The needs of family members accompanying patients into a trauma casuality
Date
2014-08-26
Authors
Johnson, Meghan
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Abstract
Introduction and Background
Trauma Casualty is an environment of constant unpredictability which has an impact on the
both the casualty staff, the patient and family. Family members are usually not prepared for
the sudden crisis of having a loved one injured. The Trauma Nurse therefore, has a very
important role with regards to meeting the needs of the family of patients brought into the
unit. The needs of family members in the Intensive Care or Critical Care setting has been
extensively researched using the critical care family needs inventory (CCFNI), however very
little has been researched in the setting of a trauma or emergency setting. The needs of family
members in the emergency setting has been researched in Australia, but no work has been
done in South Africa. There is, therefore, a need for research in this area.
Purpose of the study
The aim of the study was to determine the needs of family members accompanying patients
into trauma casualty, in order of importance as perceived by them, and to determine if these
needs are being met. Identification of needs will inform the role of the nurse with regard to
holistic nursing care including care of the family of the patient.
Research Method
The study made use of a quantitative descriptive exploratory design. The population (n=97)
included family members of patients brought into casualty. The sample size was determined
in consultation with a statistician from the Medical Research Council. The inclusion Criteria
incorporated family members, over the age of 18, who were willing to complete a self
administered questionnaire. Family members of patients who had died in the unit were
excluded.
An Australian developed instrument, using a Likert Scale to categorise and quantify needs
statements, was used. The tool was validated by review of a panel of experts and an inter
rater agreement of 90% established. The tool was adapted for the South African context and
validated on a subscale level using the Cronbach Alpha correlation test. Five major themes
make up the critical care family needs inventory, these consist of “Meaning”, “Proximity”,
“Communication”, “Comfort”, and “Support”. Two questionnaires were used, comprised of
the same needs statements, however CCFNI-1 was used to determine the level of importance
of needs statements, while CCFNI-2 sought to determine the level of satisfaction of needs
met.
The study setting made use of a Level 1 Trauma Casualty in a Public Tertiary Academic
Hospital, in which the pilot study was conducted before data collection in the same setting.
The data analysis process made use of descriptive statistics. After cleaning and coding, the
data were exported to STATA statistical software for values to be calculated and interpreted.
Data were analysed in three steps, namely analysis of demographic data, thematic
organisation of analysed data and content analysis of open ended questions.
Main Findings
The main findings highlighted the importance of needs relating to the themes “Meaning” and
“Communication”, while satisfaction was highest in the theme “Meaning”. A concerning
finding was the low level of satisfaction with needs being met related to communication.