A Structured Communication Intervention to Reduce the Anxiety of Family Members Waiting for Relatives Undergoing a Surgical Procedure

Monday, 9 November 2015: 10:00 AM

Kate Kynoch, MN (ICU), BN, RN, CertIVTAE
Judy Munday, DipEd (Nurs), BA (Hons), RN
Sonia J. Hines, MAppSci (Rsch), GradDipEd, BN, RN
Cara Joyce Cabilan, BN, RN
Nursing Research Centre, Mater Health Services, Brisbane, Australia

Objective: The aim of this study was to establish the effect of a structured communication program on family members’ anxiety awaiting relatives undergoing elective surgical procedures. 

Background:  It is evident through the literature that perioperative nurses recognise that family members experience increased levels of anxiety during the wait for a relative undergoing a surgical procedure. However it is during this time that little or no meaningful communication occurs between family members and health professionals. Families are increasingly expected to take an active part in care provision, particularly in the post-operative and discharge phase, but in the same way that patient anxiety can affect surgical outcome and recovery, family anxiety and being under-informed may impair the family’s ability to effectively carry out these activities. In some areas of the world, family involvement in hospital care is not only desirable but vital due to nursing staff shortages. The importance of family involvement and the concept of family centred-care have been established as key themes in many areas of healthcare practice and form the humanistic and holistic approaches to nursing care that remain the foundation of clinical practice. Thereby, it is necessary to recognise the barriers to patient support arising from family anxiety states in the perioperative environment and take steps to meet family needs during this time.  The need for this project was highlighted from a Joanna Briggs Institute systematic review which recommended that in-person interventions providing an update on the patient’s status during surgery be utilized to reduce family anxiety.  Additionally the review emphasized the need for more research investigating ways of providing information to families and assessing outcomes utilising validated tools.

Methods: This project utilised a quasi-experimental research design.  The setting was the perioperative department in a large multi-disciplinary healthcare organisation in Brisbane Australia.  The sample was 128 family members of patients undergoing elective surgical procedures.  Consecutive sampling was used to recruit family members firstly for the control group, and then secondly for the intervention group.  Eligible participants were recruited during the admission process. The intervention group received a structured communication intervention which included an information card with hospital information and phone numbers as well as the approximate surgery completion time.  In addition, families also received an in-person nursing report when the patient arrived in the recovery room. The control group received usual care.  A demographic data collection form and the validated State Trait Anxiety Inventory were used to collect data.  

Results:  Results from the project confirm that structured communication interventions for families awaiting relatives undergoing surgical procedures do reduce family anxiety however results were not statistically significant.  There was a strong negative correlation between the age of the patient and state anxiety of family.  Additionally this paper will report on several barriers to the successful implementation of recommendations from this systematic review.   Overall, families in the intervention group found the information card useful and received increased communication from the healthcare team.

Conclusion:  In the consumer-oriented and family-focused climate of current health care, more nursing interventions designed to reduce family members' anxiety during the operative waiting period are needed.  This project has contributed to the knowledge base surrounding family anxiety during surgical procedures as well as provided information on barriers to implementing communication based interventions.  In order for these types of interventions to be successful a dedicated role needs to be established.  This requires the acknowledgement of organisations and management of the important role families play in the care and recovery of patients in the acute health care system.