol. A sample of 20 caregivers was selected for the study: 10 in the intervention group and 10 in the control group. This sample size was selected based on pilot study literature and is considered adequate to report feasibility, acceptability, and preliminary efficacy.

Results: The pilot study is expected to confirm the feasibility and acceptability of a nurse-led educational intervention for caregivers of intensive care unit patients. Preliminary effects regarding the reduction of symptoms of anxiety and depression among caregivers and increased caregiver satisfaction will also be explored.

Interventions

• Other Nurse-Led Educational Intervention for Caregivers of ICU Patients (Nurses For Family - N4F)
  The intervention was designed as a two-stage process: a theoretical component and a practical component: (I) The intervention begins by providing families with an informational brochure titled "Guide to the Intensive Care Unit." This initial step aims to reduce uncertainty and anxiety by setting clear expectations regarding the stay in the ICU. The theoretical part will be delivered by an experienced ICU nurse, a specialist in intensive care, in person in a designated room to ensure a comfortab

Primary outcome measures

• Feasibility measured by session completion and dropout rate differences between groups [Time frame: From the time of enrollment in the study until 7 days after the intervention]
• Acceptability of the intervention sssessed via semi-structured individual interviews. [Time frame: From the time of enrollment in the study until 7 days after the intervention.]

Secondary outcome measures (2)

• Change from baseline to day 7 in Anxiety, Depression [Time frame: At the beginning of the study and 7 days after receiving the intervention.]
• Change from baseline to day 7 in Family Satisfaction Scores. [Time frame: At the beginning of the study and 7 days after receiving the intervention.]

Eligibility criteria

Inclusion criteria

Patients:

• Age >18 years
• ICU stay > 24h

Caregivers:

• Age >18 years
• consent to participate in the study
• meeting the definition of a caregiver
• able to complete questionnaires

Exclusion criteria

Patients:

• Age < 18 years
• Discharged/Deceased form ICU < 24h

Caregivers:

• Age < 18 years
• without cognitive impairment
• no consent to participate in the study
• No able to complete questionnaires

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Supportive care

Study locations

Center list to be confirmed — check the primary protocol.

Publications

• Satysfakcja rodziny z opieki na oddziale Anestezjologii i Intensywnej Terapii: FS-ICU 24R© 2019. https://www.fsicu.ca/professionals/survey/versions/
• De Walden-Gałuszko K, Majkowicz M. Praktyczna ocena efektywności opieki paliatywnej -wybrane techniki badawcze. Skala HADS-M (zmodyfikowana skala HAD). w: Ocena jakości opieki paliatywnej w teorii i praktyce. 2000.
• Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x. PMID 6880820
• Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017 Jan 26;17(1):88. doi: 10.1186/s12913-017-2031-8. PMID 28126032
• Teresi JA, Yu X, Stewart AL, Hays RD. Guidelines for Designing and Evaluating Feasibility Pilot Studies. Med Care. 2022 Jan 1;60(1):95-103. doi: 10.1097/MLR.0000000000001664. PMID 34812790
• Szczeklik W, Fronczek J, Włudarczyk A, Fronczek M. Przewodnik po oddziale intensywnej terapii. Broszura informacyjna dla rodzin i bliskich hospitalizowanych pacjentów
• Mailhot T, Cossette S, Lavoie P, Maheu-Cadotte MA, Fontaine G, Bourbonnais A, Cote J. The development of the MENTOR_D nursing intervention: Supporting family involvement in delirium management. Int J Older People Nurs. 2022 Sep;17(5):e12462. doi: 10.1111/opn.12462. Epub 2022 Apr 10. PMID 35403357
• Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios LP, Robson R, Thabane M, Giangregorio L, Goldsmith CH. A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010 Jan 6;10:1. doi: 10.1186/1471-2288-10-1. PMID 20053272

Identifiers

NCT: NCT07603219 · KB 18/26

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗