Integrating Family Involvement in Neuro-Intensive Care: A Pathway to Enhanced Family Satisfaction in Traumatic Brain Injury (TBI) Management

Cureus. 2024 Nov 29;16(11):e74748. doi: 10.7759/cureus.74748. eCollection 2024 Nov.

Abstract

Introduction Traumatic brain injury (TBI) is a major health concern due to its poor clinical and functional outcome and its impact on family homeostasis. Often, the stressed and anxious family is not involved in the care process until the rehabilitation phase. This study aimed to evaluate the integration of family involvement in the neuro-intensive care of TBI patients on family satisfaction. Materials and methods This pre-test-post-test quasi-experimental study involved 70 families of moderate and severe TBI patients, divided equally into experimental and control groups. A guideline, Family Involvement in the Care of TBI (FIC-TBI), was developed. The key elements of this guideline were structured communication, participation in basic care, and shared decision-making. FIC-TBI was integrated into the critical care management of TBI. The impact of FIC-TBI was evaluated using the Family Satisfaction in the ICU Care Unit 24R (FS-ICU 24R) tool. Results Data analysis was done through paired and unpaired t-tests as well as analysis of covariance (ANCOVA). The results showed statistically significant differences in the post-test family satisfaction scores between the experimental and control groups. The adjusted mean satisfaction scores of components such as satisfaction with care (F(1, N-2)=984.63; p<0.001), satisfaction with decision-making (F(1, N-2)=1489.63; p<0.001), and overall satisfaction (F(1, N-2)=712.87; p<0.001) were higher in the experimental group. The study found a significant correlation between family satisfaction levels and variables such as gender and education. Conclusions This study was done with the objective to evaluate the impact of integration of family involvement into the neuro-intensive care of TBI on family satisfaction. The findings demonstrated that the FIC-TBI guideline improved satisfaction across multiple dimensions, such as care, communication, decision-making, and overall experience. The study also found a significant correlation between family satisfaction and gender and education. This study emphasized the importance of early family involvement in critical care settings as a vital component of holistic TBI management.

Keywords: communication; family icu syndrome; family involvement in care; family satisfaction; family satisfaction in the intensive care unit 24r (fs-icu 24r); holistic neurocritical care model; neuro-intensive care; shared decision-making in the icu; staff burnout; traumatic brain injury critical care.