Document Type : Original Article

Authors

1 Departments of Psychiatric and Mental Health Nursing

2 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Student Research Committee, Rafsanjan University of Medical Sciences

3 Department of Cardiology, Medical School, Non‑Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

4 Departments of Community Health Nursing, School of Nursing and Midwifery, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences

Abstract

INTRODUCTION: The family members’ presence during teaching rounds is introduced as a
challenging issue. The outcomes of family presence during teaching rounds in adult care settings is
an under investigate issue. The propose of this study was to determining the effect of family presence
at teaching rounds on patient’s anxiety and satisfaction in cardiac intensive care unit (CICU).
MATERIALS AND METHODS: In this double‑blind randomized controlled trial, 60 patients who
were hospitalized in CICU were selected based on inclusion criteria and then assigned into 2
groups (with and without family members presence during teaching round), equally by the random
minimization method. The patient’s anxiety score was measured before and after rounds on the
Spielberger State‑Trait Anxiety Inventory (STAI). Furthermore, the patient’s satisfaction about various
clinical aspects of round was measured by a self‑reported questionnaire. The data were analyzed by
SPSS software using Kolmogorov–Smirnov test, Chi‑square test, independent sample and paired
sample t‑test, at the significance level of 0.05.
RESULTS: The study groups were similar in terms of demographic variables. In the family members
presence group, the STAI score significantly decreased after intervention (P = 0.001). Furthermore,
in this group, the after‑intervention STAI score was significantly lower than family absence
group (P = 0.011). The mean changes of patient’s satisfaction about quality of round score in family
member presence group were significantly higher than family absence group (P = 0.001).
CONCLUSIONS: Family presence during teaching rounds led to patient’s lower anxiety and higher
satisfaction score.

Keywords

1. Abdool MA, Bradley D. Twelve tips to improve medical teaching
rounds. Med Teach 2013;35:895‑9.
2. Mittal V. Family‑centered rounds: A decade of growth. Hosp
Pediatr 2014;4:6‑8.
3. Sisterhen LL, Blaszak RT, Woods MB, Smith CE. Defining
family‑centered rounds. Teach Learn Med 2007;19:319‑22.
4. Davidson JE. Family presence on rounds in neonatal, pediatric,
and adult intensive care units. Ann Am Thorac Soc 2013;10:152‑6.
5. Rea KE, Rao P, Hill E, Saylor KM, Cousino MK. Families’
experiences with pediatric family‑centered rounds: A systematic
review. Pediatrics 2018;141. pii: e20171883.
6. Jacobowski NL, Girard TD, Mulder JA, Ely EW. Communication
in critical care: Family rounds in the intensive care unit. Am J Crit
Care 2010;19:421‑30.
7. RappaportDI, KettererTA, NilforoshanV, SharifI. Family‑centered
rounds: Views of families, nurses, trainees, and attending
physicians. Clin Pediatr (Phila) 2012;51:260‑6.
8. Young HN, Schumacher JB, Moreno MA, Brown RL,
Sigrest TD, McIntosh GK, et al. Medical student self‑efficacy
with family‑centered care during bedside rounds. Acad Med
2012;87:767‑75.
9. Rao P, Hill E, Palka C, Rea K, Jones K, Balzer K, et al. Improving
pediatric resident communication during family‑centered rounds
using a novel simulation‑based curriculum. MedEdPORTAL
2018;14:10733.
10. Ingram TC, Kamat P, Coopersmith CM, Vats A. Intensivist
perceptions of family‑centered rounds and its impact on physician
comfort, staff involvement, teaching, and efficiency. J Crit Care
2014;29:915‑8.
11. Rappaport DI, Cellucci MF, Leffler MG. Implementing
family‑centered rounds: Pediatric residents’ perceptions. Clin
Pediatr (Phila) 2010;49:228‑34.
12. Kuo DZ, Sisterhen LL, Sigrest TE, Biazo JM, Aitken ME, Smith CE.
Family experiences and pediatric health services use associated
with family‑centered rounds. Pediatrics 2012;130:299‑305.
13. Au SS, Roze des Ordons AL, Parsons Leigh J, Soo A, Guienguere S,
Bagshaw SM, et al. A multicenter observational study of family
participation in ICU rounds. Crit Care Med 2018;46:1255‑62.
14. Cypress BS. Family presence on rounds: A systematic review of
literature. Dimens Crit Care Nurs 2012;31:53‑64.
15. Pandis N. Randomization. Part 2: Minimization. Am J Orthod
Dentofacial Orthop 2011;140:902‑4.
16. Adibi P, Enjavian M, Alizadeh R, Omid A. The effect of ward
round teaching on patients: The health team and the patients’
perspectives. J Educ Health Promot 2013;2:35.
17. İşlekdemir B, Kaya N. Effect of family presence on pain and
anxiety during invasive nursing procedures in an emergency
department: A randomized controlled experimental study. Int
Emerg Nurs 2016;24:39‑45.
18. Aronson PL, Yau J, Helfaer MA, Morrison W. Impact of family
presence during pediatric intensive care unit rounds on the family
and medical team. Pediatrics 2009;124:1119‑25.
19. Voos KC, Ross G, Ward MJ, Yohay AL, Osorio SN, Perlman JM.
Effects of implementing family‑centered rounds (FCRs) in a
neonatal intensive care unit (NICU). J Matern Fetal Neonatal Med
2011;24:1403‑6.
20. Mittal V, Krieger E, Lee BC, Kind T, McCavit T, Campbell J, et al.
Pediatrics residents’ perspectives on family‑centered rounds:
A qualitative study at 2 children’s hospitals. J Grad Med Educ
2013;5:81‑7.
21. Knoderer HM. Inclusion of parents in pediatric subspecialty team rounds: Attitudes of the family and medical team. Acad Med
2009;84:1576‑81.
22. Ladak LA, Premji SS, Amanullah MM, Haque A, Ajani K,
Siddiqui FJ, et al. Family‑centered rounds in Pakistani pediatric
intensive care settings: Non‑randomized pre – And post‑study
design. Int J Nurs Stud 2013;50:717‑26.
23. Ratelle JT, Sawatsky AP, Kashiwagi DT, Schouten WM, Erwin PJ,
Gonzalo JD, et al. Implementing bedside rounds to improve
patient‑centred outcomes: A systematic review. BMJ Qual Saf
2019;28:317‑26.