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Patient family needs: perception of Iranian intensive care nurses and

families of patients admitted to ICUs

Article · July 2014

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 Asian Journal of Nursing Education and Research 4(3): July-September 2014

www.anvpublication.org ISSN- 2231-1149 (Print)

2349-2996 (Online)

RESEARCH ARTICLE

Patient family needs: perception of Iranian intensive care nurses and families
of patients admitted to ICUs
Sedighe Iranmanesh1, Akbar Sheikhrabori2*, Sakine Sabzevari3, Mansooreh Azizzade Frozy4,
Farideh Razban5
1
Ph.D., School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
2
M.Sc. Student, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
3
Ph.D., School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
4
M.Sc., Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical
Science, Kerman, Iran
5
School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
*Corresponding Author Email: iranmanesh@kmu.ac.ir, p.shykhrabory@gmail.com, S_sabzevari@kmu.ac.ir,
forozy@gmail.com, razbanfarideh@yahoo.com

ABSTRACT:
Background and Objectives: In the recent studies about patient family needs in deference society and cultures, a consensus
has done about patient family needs definition. Inadequate attention to the needs of patient family causes inappropriate and
incoherence care and increases conflict between patient family and caregivers. Attention to the needs of family of patients
who are in crisis can lead to increase their sense of trust and support and can help them in getting their decisions in relation
to their patient health. The aim of this study was comparison of the perception of nurses and families of patients admitted
to the ICUs about the needs of families of patients in ICUs.
Methods: This was a cross-sectional descriptive comparative study which conducted in Kerman University of Medical
Sciences. Convenience sampling was used and patient families of patients who admitted to ICUs and nurses who work in
ICUs were participated in the study. The Critical Care Family Needs Inventory was used to data gathering. The patient
families and nurses' socio- demographic data were gathered as well. Data analyses were done by using SPSS version 18.
Descriptive and inferential analyses were used.
Results: Totally 105 patient families of ICU patients and 105 ICU nurses were participated in the study. Data analysis
showed there were significant differences between patient families and nurses perception of ICU patient family needs
(p<0.05). Data analysis according to deferent factors showed that except Comfort factor, the other factors including
"Assurance and anxiety reduction", "Information", "Proximity and accessibility" and "Support" were significantly deferent
between two groups (p<0.05).
Conclusion: Nurses' appropriate perception of ICU patient family needs can lead to adopt the best approach to meet these
needs and can help them to provide family based nursing care as well.

KEY WORDS: patient family needs, intensive care unit patient, critical care, critical care nursing

1. INTRODUCTION:
The family is the paramount social organ and in fact the The stresses and tensions, which are exerted on one
most fundamental unit of community that has the maximum member of a family, may effect on the family entirely and
effect on its members. The members of a family are directly the disease can cause creation of crisis in the family as one
affected by family group. of the stressful factor (Lancaster and Stanhope, 2000). The
knowledge of patient’s family about disease phases and
patient’s requirements may cause the family to become
Received on 03.03.2014 Modified on 10.05.2014 adapted to stressful situations (Hinkle and Fitzpatrick,
Accepted on 10.06.2014 © A&V Publication all right reserved 2009).
Asian J. Nur. Edu. & Research 4(3): July- Sept., 2014; Page 290-297
290
Many studies have been carried out regarding needs of members agreed that the nurses were the foremost and most
patient’s family within several types of cultures and appropriate employees to meet their requirements.
geographical regions during 20 years ago and all of these
investigations signify acquiring an appropriate and In a study done by Fitzpatrick and Hinkle (2011) in order to
appropriate definition about needs of patient’s family determine the different perception of patients’ relatives,
(Delva et al., 2002). These needs include five categories: physicians, and nurses regarding the relatives’ requirements
Information, assurance and anxiety reduction, proximity for ones who visit the hospitalized patients in ICU units,
and accessibility, and support and comfort (Leske, 1991). they showed that perception of relatives, physicians, and
The exploration and acquiring accurate response to nurses was only similar in 8 questions out of total 45
requirements of patients’ family in Intensive Care Unit questions in the given questionnaire and there was
(ICU) may have important impact on stress reduction, significant difference among the attitudes of these three
ability and positive adaptability, increase in family’s groups in terms of information, support, and comfort fields.
satisfaction with patient’s care, and rising assurance (Delva The results came from these studies may reflect that there is
et al., 2002). The inadequate care about family’s quantitative similarity among the perception in patients’
requirements may cause discontinued care, lack of family and nurses concerning to requirements of the
correlation in patient’s family, and increasing the hospitalized patients’ family in ICU wards and the nurses
contradiction and conflict among patient’s family and care often consider requirements of patients’ family less
provider (Bijttebier et al., 2001). important toward their families (Hinkle and Fitzpatrick,
2011;Maxwell et al., 2007).
The patient’s family needs in ICUs are always considered
as a challenge for healthcare providers, especially the Whereas a few limited studies have been conducted in this
physicians and nurses since patient’s family relies on regard in Iran and particularly in the given population
healthcare providers in order to acquire information about namely in Kerman City and at the same time given that the
patient’s conditions and status and disease trend (Hashim nurses in ICU wards have little time to devote it to patient’s
and Hussin, 2012). Whereas ICU nurses are closely family to meet their requirements because of high workload
interacted with the patients round- the- clock thus they can and shortage of time thus the present research was
provide an ideal situation to meet needs of patient’s family conducted by aiming at the comparison of perception in
(O’Malley et al., 1991). Nevertheless, these needs can be nurses and the hospitalized patient’s family in ICU wards.
identified only when they are valuable and efficient and
predictable (Gavaghan and Carroll, 2002). The 2. MATERIALS AND METHODS:
communication needs of patient’s family and relatives can 2.1. Study Design
offer accurate information about patient’s status as a very This was a cross-sectional descriptive comparative study
important element in patient’s care (Azoulay, 2001). This is conducted in Kerman medical university hospitals (the
considered as an important point for the nurses to be able to largest city in southeastern Iran with a population of
meet patient’s family requirements as supporters of patients 534,441) where are dedicated to provide timely access for
since patient’s family cannot provide medical care for the intensive care to patients in southeast of Iran.
patient under critical conditions. Satisfaction of patient’s 2.2. Sampling
family and meeting of their needs may improve care and We used the 0.05 percent significance level and the effect
support and thus enhancing the efficient care for the given size: (0.5s) 2 to estimate sample size. 105intensive care
disease (Miracle, 2006). nurse and 105 patient family (parents, partner, brother,
sister and children) participated in the study by convenience
In their survey, Chui and Chan (2007) concluded that those sampling. All subjects were approached during their regular
members of family, who are present before their own shift work or being in waiting room and asked to participate
patients in ICU units are subjected to stress and anxiety at in the study. The aims of study were explained and
high level and also they found that their relative with lower informed consent was obtained orally. We used interviews
educational degrees might be exposed to more stress. In a instead of the self-administered method for illiterate
qualitative study, it was reported that members of patient’s individuals. Sampling lasted from March 2013 to
family had two main objectives in their mind where one of November 2013.
them was that they could be assured about providing best 2.3. Measurement tool and study variables
care for their patients and the other one was to keep in touch The study population consisted of ICU nurses and patient
with the aforesaid patient. In their study, Lam and Beauliew families, aged 18 years and above who their patient were
(2004) and Pochard et al (2001) reported that more than two hospitalized in ICU at least 48 hours. Socio-demographic
third of the persons, who visit the patients under critical data such as age, gender, educational status, marital status,
situation of hospitalization in ICU units, may suffer from job experience and Intensive care experience were asked
anxiety and depression. The findings derived from from the nurses. Patient family socio-demographic data
exploration done by Hussin and Hashim (2012) indicated such as age, gender, educational status, marital status,
that family members put the hope and assurance on top of relation to patient, duration of patient ICU hospitalization
priorities of their own requirements. Similarly, family and patient experience of ICU hospitalization were
gathered.
Table 1. Variables distribution of ICU patient families and ICU nurses
Variables Patient Families (n= 105) Nurses (n= 105)
Frequency (%) /Mean (SD) Frequency (%) /Mean (SD)
Age (yrs.) 30.82 ( 9.33) 29.4 ( 4.92)
Gender
Female 36 (34.3) 87 (82.9)
Male 69 (65.7) 18 (17.1)
Marital status
Single 33 (31.4) 31 (29.5)
Married 72 (68.6) 74 (70.5)
Educational status
Illiterate 2 (1.9)
Under diploma 13 (12.4)
Diploma 59 (56.2)
Above diploma 31 (29.5)
Bachelor of nursing 103 (98.1)
MS in nursing 2 (1.9)
Job
Azad 22 (21)
Bikar 55 (52.4)
Kargar 4 (3.8)
Karmanddolat 17 (16.2)
Other 7 (6.7)
Relation to patient
Partner 4 (3.8)
Father 14 (13.3)
Mother 17 (16.2)
Sister 35 (33.3)
Brother 19 (18.1)
Child 16 (15.2)
Duration of patient ICU hospitalization (day) 7.53 ( 3.83)
Patient previous experience of ICU hospitalization
Yes
No 20 (19)
85 (81)
Nursing Experience (yr) 5.5 ( 3.88)
Intensive Nursing care Experience (yr) 3.45 ( 2.72)

Critical Care Family Needs Inventory (CCFNI) was used to 0.05% significance level and 10% type-2 error were used in
access family needs. The CCFNI consists of 45 items rated this study.
on a scale of 1 (not important) to 4 (very important).This
valid Inventory has used in many studies (Burr, 1998; Lee 3. RESULTS:
et al., 2000; Bijttebier et al., 2001; Holden et al., 2002) and In this study, totally 105 nurses who were employed in ICU
according to those consists of five factors including: wards at Shifa, Bahonar, and Afzalipoor hospitals along
Assurance and anxiety reduction (7 items), Comfort (6 with 105 family members of the hospitalized patients in
items), Information (9 items), Proximity and accessibility (9 ICUs in the above-said hospitals, filled out Critical Care
items) and Support (14 items). Family Needs Inventory (CCFNI questionnaire).
As the Persian translation did not exist for the CCFNI, we The mean age of the hospitalized patients’ family members
generated Persian language versions of these instruments in ICU wards was 30.58 ± 9.60. More than 60% of patients’
using a modified forward/backward translation procedure. companions were male and married ones. 85.7% of
In the next step, Content validity was used to validate the members of patients’ family had education at levels of high
scale. Therefore, the scale had presented to ten experts to school diploma and higher degrees. A half of the
determine the proportionality of each item. To determine hospitalized patients’ companions in ICUs were jobless.
reliability of the scale Cronbach’s  for 30 intensive care The maximum dependency between companions and the
nurse and patient family was assessed that was 0.7. hospitalized patients in ICU wards was related to sister of
those patients. The mean period of hospitalization for the
2.4. Statistical analysis patients in ICU wards was 7.53 ±3.83 and more than 80%
Descriptive statistics (frequency and percentage, mean, and of these patients had no former background for
standard deviation) and analytical statistics (independent t- hospitalization in ICUs (Table 1).
test) were used to analyze the data. To study association
between socio-demographic variables and intensive care The mean age of the nurses, who were employed in ICUs,
family needs, Spearman's rho Correlation Coefficient and was 4.92 ± 29.4. 82.9% of the employed nurses were female
Eta Squared was used. SPSS version 16 (IBM Corporation, in ICUs. Most of the nurses were married and with BS
Armonk, NY, USA) was used to analyze the data. The degree.
Table 2. Comparison of the CCFNI score between ICU patient families and ICU nurses
Factors Needs Patients Family Nurses T P
(Mean and SD) (Mean and SD) test value
Assurance 7) To feel there is hope 3.70  0.55 3.48  0.68 2.68 0.008
and anxiety 2) To know specific facts concerning patient’s progress 3.52  0.59 3.02  0.85 5.17 0.000
reduction 5) To know the expected outcome 3.52  0.67 3.05  .080 4.68 0.000
3) To have questions answered honestly 3.39  0.66 3.10  0.75 3.02 0.003
1) To be assured the best possible care is being given 3.31  0.70 3.21  0.70 1.08 0.280
4) To feel that hospital personnel care about patient 3.30  0.77 3.23  0.67 0.67 0.504
6) To have explanations given that are understandable 3.29  0.68 3.36  0.61 -0.83 0.410
Total 3.44  0.35 3.20  0.36 4.73 0.000
Comfort 12) To feel accepted by the hospital staff 3.67  0.55 3.41  0.57 3.34 0.001
11) To have good food available while in the hospital 3.34  0.55 3.24  0.66 1.25 0.213
10) To have a telephone near the waiting room 3.24  0.58 3.32  0.58 -1.07 0.286
9) To have a bathroom near the waiting room 3.17  0.61 3.25  0.68 -0.86 0.393
8) To have comfortable furniture in the waiting room 3.16  0.68 3.34  0.62 -2.02 0.045
13) To be assured it is all right to leave the hospital for a while 2.87  0.77 2.91  0.77 -0.36 0.721
Total 3.24  0.35 3.25  0.38 -0.06 0.950
Information 22) To talk to the doctor every day 3.69  0.54 3.46  0.47 0.59 0.553
15) To know exactly what is being done for patient 3.64  0.57 3.09  0.79 5.69 0.000
19) To know why things were done for a patient 3.50  0.68 3.10  0.74 3.96 0.000
14) To know how patient is being treated medically 3.48  0.74 3.03  0.71 4.40 0.000
16) To have specific person to call at the hospital 3.41  0.63 3.23  0.70 1.97 0.050
18) To know which staff members could give what information 3.30  0.59 3.09  0.67 2.30 0.023
17) To know about the types of staff members taking care of the 3.24  0.69 2.30  0.74 9.50 0.000
patient
21) To help with the patient’s physical care 3.20  0.67 3.15  0.73 0.49 0.623
20) To be told about chaplain services 2.90  0.73 2.81  0.88 0.69 0.487
Total 3.37  0.28 3.03  0.55 5.59 0.000
Proximity 26) To be told about transfer plans while they are being made 3.55  0.57 3.30  0.59 3.22 0.002
and 29) To see the patient frequently 3.52  0.68 2.62  1.07 7.32 0.000
accessibility 23) To be called at home about changes in the condition 3.50  0.68 2.94  0.89 5.15 0.000
24) To receive information about patient once a day 3.50  0.71 3.15  0.68 3.69 0.000
27) To have the waiting room near the patient 3.27  0.54 3.12  0.76 1.57 0.117
28) To have visiting hours start on time 3.24  0.63 3.18  0.69 0.63 0.531
31) To have visiting hours changed for special conditions 3.23  0.72 3.02  0.82 1.96 0.051
25) To talk to the same nurse every day 3.18  0.65 2.87  0.82 3.08 0.002
30) To visit at any time 3.06  0.84 1.57  0.73 13.65 0.000
Total 3.34  0.27 2.86  0.35 10.91 0.000
Support 43) To have directions as to what to do at the bedside 3.60  0.51 3.39  0.63 2.65 0.009
42) To have friends nearby for support 3.50  0.54 3.18  0.76 3.47 0.001
38) To have someone to help with financial problems 3.50  0.61 3.09  0.77 4.37 0.000
37) To have explanations of the environment before going into 3.48  0.73 3.04  0.71 4.40 0.000
the critical care unit for the first time
32) To have a pastor visit 3.41  0.63 2.70  0.81 7.13 0.000
35) To have someone be concerned with your health 3.36  0.57 3.08  0.68 3.30 0.001
36) To be told about people who could help with problems 3.34  0.65 3.13  0.69 2.26 0.025
33) To have a place to be alone while in the hospital 3.31  0.64 3.07  0.74 2.60 0.010
39) To have another person with you when visiting critical care unit 3.26  0.67 2.92  0.69 3.57 0.000
34) To be told about people who could help with problems 3.21  0.68 3.08  0.68 1.43 0.154
40) To be alone at any time 3.19  0.65 3.02  0.71 1.83 0.069
44) To talk about feelings about what has happened 2.99  0.78 2.99  0.64 0.00 1
41) To feel it is all right to cry 2.94  0.72 2.82  0.81 1.18 0.241
45) To talk about the possibility of the patient’s death 2.25  1.08 2.33  1.03 -0.59 0.558
Total 3.24  0.22 2.99  0.30 6.89 0.000
Total 3.32  0.19 3.04  0.24 8.65 0.000

The average rate of working background in nursing field perception variable in these two groups regarding variable
was 5.5 ± 3.88 years while the average rate of working of “comfort” showed no significant difference (p> 0.05).
background was 3.45 ± 2.72 years in ICU wards (Table 1). The mean value of nurses’ perception about the hospitalized
There was statistically significant difference among the patients’ family needs was at level 3.04 ± 0.27 in ICU
attitude of the hospitalized patients’ family members in wards while the mean rate of the perceived needs by
ICUs and the employed nurses in ICUs regarding the fields members of the hospitalized patients’ family was 3.32 ±
of “assurance and anxiety reduction”, “information”, 0.19 in ICUs so that there was statically significant
“proximity and accessibility”, and “support” (p<0.05). But difference between these rates (p< 0.05).
Table 3. Association between the CCFNI score and patient families demographic data
Need score Factor A Factor C Factor I Factor P Factor S Total
Variable
Age r = 0.14 r = 0.14 r = 0.04 r = 0.06 r = 0.10 r = 0.18
p = 0.16 p = 0.15 p = 0.65 p = 0.56 p = 0.30 p = 0.07
Gender 2 = 0.02 2 = 0.01 2 = 0.03 2 = 0.00 2 = 0.00 2 = 0.00
p = 0.17 p =0.31 p =0.10 p = 0.56 p = 0.83 p = 0.94
Marital status 2 = 0.00 2 = 0.05 2 = 0.00 2 = 0.00 2 = 0.00 2 = 0.00
p = 0.56 p = 0.02 p = 0.91 p = 0.56 p = 0.48 p = 0.74
Educational Status 2 = 0.03 2 = 0.02 2 = 0.06 2 = 0.03 2 = 0.07 2 = 0.06
p = 0.39 p = 0.48 p = 0.08 p = 0.34 p = 0.05 p = 0.08
Job 2 = 0.00 2 = 0.06 2 = 0.00 2 = 0.01 2 = 0.03 2 = 0.02
p = 0.99 p = 0.20 p = 0.97 p = 0.94 p = 0.60 p = 0.82
Relation to patient 2 = 0.07 2 = 0.06 2= 0.16 2 = 0.07 2 = 0.04 2 = 0.10
p = 0.23 p = 0.25 p = 0.00 p = 0.24 p = 0.50 p = 0.053
Duration of patient ICU hospitalization r = -0.01 r = -0.11 r = -0.03 r = -0.02 r = -0.12 r = -0.07
p = 0.90 p = 0.27 p = 0.73 p = 0.85 p = 0.20 p = 0.50
Patient previous experience of ICU 2 = 0.00 2 = 0.01 2 = 0.00 2 = 0.02 2 = 0.02 2 = 0.00
hospitalization p = 0.47 p = 0.42 p = 0.76 p = 0.18 p = 0.20 p = 0.56
 Spearman rho's coefficient
 Eta squared

Table 4. Association between the CCFNI score and nursesdemographic data

Need score Factor A Factor C Factor I Factor P Factor S Total
Variable

Age r = 0.09 r = 0.06 r = -0.09 r = -0.14 r = 0.10 r = 0.01
p = 0.35 p = 0.54 p = 0.34 p = 0.16 p = 0.34 p = 0.95
Gender 2 = 0.00 2 = 0.00 2= 0.01 2= 0.01 2 = 0.02 2 = 0.01
p = 0.93 p = 0.70 p = 0.22 p = 0.38 p = 0.14 p = 0.30
Marital status 2 = 0.00 2 = 0.00 2 = 0.04 2 = 0.01 2 = 0.01 2 = 0.02
p = 0.83 p = 0.63 p = 0.03 p = 0.35 p = 0.24 p = 0.20
Educational Status 2= 0.00 2 = 0.00 2 = 0.00 2 = 0.00 2 = 0.01 2 = 0.00
p = 0.97 p = 0.77 p = 0.67 p = 0.59 p = 0.28 p = 0.70
Nursing experience r = 0.20 r = 0.18 r = -0.01 r = -0.07 r = 0.15 r = 0.13
p = 0.04 p = 0.06 p = 0.90 p = 0.46 p = 0.14 p = 0.30
Intensive nursing care r = 0.19 r = 0.08 r = -0.01 r = -0.06 r = 0.11 r = 0.10
experience p = 0.047 p = 0.39 p = 0.90 p = 0.51 p = 0.27 p = 0.30
 Spearman rho's coefficient
 Eta squared

According to viewpoint of patients’ family members, members of the hospitalized patients in ICUs, separately
among 45 questions in this inventory, the mean rate of 40 based on these variables, showed that there was significant
questions was greater than 3 (very important and important relationship among variables of “marital status” and
choices) and based on the nurses’ attitude, the mean value “comfort” (p< 0.05). Similarly, a significant relationship
of 33 questions was greater than 3. Likewise, according to was seen among variables of “reliance on patient” and
attitude of family members, the five following needs could “information” (p< 0.05). No relationship was observed
acquire the maximum significance among other between other demographic variables and score of CCFNI
requirements, respectively: “To feel there is hope; to talk to questionnaire separately based on variables (p> 0.05)
the doctor every day; to feel accepted by the hospital staff; (Table 3).
to know exactly what is being done for patient; to have
directions as to what to do at the bedside”. From nurses’ There was no significant relationship among score of
point of view, the five following needs had the maximum CCFNI questionnaire and demographic variables in the
importance among other requirements, respectively: “To employed nurses in ICUs (p> 0.05). The statistical analysis
feel there is hope; to talk to the doctor every day; to feel indicated the relationship between demographic variables
accepted by the hospital staff;to have directions as to what among the employed nurses in ICUs, particularly based on
to do at the bedside; to have explanations given that are sores of variables separately and this showed that there was
understandable”. (Table 2) significant relationship among variables of “working
background” and “assurance and anxiety reduction” (p<
There was no significant relationship among personal
0.05). Likewise, a significant relationship was seen among
characteristics of family members of the hospitalized
variable of “working background in ICUs” and field of
patients in ICU wards (including age, gender, educational
“assurance and anxiety reduction” (p < 0.05). No significant
degree, occupation, reliance on patient, and period of
relationship was observed between other demographic
patient’s hospitalization) and the score derived from CCFNI
variables in the nurses with the score derived from CCFNI
questionnaire (p> 0.05). Conducting the statistical analysis
questionnaire separately based on variables (p > 0.05)
on the relationship among demographic variables of family
(Table 4).
4. DISCUSSION: (2004), the relevant needs to field of assurance, which were
The results of data analysis in this investigation indicated at highest preference based on attitude of Jordanian
that there was significant difference between the score of patients’ families, the highest micro needs in this field was
the perceived needs by the nurses and patients’ family. allocated to “To have explanations given that are
Similarly, the results came from data analysis, separately understandable” while this has the least importance in our
based on variables, showed that except for variable of study. In their investigation, Abazari and Abbaszadeh
comfort, there was significant difference in other fields of (2001) found that need to “To be assured the best possible
“assurance and anxiety reduction”, “information”, care is being given” has the highest preference from
“proximity and accessibility”, and “support” between two patients’ families view point while the nurses have
groups. Likewise, there was no significant relationship mentioned this need as their own second priority and least
between individual characteristics in family members of the important need in this field was “To have explanations
hospitalized patients in ICUs and the score derived from given that are understandable” according to nurses’ attitude
CCFNI questionnaires. But, there was significant while this micro need was placed at second priority for
relationship among variables of “marital status and field of nurses in our study.
comfort” and “reliance on patient with the field of
information”. There was no significant relationship among Most of the conducted studies have introduced information
score of CFNI questionnaire with demographic variables in as the most important variables in group of needs while
the employed nurses in ICUs. But, there was also “need for receiving information” was placed at second rank
significant relationship among variables of “working in our study based on patients’ families’ attitude and sub-
background and field of assurance and anxiety reduction” category of “To talk to the doctor every day” has the
and “working background in ICUs with field of assurance highest importance according to patients’ families and
and anxiety reduction”. nurses. In the exploration that was done by Hweidi and Al-
Hassan (2004) in Jordan, the need to information was
In a study which was conducted in Sweden, a significant ranked at second position and “to talk to the doctor every
difference was seen between scores of variable of the day” field had the highest importance as a need so that this
perceived needs among patients’ relatives with the nurses in finding was in line with our study. In the investigation done
the fields of information, support, and comfort. The results by Chen et al (2006), need to information and “To be
of investigations, which had been carried out by Takman assured the best possible care is being given” variable had
and Severinsson (2006) and Fitzpatrick and Hinkle (2011) the highest priority. In another research that was done 72
in USA, also indicated that perception of patients’ relatives, hours after hospitalization in ICU ward in Belgium, the
physicians, and nurses from the needs of patients’ relatives variable of need to information was ranked at the highest
might significantly differ in the fields of “information”, level among the needs (Bitjttebier et al: 2001). Similarly,
“support”, and “comfort”. Verhaeghe et al (2005) in a revision study have purposed
the need to information as a global requirement for patients’
The findings from this investigation showed that the needs family while none of these studies were complied with the
in the field of assurance and anxiety reduction had the results of our investigation. In several studies which have
maximum mean score based on the viewpoint of patients’ been carried out by Fitzpatrick and Hinkle (2011) in USA
family and nurses and among sub-variables in this field, the and Takman and Severinsson (2006) in Norway, The
highest preference is related to sub-category of “To feel patients’ family and nurses have expressed the field of
there is hope” based on the attitude of both groups. In a information as their own paramount preference so that the
survey done by Fitzpatrick and Hinkle (2011), the needs in sub- category of “To know exactly what is being done for
the field of assurance was ranked at fourth position in terms patient” had the highest priority from viewpoint of patients’
of importance so for this reason, the given finding is not family while according to findings from our study, this
complied with our study. Similarly, American families variable has been reported as second rank based on patients’
allocated the highest needs in this field to variables of “To family viewpoint and as fifth preferred rank according to
be assured the best possible care is being given” that this nurses’ attitude.
need was placed at fourth rank in our study. Moreover, the
nurses selected the highest priority to variable of “To have The findings in our study has put the needs in the field of
questions answered honestly” where in our study; this “proximity and accessibility” according to view from the
requirement is placed at fifth rank. Likewise, according to hospitalized patients’ family in ICUs and this variable has
attitude of patients’ family and Swedish nurses, the highest been ranked in third position based on the employed nurses’
need was ascribed to variable of “To know the expected viewpoint in this ward and based on the attitude of both
outcome” while this need is placed at second and sixth groups, the sub- category of this field under title of “To be
ranks based on attitude of patients’ family as well as nurses told about transfer plans while they are being made” had the
(Takman and Severinsson; 2006). Also in a survey done by highest priority. The results of the conducted studies in
Molter (1979), like our study, among 10 purposed needs, Jordan have also put the needs in this field at third priority
the variable of “To feel there is hope” was the highest but they differed from them in that the sub- category of “To
priority (Molter, 1979; Al- Hassan and Hweidi, 2004). In an receive information about patient once a day” had the
study which was conducted by Hweidi and Al-Hassan
highest priority in this study (Al-Hassan and Hweidi,
2004)
while in our study, this micro need is placed at third rank In another investigation, which dealt with the experiences
based on attitude taken by patients’ family and nurses. The of relatives of the hospitalized patients about support and
results came from the studies, which have been carried out participation in ICU ward, the results indicated that
by Takman and Severinsson (2006) in Sweden and Norway; participation and support serve as contributory factor that is
Bijtteber et al (2001) in Belgium, and Fitzpatrick and done by professional care providers for the sake of comfort
Hinkle (2011) in USA indicated that patients’ family and and empowerment of patients’ relatives in order to take care
nurses have ranked the relevant needs in the field of of their patients and furthermore this may improve their
proximity and accessibility at the lowest level of self-reliance and increase participation in providing care for
importance so this finding is not complied with the results the patient (Bailey et al, 2010) while it has been reported
of our study. In a study done by Molter (1979), 10 from other conducted studies during recent years that
important needs were posited by these families where the hospital modern technology pay no attention to subject of
need to “To see the patient frequently” had the lowest support from patients and their companions and their
priority based on nurses’ view while this variable acquired families have not been adequately supported in such a way
the 8th rank among our 9 purposed needs so accordingly this that in a survey that was conducted by Hussin and Hashim
finding is in line with results of our investigation but (2012) in Malaysia, variable of “support” had the lowest
patients’ families have put this need at their own fourth importance based on the opinion of families of ICU
priority. In another investigation, the participants put the hospitalized patients. Probably, one could interpret its
need for “To be called at home about changes in conditions reason in that it is difficult to provide adequate and
(of their patients)” as the highest priority while according to appropriate support from family members upon
findings of our study this need can be ranked at third hospitalization of one its members, particularly if s/he
position and based on the nurses’ view, this need is placed suffers from a serious disease therefore one way for
at sixth position of importance. improving quality of support from companions of patients
is that to meet their needs in another fields during period of
The findings in this study showed that the needs in the field patient’s hospitalization in ICUs.
of “support” are placed as fourth priority based on the
attitude of patients’ family and the nurses. And among sub- The need to “comfort” has had the lowest important based
categories in this field, the highest preference have been on the opinion of patient’s family in this study while the
allocated to variable of “to have directions as to what to do first priority was devoted to need to “to feel accepted by the
the bedside” according to patients’ family and the nurses’ hospital staff”. In the conducted studies by Al-Hassan and
viewpoint. The investigation done by Leske (1991) Hweidi (2004) in Jordan and also the investigations done by
indicated that the sub- category of “support” including “to Hinkle and Fitzpatrick (2011), the needs of this field were
know exactly what is being done for patient” is the placed at fourth order while in USA, this need is ranked at
paramount need for patient’s family with critical status the second priority based on attitude of patients’ families
since this may cause the patient to personally receive the and it is ranked at third order from the nurses’ opinion. In a
best care from the family while in our study, this sub- study that was carried out in Sweden, the most important
category of need has been placed at third rank based on need in this field was ascribed to “to have comfortable
patients’ family and also at eighth rank from the nurses’ furniture in the waiting room” while in our study this
view. According to the findings of the conducted study in requirement is ranked at fifth order from viewpoint of
USA, which have dealt with review on need for the family patients’ family and also as the second priority according to
of hospitalized patients in ICU ward, the results indicated nurses’ opinion (Severinsson and Takman; 2006).
that the relevant needs to field of “support” has been placed
at third rank based on attitude of patients’ family and also it The findings in this study refer to the existing significant
is ranked at second place according to the nurses’ opinion difference between demographic variables of family and
(Hinkle and Fitzpatrick, 2011). fields of comfort and information. In another study done by
Abazari and Abbaszadeh (2001), it has been referred to the
In their revised study, which was concerned with the needs existing difference among way of giving answers to
of hospitalized patients’ family in ICU wards in Jordan and questions and personal characteristics of family members
done by Hweidi and Al-Hassan (2004), and also Naderi et including gender and marital status. Similarly, in the
al (2013), in their reviewed investigation, examined 15 investigation which was conducted by Abazari and
studies regarding the requirement of family of the Abbaszadeh (2001), the significant difference was implied
hospitalized patients in ICUs and concluded that most of among way of responsiveness with working background
studies in this regard, have posited the field of “support” at while the findings of our study also refer to the existing
the lowest level among the needs of patients’ family. This significant difference among working background in ICUs
issue has reflected that the families are too involved in care and way of responsiveness in the field of “assurance”.
for the patient as a member of their family that they might
ignore their own requirements while they think about the
support for their patient and assurance for his/ her
5. CONCLUSION:
treatment. In the current research, assurance and anxiety reduction
have been considered as the basic structure that expresses
some of basic needs for companions regarding patient’s
 Asian Journal of Nursing Education and Research 4(3): July-September 2014

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