UNASSIGNED: Knowledge and support by members of the family towards the care of the consumers of mental health services is the core priority and is noticeable by the users as it gives and eases the life of the users during therapy and rehabilitation. However, there have been documented instances of families that neglect their relatives with mental illnesses.
UNASSIGNED: This study explored the experiences of mental healthcare consumers regarding family members\' knowledge of mental disorders and support.
UNASSIGNED: Participants who were granted leave of absence were selected through nonprobability, purposive sampling. Data were collected using face-to-face unstructured discussions. Data were analyzed using Colaizzi\'s technique.
UNASSIGNED: Findings revealed misconceptions versus insight on the cause of mental disorders, knowledge deficit on the effect of treatment, poor support from family members, financial challenges perceived as a source of poor support, and lack of psychological support and its consequences. Mental healthcare consumers verbalized limited support from family members. They reported variation in terms of family members\' knowledge of their mental condition.
UNASSIGNED: Training family members on mental health illness is critical to the future of health care as there will be no misunderstanding between them and the consumers of mental health care. Healthcare consumers\' feelings of sadness and anxiety could be avoided by avoiding conflicts over their social grants. The government should invest in assisting family members of mental healthcare consumers.

OBJECTIVE: Family members of Intensive Care Unit (ICU) patients can experience mental health difficulties. These are collectively described as Post Intensive Care Syndrome-Family (PICS-F). There are no standardised outcome measures to benchmark the impact of PICS-F. This scoping review aimed to map and characterise interventions, outcomes, and outcome instruments related to PICS-F.
METHODS: Eight databases were searched in June 2023: Pubmed, CINAHL, Ovid Medline, EMBASE, PsycInfo, AMED, Emcare and Cochrane. The grey literature was also searched. Studies published after 2012 related to PICS-F were included. Search strategy included: (Population) family members of adult ICU patients, (Concept) PICS-F, (Context) ICU settings. Frequency analysis of outcomes was performed, and instruments were mapped to describe the characteristics.
RESULTS: Of the identified 4848 records, 46 papers representing 44 unique studies met the inclusion criteria and were retained for analysis. In total, 8008 family members were represented across 15 countries in four continents worldwide. The number of studies reporting PICS-F interventions increased rapidly over the past 12 years and were performed in ICUs treating mixed conditions. Studies were randomised control trials (n = 33), before-and-after design (n = 6) and non-randomised trials (n = 5). A total of 18 outcome instruments were used measuring predominantly anxiety, with complicated grief measured only once. The identified instruments were mostly validated for clinical and disease specific populations but not validated among relatives of ICU patients.
CONCLUSIONS: There is a plethora of instruments measuring PICS-F outcomes. No core outcome set is currently available for PICS-F. To reduce heterogeneity of how PICS-F is measured, a core outcome set with validated measurements is recommended to allow benchmarking and to document the impact of PICS-F interventions.
CONCLUSIONS: Recognising PICS-F symptoms and understanding how to assess them could help clinicians to develop interventions to improve family outcomes. Validated instruments are needed to evaluate these interventions.

BACKGROUND: Hospice care plays an important role in improving the quality of life of advanced cancer patients, but controversy remains over whether age affects the attitudes of family members toward hospice care.
OBJECTIVE: To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.
METHODS: The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022. The participants were divided into youth (< 40 years, n = 65), middle-aged (40-60 years, n = 59), and elderly (> 60 years, n = 51) groups. Researchers investigated and compared the degree of awareness regarding hospice care, attitudes, and whether the family members of patients would choose hospice care.
RESULTS: Among the family members of 175 patients, approximately 28% (49/175) were aware of hospice care. Awareness of hospice care, the proportion of hospice care acceptance and adaptation attitudes, and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups (P < 0.05). No statistically significant difference was found in these three indicators between the middle-aged and elderly groups (P > 0.05). Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment, whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.
CONCLUSIONS: The family members of patients with advanced cancer had relatively low awareness of hospice care, while youth had a higher awareness of hospice care, acceptance, and adaptation attitudes, and were more willing to choose hospice care.

BACKGROUND: Caregivers\' involvement in the diagnostic and monitoring processes of the level of consciousness of patients with Disorders of Consciousness (DoC) is strongly encouraged by international guidelines, as current literature suggests a better chance to detect behavioural responses when caregivers are involved in clinical assessments. Since caregivers\' involvement during clinical assessments can be difficult, the Social And Family Evaluation (SAFE) scale has been recently proposed as a standardised tool that caregivers can autonomously use to collect their opinions about the level of consciousness of patients with DoC, based on the behaviours manifested by the patients in a given time-window.
OBJECTIVE: Providing preliminary results concerning SAFE adoption.
METHODS: 22 patients with DoC were assessed through the Coma Recovery Scale-revised (CRS-r), while their caregivers filled-in the SAFE.
RESULTS: The SAFE showed a very high internal consistency, very high test-retest reliability, and high criterion validity when correlated to the CRS-r total score. Moreover, in line with the literature, the SAFE allowed the detection of some behaviours indicative of a higher level of consciousness than those detected by clinicians through the CRS-r in more than half of the sample.
CONCLUSIONS: Overall, these preliminary data are promising for the adoption of the SAFE to collect the opinions of the caregivers about the level of consciousness of patients with DoC, especially in those settings where it would be otherwise difficult to monitor the patients, such as long-term care structures and at home, as a tool for telemedicine allowing the monitoring of patients in remote settings.

BACKGROUND: People with intellectual disabilities are more likely to be prescribed psychotropic medication than the general population and are frequently prescribed multiple medications. Understanding people with intellectual disabilities and carer perspectives is essential to improving the quality of psychotropic medication prescribing and usage.
METHODS: A rapid review explored people with intellectual disabilities\' understanding of psychotropic medications, as well as family members and paid carers, and how this understanding can be improved.
RESULTS: Twenty-one journal articles were included. Lack of understanding of medication was universal, with participants often unaware of adverse effects, alternatives, and rights around medication. There was also a lack of involvement in decision making for all participants. Some interventions aimed at people with intellectual disabilities or paid carers helped to improve knowledge.
CONCLUSIONS: Evaluating how best to improve psychotropic medication understanding for people with intellectual disabilities, family members and paid carers should be a focus for future research.

UNASSIGNED: Medical consultations with older patients often include triadic conversations and decision-making processes involving physicians, patients, and family members. The presence of family members may change the communication dynamics and therefore increase the complexity of the consultation and decision-making process.
UNASSIGNED: This study explored associations between physicians\' shared decision-making (SDM) behaviour and patients\' and family members\' participation in the decision-making process.
UNASSIGNED: Using an observational design, we analysed 95 recorded consultations between medical specialists, patients aged ≥65 years, and accompanying family members at a Dutch hospital. The OPTIONMCC was used to assess the physicians\' SDM behaviour and patients\' and family members\' levels of involvement in SDM.
UNASSIGNED: We found a strong positive correlation between physicians\' behaviour and patients\' and family members\' participation in SDM (0.68 and 0.64, respectively, p < .01). Family members were more involved in SDM for patients aged 80 and older.
UNASSIGNED: While not asserting causation, our study suggests physicians potentially play a facilitating role in shaping the SDM process together with proactive contributions from patients and family members.
UNASSIGNED: The results offer new insights into triadic SDM and provide suggestions for refining the OPTIONMCC. Further research is recommended into participants\' mutual directional influences in triadic SDM.

UNASSIGNED: Exploring the experiences, perceptions and meanings of family members and close friends of Israeli individuals who sought aid-in-dying outside Israel.
UNASSIGNED: Using the phenomenological-interpretive approach, a qualitative research design was employed, based on ten in-depth semi-structured interviews with Israelis who had provided support for a relative who embarked on suicide tourism.
UNASSIGNED: The following five themes emerged from interviews: (1) facilitators for supporting an individual requesting suicide tourism; (2) choosing death and actively making the decision to die; (3) the meaning of traveling to die; (4) offering support throughout the process; and (5) facilitating procedures after death.
UNASSIGNED: The participants spoke of the active role that they played in their relative\'s suicide-tourism journey. They conveyed conflicting emotions and values regarding the decision at hand, the ability to say goodbye thanks to their pre-planned death, helping to reduce their suffering and burden, and dealing with the challenge of disclosing the deceased\'s plans, before and after the act, as well as their own involvement in the process. Relatives of suicide-tourism patients should receive professional support during and following this difficult process.

BACKGROUND: Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients.
METHODS: The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel\'s Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty.
RESULTS: According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients.
CONCLUSIONS: Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.

BACKGROUND: Decision aids (DAs) have been proposed to support patients and families with disease information processing and decision-making, but their effectiveness for critically ill patients and their families is incompletely understood.
OBJECTIVE: To systematically synthesize evidence on the effectiveness of the DAs on the prognosis of critically ill patients and knowledge, anxiety, depression and decisional conflict of their family members.
METHODS: Systematic review and meta-analysis. We conducted a systematic search of literature using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature database, Scopus, PsycNet, CNKI and Wanfang Database from the inception of the databases until May 2023 to identify randomized clinical trials (RCTs) describing DAs interventions targeted at adult intensive care unit (ICU) patients or their families. We also searched grey literature in four databases: Chinese Clinical Trials Registry, Chinese Cochrane Center, Open Grey and GreyNet International.
RESULTS: Seven RCTs were included in the review. Meta-analysis identified longer hospital length of stay (LOS) among all patients compared with usual care (mean difference [MD] = 5.64 days, 95% confidence interval, CI [0.29, 10.98], p = .04), but not in surviving patients (MD = 2.09 days, 95% CI [-3.70, 7.89], p = .48). However, there was no evidence of an effect of DAs on hospital mortality (RR = 1.25, 95% CI [0.92, 1.70], p = .15), ICU LOS (MD = 3.77 days, 95% CI [-0.17, 7.70], p = .06) and length of mechanical ventilation (MD = 0.88 days, 95% CI [-2.22, 3.97], p = .58). DAs led to a statistically significant improvement in family members\' knowledge (standard mean difference = 0.84, 95% CI [0.12, 1.56], p = .02). We found no significant effect of DAs on anxiety, depression, post-traumatic stress disorder, decisional conflict and quality of communication of family members.
CONCLUSIONS: This review provides effective evidence that DAs can potentially improve the knowledge level of family members while prolonging the hospital LOS among critically ill patients.
CONCLUSIONS: Well-designed large-scale studies with DAs tailored to the individuals\' preferences and existing cultural values are warranted.

OBJECTIVE: To describe the variations of family members\' conceptions of their supportive care needs (SCN) across the colorectal cancer (CRC) trajectory.
METHODS: A descriptive qualitative study with a phenomenographic approach.
METHODS: Individual semi-structured interviews were conducted from May 2022 to October 2022 with 23 family members of persons diagnosed with colorectal cancer. The interviews were analysed using phenomenographic analysis following the Consolidated criteria for reporting qualitative research (COREQ) checklist.
RESULTS: The phenomenographic analysis resulted in five categories. Not of importance describes family members\' needs as unimportant due to the good prognosis and the organization of care and in relation to the needs of others. Only satisfiable by professionals describes information possessed by the healthcare professionals as key, as well as the need for professional counselling for the family members to process their emotions. Managed by themselves describes family members preferring to manage their SCN themselves by turning to the appropriate social support and/or by using coping skills. Understood retrospectively describes SCN as only understandable when things have calmed down and as requiring one\'s own experience to understand. Left unmet describes SCN as unnoticed by the healthcare professionals or not brought to light by the family members, or family members not knowing where to turn for support.
CONCLUSIONS: Supportive care should involve individualized information, proactive and repeated assessments of needs across the trajectory, as well as encouragement of family members to reflect on their needs and to accept support when needed.
CONCLUSIONS: There is a gap in the literature regarding family members\' SCN across the CRC trajectory which this study addresses. Findings show five categories of family members\' conceptions of their SCN. Those findings could serve as a basis for the development of clinical colorectal supportive care across the cancer trajectory.
UNASSIGNED: Findings show that to offer family members of persons diagnosed with colorectal cancer support only at the time of diagnosis is insufficient. Instead, the healthcare team is recommended to proactively and repeatedly try to identify those in need and the characteristics of their needs. In addition, it is important to offer individualized information and strive to encourage family members to reflect on their situation and to not suppress their own needs if emerging.
UNASSIGNED: Reporting adheres to the consolidated criteria for reporting qualitative research (COREQ) checklist.
UNASSIGNED: No patient or public contribution.