Brief Cognitive-Behavioral Education Program for Main Family Carers of Patients in Intensive Care Units: A Randomized Controlled Trial

Wednesday, 1 August 2012

Vico C. L. Chiang, PhD, MHA, GDipMgtStudies, BN, RN, MRCNA1
Rainbow L. P. Lee, MSN, BSN, RN (HK)2
Wai-Tong Chien, PhD, MPhil, PGDipNEdu, BN, RMN (HK), RTN (HK)2
Sharron SK Leung, PhD, BBS (Hon), DipEpi&Bios, RN (HK)3
Daniel FK Wong, PhD, MSW, BA, BSW4
(1)School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
(2)School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
(3)School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
(4)Department of Applied Social Studies, City University of Hong Kong, Kowloon, Hong Kong

Learning Objective 1: To appreciate the importance of including main family members of critically ill patients in the nursing process

Learning Objective 2: To consider whether brief cognitive-behaviorial education can be used as an ICU nursing intervention to alleviate family members' stress and anxiety


Having a loved one in ICU is a stressful event and this experience may cause a high level of anxiety in main family carers (MFC) of the patients.  Stressors to the MFC may accumulate and lead to unhealthy emotions and behaviours that threaten family integrity.  Well-being of MFC assures their support to the patients during the course of illness or after discharging from ICU.  The purpose of this study is to investigate the effectiveness of a brief cognitive-behavioral (CB) education program to manage stress and anxiety of the MFC who has a critically ill relative in ICU.


Beck’s (1976) cognitive therapy model had informed the Wong’s (2005) CB method and it was modified to a brief education program for Hong Kong teachers to manage their work-related distress by Leung, Chiang, Chui, Mak, and Wong (2011).  The brief CB education program for MFC in this study was designed based on Wong’s CB method.  In order to achieve the study purpose, a RCT, with a pre/post-test and control group design was conducted in two ICUs with a similar level of patient casemix and care.  According to the power analysis, 21 MFC in the intervention group (with another 21 as control) are recruited for the study.  The Chinese version of the Depression Anxiety Stress Scale (C – DASS) and Critical Care Family Need Inventory (C – CCFNI) are used to evaluate the primary outcomes on stress and anxiety, and satisfaction with family needs.


The data collection is in process and the results will be ready for report and discussion in July 2012 for implications to clinical practice.


With the findings, recommendations for further study and for critical nursing practice that focuses on the need of MFC and patient as a dyad of care (Chiang, 2011) will be made.