FACILITATED SENSEMAKING
When a loved one is admitted to an ICU especially in critical health status, patient family members usually experienced anxiety, fear, depression, uncertainty and nervousness, traumatic experiences (post-traumatic stress). This needed support among the healthcare members especially nurses who assume the role of patient advocate. Family need to have a better understanding of the situation and what they should do to promote the feeling of comfort, security, serenity and to adapt to their new role as caregiver, thus preventing adverse psychological outcomes.
Most ICU patients cannot make a decision for their own medical treatment, in such way family may be required to make a difficult decision on behalf of the patient,
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Sensemaking is an iterative process that should be addressed as patient condition changes, providing an understanding of situation and surroundings.
Laurette et al., (2007) conducted a randomised controlled trial in France to investigate adverse psychological outcomes in family members in ICU and showed significant reduction of adverse outcomes using written information and a structured method of case conferencing. The family members are given an opportunity to enquire questions, express worries, and confront painful emotions with the help of caring, compassionate professionals.
Davidson (2010) recommends set of nursing interventions in facilitated sensemaking to helping families make sense of the situation and give meaning to the caregiver such as:
1.) Establishing rapport, to know the patient family members and describing the cues in the environment, evaluating family understanding of why the patient is brought in
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Often family members of patient needs are being neglected or unintentionally overlooked especial simple needs. The opportunity given to family members to be involved in bedside care lessen their feeling of helplessness. Addressing family needs help them through the process thus minimise adverse psychological outcomes. Further testing of facilitated sense making is warranted to recognise if the set interventions are effective. Perhaps it will be in advantage having a post-ICU clinic run by nurses like in the United Kingdom to assist family needs in addressing long-lasting anxiety, depression and symptoms of