P094 - FAMILY ENGAGEMENT IN THE CARDIAC INTENSIVE CARE UNIT: INSIGHTS FROM THE FAME STUDY

Background: Family involvement in patient care in the cardiac ICU is recommended by cardiovascular professional societies. However, the extent to which family members are involved in patient care within the cardiac ICU remains poorly understood. Thus, the aim of this study is to analyze data from the FAME study to explore how family members are engaged in patient care in the cardiac ICU and compare it with family engagement behaviour in the medical-surgical ICU.

METHODS AND RESULTS: The FAME study was a prospective, observational cohort study designed to validate the FAMily Engagement (FAME) tool, a self-reported measure of family involvement in patient care. Data were collected from 269 family members of patients across 3 cardiac ICUs and 5 medical-surgical ICUs in Canada. At enrollment, the FAME score (ranging from 0 to 100, with higher scores indicating greater care engagement) and its six component engagement domains were assessed. Post-discharge, family satisfaction was measured using the Family Satisfaction in the Intensive Care Unit (FS-ICU) scale, and mental health was assessed using the Hospital Anxiety and Depression Scale (HADS).

There were 94 family members of cardiac ICU patients (age 57.7±15.3 years; 78% female; 14% non-White) and 175 family members of medical-surgical patients (age 56.2±15.0 years; 63% female; 20% non-White). There were no between group differences in race/ethnicity, relationship to the patient or highest level of education achieved. Family members of cardiac ICU patients had lower FAME scores compared to those in the medical-surgical ICU (74.3±16.1 vs 79.5±13.7, p=0.006). Differences in engagement were observed across several FAME domains, with higher scores in the medical-surgical ICU for Perception of Engagement, Communication/Education, and Decision-Making, and a higher score in the cardiac ICU for Contributing to Care (all p< 0.05). Cardiac ICU family members reported overall lower family satisfaction scores (73.5±19.1 vs 79.6±19.5, p=0.02) and lower scores in the subdomains of Care Satisfaction (p=0.04) and Decision-Making (p=0.006). Depressive and anxiety symptoms were present in 27.6% and 42.5% of cardiac ICU family members, respectively. HADS-depression scores were lower in cardiac ICU family members than medical-surgical ICU family members (4.1±3.3 vs 5.1±3.9, p=0.03) but not HADS-anxiety scores (7.0±4.0 vs 7.2±3.7, p=0.38).

Conclusion: In conclusion, family members of patients in the cardiac ICU reported lower levels of engagement and satisfaction compared to those in the medical-surgical ICU. These findings highlight the need to study targeted interventions to enhance family engagement and support in the cardiac ICU setting.