Patient-important upper gastrointestinal bleeding in the ICU : A mixed-methods study of patient and family perspectives

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved..

INTRODUCTION: The objective of this study was to create a definition of patient-important upper gastrointestinal bleeding during critical illness as an outcome for a randomized trial.

DESIGN: This was a sequential mixed-methods qualitative-dominant multi-center study with an instrument-building aim. In semi-structured individual interviews or focus groups we elicited views from survivors of critical illness and family members of patients in the intensive care unit (ICU) regarding which features indicate important gastrointestinal bleeding. Quantitative demographic characteristics were collected. We analyzed qualitative data using inductive content analysis to develop a definition for patient-important upper gastrointestinal bleeding.

SETTING: Canada and the United States.

PARTICIPANTS: 51 ICU survivors and family members of ICU patients.

RESULTS: Participants considered gastrointestinal bleeding to be important if it resulted in death, disability, or prolonged hospitalization. The following also signaled patient-important upper gastrointestinal bleeding: blood transfusion, vasopressors, endoscopy, CT-angiography, or surgery. Whether an intervention evinced concern depended on its effectiveness, side-effects, invasiveness and accessibility; contextual influences included participant familiarity and knowledge of interventions and trust in the clinical team.

CONCLUSIONS: Survivors of critical illness and family members described patient-important upper gastrointestinal bleeding differently than current definitions of clinically-important upper gastrointestinal bleeding.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:81

Enthalten in:

Journal of critical care - 81(2024) vom: 26. Apr., Seite 154761

Sprache:

Englisch

Beteiligte Personen:

Vanstone, Meredith G [VerfasserIn]
Krewulak, Karla [VerfasserIn]
Taneja, Shipra [VerfasserIn]
Swinton, Marilyn [VerfasserIn]
Fiest, Kirsten [VerfasserIn]
Burns, Karen E A [VerfasserIn]
Debigare, Sylvie [VerfasserIn]
Dionne, Joanna C [VerfasserIn]
Guyatt, Gordon [VerfasserIn]
Marshall, John C [VerfasserIn]
Muscedere, John G [VerfasserIn]
Deane, Adam M [VerfasserIn]
Finfer, Simon [VerfasserIn]
Myburgh, John A [VerfasserIn]
Gouskos, Audrey [VerfasserIn]
Rochwerg, Bram [VerfasserIn]
Ball, Ian [VerfasserIn]
Mele, Tina [VerfasserIn]
Niven, Daniel J [VerfasserIn]
English, Shane W [VerfasserIn]
Verhovsek, Madeleine [VerfasserIn]
Cook, Deborah J [VerfasserIn]
Canadian Critical Care Trials Group [VerfasserIn]

Links:

Volltext

Themen:

Critical care
Gastrointestinal bleeding
Intensive care unit
Journal Article
Multicenter Study
Patient and family centered care
Patient engagement
Patient-oriented research
Randomized trial

Anmerkungen:

Date Completed 03.04.2024

Date Revised 03.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jcrc.2024.154761

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369370678