The Family Navigator: A Pilot Intervention to Support Intensive Care Unit Family Surrogates.
Alexia M Torke, Lucia D Wocial, Shelley A Johns and 8 others
PMID 27802950WHAT IT FOUND
A nurse-led family support role was feasible and well-liked in the ICU, but showed no significant difference in family surrogates' stress, anxiety, depression, or decision regret compared to usual care.
The pilot was too small to prove clinical benefit.
Key findings
01The intervention was feasible and acceptable: all intervention participants had initial meetings, and 90% or more of eligible weekdays included contact with the nurse navigator.
02There were no significant differences in posttraumatic stress, anxiety, depression, decision conflict, or decision regret between the nurse-led intervention group and the control group.
03The study was underpowered to detect differences, with a small sample size of 26 participants and a 41% refusal rate that may have introduced bias.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was very small (26 participants), making the study underpowered to detect true differences in clinical outcomes. There was a 41% refusal rate, which may have introduced selection bias. Baseline imbalances were noted, with the intervention group having lower education levels and higher baseline scores for depression and anxiety, which could impact comparisons. Loss to follow-up was higher in the intervention group (4 participants) than in the control group (1 participant). The study was conducted in a single Midwest tertiary ICU with moderately high health literacy, limiting generalizability to other settings. The outcome measures, while validated for patients, lacked specific validation data for family surrogates.
Declared interests
The study was supported by an NIH grant. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the null findings as evidence that the Family Navigator intervention is ineffective. The pilot was explicitly designed to test feasibility and acceptability, not efficacy, and the small sample size (n=26) was too underpowered to detect differences in outcomes like stress or decision regret.