Quality and associated factors of counselling of intensive care patients and family members in adult intensive care

The subject of this study affects a large number of intensive care patients and their family members every year. Patients admitted to intensive care often feel they have lost control of their lives, especially when their care requires sedation or ventilator treatment. A critical illness that leads to intensive care is a crisis for the patient's family members, who need to receive the counselling they need to understand the situation. The knowledge needs of intensive care patients and their family members are significant, and when providing counselling in the intensive care unit, intensive care professionals need to structure the content of the counselling in a way that is understandable to the individual needs of the patient and their family members within a limited time frame.

The aim of the study was to describe and assess the quality of counselling in adult intensive care and to explain the factors associated with the quality of counselling. This dissertation found that counselling in intensive care patients helps patients to believe in their own recovery and they remember the psychosocial support they received even after their stay in intensive care. Intensive care patients had clear memories of the counselling they received, particularly in relation to procedures and symptoms of illness. High-quality counselling for intensive care patients includes knowledge about the reasons for intensive care care, the interventions to be performed and the professionals involved in the care.

According to family members, quality care includes knowledge about the patient's critical care illness and the intensive care environment before and during the visit. They rated the counselling as good, but they wanted to discuss the content of the counselling beyond giving the opportunity to ask questions. They felt that the professionals did not sufficiently ensure their understanding of the issues during counselling and the possibility of giving feedback on the counselling to the professionals. Family members considered that they benefited from the counselling in terms of being able to maintain a normal life during the patient's stay in intensive care.

According to the study, intensive care professionals perceived counselling skills to be associated with shorter patient recovery times and needed more knowledge about counselling methods. For example by providing training to meet the skills needs of professionals, the quality of counselling can be improved and the benefits of counselling can be enhanced. The findings also highlight the importance of documentation, evaluation and follow-up of counselling. Based on the results of the study, the evaluation of the quality of counselling can be enhanced by developing documentation practices both in the ICU and in the post-ICU.