1. INTRODUCTION:

The family is the paramount social organ and in fact the most fundamental unit of community that has the maximum effect on its members. The members of a family are directly affected by family group.

The stresses and tensions, which are exerted on one member of a family, may effect on the family entirely and the disease can cause creation of crisis in the family as one 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 adapted to stressful situations (Hinkle and Fitzpatrick, 2009).

Many studies have been carried out regarding needs of patient’s family within several types of cultures and geographical regions during 20 years ago and all of these investigations signify acquiring an appropriate and appropriate definition about needs of patient’s family (Delva et al., 2002). These needs include five categories: Information, assurance and anxiety reduction, proximity and accessibility, and support and comfort (Leske, 1991). The exploration and acquiring accurate response to requirements of patients’ family in Intensive Care Unit (ICU) may have important impact on stress reduction, ability and positive adaptability, increase in family’s satisfaction with patient’s care, and rising assurance (Delva et al., 2002). The inadequate care about family’s requirements may cause discontinued care, lack of correlation in patient’s family, and increasing the contradiction and conflict among patient’s family and care provider (Bijttebier et al., 2001).

The patient’s family needs in ICUs are always considered as a challenge for healthcare providers, especially the physicians and nurses since patient’s family relies on healthcare providers in order to acquire information about patient’s conditions and status and disease trend (Hashim and Hussin, 2012). Whereas ICU nurses are closely interacted with the patients round- the- clock thus they can provide an ideal situation to meet needs of patient’s family )O’Malley et al., 1991). Nevertheless, these needs can be identified only when they are valuable and efficient and predictable (Gavaghan and Carroll, 2002). The communication needs of patient’s family and relatives can offer accurate information about patient’s status as a very important element in patient’s care (Azoulay, 2001). This is considered as an important point for the nurses to be able to meet patient’s family requirements as supporters of patients since patient’s family cannot provide medical care for the patient under critical conditions. Satisfaction of patient’s family and meeting of their needs may improve care and support and thus enhancing the efficient care for the given disease (Miracle, 2006).

In their survey, Chui and Chan (2007) concluded that those members of family, who are present before their own patients in ICU units are subjected to stress and anxiety at high level and also they found that their relative with lower educational degrees might be exposed to more stress. In a qualitative study, it was reported that members of patient’s family had two main objectives in their mind where one of them was that they could be assured about providing best care for their patients and the other one was to keep in touch with the aforesaid patient. In their study, Lam and Beauliew (2004) and Pochard et al (2001) reported that more than two third of the persons, who visit the patients under critical situation of hospitalization in ICU units, may suffer from anxiety and depression. The findings derived from exploration done by Hussin and Hashim (2012) indicated that family members put the hope and assurance on top of priorities of their own requirements. Similarly, family members agreed that the nurses were the foremost and most appropriate employees to meet their requirements.

In a study done by Fitzpatrick and Hinkle (2011) in order to determine the different perception of patients’ relatives, physicians, and nurses regarding the relatives’ requirements for ones who visit the hospitalized patients in ICU units, they showed that perception of relatives, physicians, and nurses was only similar in 8 questions out of total 45 questions in the given questionnaire and there was significant difference among the attitudes of these three groups in terms of information, support, and comfort fields. The results came from these studies may reflect that there is quantitative similarity among the perception in patients’ family and nurses concerning to requirements of the hospitalized patients’ family in ICU wards and the nurses often consider requirements of patients’ family less important toward their families (Hinkle and Fitzpatrick, 2011;Maxwell et al., 2007).

Whereas a few limited studies have been conducted in this regard in Iran and particularly in the given population namely in Kerman City and at the same time given that the nurses in ICU wards have little time to devote it to patient’s family to meet their requirements because of high workload and shortage of time thus the present research was conducted by aiming at the comparison of perception in nurses and the hospitalized patient’s family in ICU wards.

2. MATERIALS AND METHODS:

2.1. Study Design

This was a cross-sectional descriptive comparative study conducted in Kerman medical university hospitals (the largest city in southeastern Iran with a population of 534,441) where are dedicated to provide timely access for intensive care to patients in southeast of Iran.

2.2. Sampling

We used the 0.05 percent significance level and the effect size: (0.5s)² to estimate sample size. 105intensive care nurse and 105 patient family (parents, partner, brother, sister and children) participated in the study by convenience sampling. All subjects were approached during their regular shift work or being in waiting room and asked to participate in the study. The aims of study were explained and informed consent was obtained orally. We used interviews instead of the self-administered method for illiterate individuals. Sampling lasted from March 2013 to November 2013.

2.3. Measurement tool and study variables

The study population consisted of ICU nurses and patient families, aged 18 years and above who their patient were hospitalized in ICU at least 48 hours. Socio-demographic data such as age, gender, educational status, marital status, job experience and Intensive care experience were asked from the nurses. Patient family socio-demographic data such as age, gender, educational status, marital status, relation to patient, duration of patient ICU hospitalization and patient experience of ICU hospitalization were gathered.

Table 1. Variables distribution of ICU patient families and ICU nurses

Variables

Patient Families (n= 105)

Frequency (%) /Mean (SD)

Nurses (n= 105)

Frequency (%) /Mean (SD)

Age (yrs.)

30.82 (± 9.33)

29.4 (± 4.92)

Gender

Female

Male

36 (34.3)

69 (65.7)

87 (82.9)

18 (17.1)

Marital status

Single

Married

33 (31.4)

72 (68.6)

31 (29.5)

74 (70.5)

Educational status

Illiterate

Under diploma

Diploma

Above diploma

Bachelor of nursing

MS in nursing

2 (1.9)

13 (12.4)

59 (56.2)

31 (29.5)

103 (98.1)

2 (1.9)

Job

Azad

Bikar

Kargar

Karmanddolat

Other

22 (21)

55 (52.4)

4 (3.8)

17 (16.2)

7 (6.7)

Relation to patient

Partner

Father

Mother

Sister

Brother

Child

4 (3.8)

14 (13.3)

17 (16.2)

35 (33.3)

19 (18.1)

16 (15.2)

Duration of patient ICU hospitalization (day)

7.53 (± 3.83)

Patient previous experience of ICU hospitalization

Yes

20 (19)

85 (81)

Nursing Experience (yr)

5.5 (± 3.88)

Intensive Nursing care Experience (yr)

3.45 (± 2.72)

Table 2. Comparison of the CCFNI score between ICU patient families and ICU nurses

Factors	Needs	Patients Family (Mean and SD)	Nurses (Mean and SD)	T test	P value
Assurance and anxiety reduction	7) To feel there is hope	3.70 ± 0.55	3.48 ± 0.68	2.68	0.008
	2) To know specific facts concerning patient’s progress	3.52 ± 0.59	3.02 ± 0.85	5.17	0.000
	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 patient	3.24 ± 0.69	2.30 ± 0.74	9.50	0.000
	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 and accessibility	26) To be told about transfer plans while they are being made	3.55 ± 0.57	3.30 ± 0.59	3.22	0.002
	29) To see the patient frequently	3.52 ± 0.68	2.62 ± 1.07	7.32	0.000
	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 the critical care unit for the first time	3.48 ± 0.73	3.04 ± 0.71	4.40	0.000
	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

Table 3. Association between the CCFNI score and patient families demographic data

Need score

Variable

Factor A

Factor C

Factor I

Factor P

Factor S

Total

Age^*

r = 0.14

p = 0.16

r = 0.14

p = 0.15

r = 0.04

p = 0.65

r = 0.06

p = 0.56

r = 0.10

p = 0.30

r = 0.18

p = 0.07

Gender^ò

h² = 0.02

p = 0.17

h² = 0.01

p =0.31

h² = 0.03

p =0.10

h² = 0.00

p = 0.56

h² = 0.00

p = 0.83

h² = 0.00

p = 0.94

Marital status^ò

h² = 0.00

p = 0.56

h² = 0.05

p = 0.02

h² = 0.00

p = 0.91

h² = 0.00

p = 0.56

h² = 0.00

p = 0.48

h² = 0.00

p = 0.74

Educational Status^ò

h² = 0.03

p = 0.39

h² = 0.02

p = 0.48

h² = 0.06

p = 0.08

h² = 0.03

p = 0.34

h² = 0.07

p = 0.05

h² = 0.06

p = 0.08

Job^ò

h² = 0.00

p = 0.99

h² = 0.06

p = 0.20

h² = 0.00

p = 0.97

h² = 0.01

p = 0.94

h² = 0.03

p = 0.60

h² = 0.02

p = 0.82

Relation to patient^ò

h² = 0.07

p = 0.23

h² = 0.06

p = 0.25

h²= 0.16

p = 0.00

h² = 0.07

p = 0.24

h² = 0.04

p = 0.50

h² = 0.10

p = 0.053

Duration of patient ICU hospitalization^*

r = -0.01

p = 0.90

r = -0.11

p = 0.27

r = -0.03

p = 0.73

r = -0.02

p = 0.85

r = -0.12

p = 0.20

r = -0.07

p = 0.50

Patient previous experience of ICU hospitalization^ò

h² = 0.00

p = 0.47

h² = 0.01

p = 0.42

h² = 0.00

p = 0.76

h² = 0.02

p = 0.18

h² = 0.02

p = 0.20

h² = 0.00

p = 0.56

* Spearman rho's coefficient

ò Eta squared

Table 4. Association between the CCFNI score and nursesdemographic data

Need score

Variable

Factor A

Factor C

Factor I

Factor P

Factor S

Total

Age^*

r = 0.09

p = 0.35

r = 0.06

p = 0.54

r = -0.09

p = 0.34

r = -0.14

p = 0.16

r = 0.10

p = 0.34

r = 0.01

p = 0.95

Gender^ò

h² = 0.00

p = 0.93

h² = 0.00

p = 0.70

h²= 0.01

p = 0.22

h²= 0.01

p = 0.38

h² = 0.02

p = 0.14

h² = 0.01

p = 0.30

Marital status^ò

h² = 0.00

p = 0.83

h² = 0.00

p = 0.63

h² = 0.04

p = 0.03

h² = 0.01

p = 0.35

h² = 0.01

p = 0.24

h² = 0.02

p = 0.20

Educational Status^ò

h²= 0.00

p = 0.97

h² = 0.00

p = 0.77

h² = 0.00

p = 0.67

h² = 0.00

p = 0.59

h² = 0.01

p = 0.28

h² = 0.00

p = 0.70

Nursing experience^*

r = 0.20

p = 0.04

r = 0.18

p = 0.06

r = -0.01

p = 0.90

r = -0.07

p = 0.46

r = 0.15

p = 0.14

r = 0.13

p = 0.30

Intensive nursing care experience^*

r = 0.19

p = 0.047

r = 0.08

p = 0.39

r = -0.01

p = 0.90

r = -0.06

p = 0.51

r = 0.11

p = 0.27

r = 0.10

p = 0.30

* Spearman rho's coefficient

ò Eta squared

According to viewpoint of patients’ family members, among 45 questions in this inventory, the mean rate of 40 questions was greater than 3 (very important and important choices) and based on the nurses’ attitude, the mean value of 33 questions was greater than 3. Likewise, according to attitude of family members, the five following needs could acquire the maximum significance among other requirements, respectively: “To feel there is hope; to talk to the doctor every day; to feel accepted by the hospital staff; to know exactly what is being done for patient; to have directions as to what to do at the bedside”. From nurses’ point of view, the five following needs had the maximum importance among other requirements, respectively: “To feel there is hope; to talk to the doctor every day; to feel accepted by the hospital staff;to have directions as to what to do at the bedside; to have explanations given that are understandable”. (Table 2)

There was no significant relationship among personal characteristics of family members of the hospitalized patients in ICU wards (including age, gender, educational degree, occupation, reliance on patient, and period of patient’s hospitalization) and the score derived from CCFNI questionnaire (p> 0.05). Conducting the statistical analysis on the relationship among demographic variables of family members of the hospitalized patients in ICUs, separately based on these variables, showed that there was significant relationship among variables of “marital status” and “comfort” (p< 0.05). Similarly, a significant relationship was seen among variables of “reliance on patient” and “information” (p< 0.05). No relationship was observed between other demographic variables and score of CCFNI questionnaire separately based on variables (p> 0.05) (Table 3).

There was no significant relationship among score of CCFNI questionnaire and demographic variables in the employed nurses in ICUs (p> 0.05). The statistical analysis indicated the relationship between demographic variables among the employed nurses in ICUs, particularly based on sores of variables separately and this showed that there was significant relationship among variables of “working background” and “assurance and anxiety reduction” (p< 0.05). Likewise, a significant relationship was seen among variable of “working background in ICUs” and field of “assurance and anxiety reduction” (p < 0.05). No significant relationship was observed between other demographic variables in the nurses with the score derived from CCFNI questionnaire separately based on variables (p > 0.05) (Table 4).

4. DISCUSSION:

The results of data analysis in this investigation indicated that there was significant difference between the score of the perceived needs by the nurses and patients’ family. Similarly, the results came from data analysis, separately based on variables, showed that except for variable of comfort, there was significant difference in other fields of “assurance and anxiety reduction”, “information”, “proximity and accessibility”, and “support” between two groups. Likewise, there was no significant relationship between individual characteristics in family members of the hospitalized patients in ICUs and the score derived from CCFNI questionnaires. But, there was significant relationship among variables of “marital status and field of comfort” and “reliance on patient with the field of information”. There was no significant relationship among score of CFNI questionnaire with demographic variables in the employed nurses in ICUs. But, there was also significant relationship among variables of “working background and field of assurance and anxiety reduction” and “working background in ICUs with field of assurance and anxiety reduction”.

In a study which was conducted in Sweden, a significant difference was seen between scores of variable of the perceived needs among patients’ relatives with the nurses in the fields of information, support, and comfort. The results of investigations, which had been carried out by Takman and Severinsson (2006) and Fitzpatrick and Hinkle (2011) in USA, also indicated that perception of patients’ relatives, physicians, and nurses from the needs of patients’ relatives might significantly differ in the fields of “information”, “support”, and “comfort”.

The findings from this investigation showed that the needs in the field of assurance and anxiety reduction had the maximum mean score based on the viewpoint of patients’ family and nurses and among sub-variables in this field, the highest preference is related to sub-category of “To feel there is hope” based on the attitude of both groups. In a survey done by Fitzpatrick and Hinkle (2011), the needs in the field of assurance was ranked at fourth position in terms of importance so for this reason, the given finding is not complied with our study. Similarly, American families allocated the highest needs in this field to variables of “To be assured the best possible care is being given” that this need was placed at fourth rank in our study. Moreover, the nurses selected the highest priority to variable of “To have questions answered honestly” where in our study; this requirement is placed at fifth rank. Likewise, according to attitude of patients’ family and Swedish nurses, the highest need was ascribed to variable of “To know the expected outcome” while this need is placed at second and sixth ranks based on attitude of patients’ family as well as nurses (Takman and Severinsson; 2006). Also in a survey done by Molter (1979), like our study, among 10 purposed needs, the variable of “To feel there is hope” was the highest priority (Molter, 1979; Al- Hassan and Hweidi, 2004). In an study which was conducted by Hweidi and Al-Hassan (2004), the relevant needs to field of assurance, which were at highest preference based on attitude of Jordanian patients’ families, the highest micro needs in this field was allocated to “To have explanations given that are understandable” while this has the least importance in our study. In their investigation, Abazari and Abbaszadeh (2001) found that need to “To be assured the best possible care is being given” has the highest preference from patients’ families view point while the nurses have mentioned this need as their own second priority and least important need in this field was “To have explanations given that are understandable” according to nurses’ attitude while this micro need was placed at second priority for nurses in our study.

Most of the conducted studies have introduced information as the most important variables in group of needs while “need for receiving information” was placed at second rank in our study based on patients’ families’ attitude and sub- category of “To talk to the doctor every day” has the highest importance according to patients’ families and nurses. In the exploration that was done by Hweidi and Al-Hassan (2004) in Jordan, the need to information was ranked at second position and “to talk to the doctor every day” field had the highest importance as a need so that this finding was in line with our study. In the investigation done by Chen et al (2006), need to information and “To be assured the best possible care is being given” variable had the highest priority. In another research that was done 72 hours after hospitalization in ICU ward in Belgium, the variable of need to information was ranked at the highest level among the needs (Bitjttebier et al: 2001). Similarly, Verhaeghe et al (2005) in a revision study have purposed the need to information as a global requirement for patients’ family while none of these studies were complied with the results of our investigation. In several studies which have been carried out by Fitzpatrick and Hinkle (2011) in USA and Takman and Severinsson (2006) in Norway, The patients’ family and nurses have expressed the field of information as their own paramount preference so that the sub- category of “To know exactly what is being done for patient” had the highest priority from viewpoint of patients’ family while according to findings from our study, this variable has been reported as second rank based on patients’ family viewpoint and as fifth preferred rank according to nurses’ attitude.

The findings in our study has put the needs in the field of “proximity and accessibility” according to view from the hospitalized patients’ family in ICUs and this variable has been ranked in third position based on the employed nurses’ viewpoint in this ward and based on the attitude of both groups, the sub- category of this field under title of “To be told about transfer plans while they are being made” had the highest priority. The results of the conducted studies in Jordan have also put the needs in this field at third priority but they differed from them in that the sub- category of “To receive information about patient once a day” had the highest priority in this study (Al-Hassan and Hweidi, 2004) while in our study, this micro need is placed at third rank based on attitude taken by patients’ family and nurses. The results came from the studies, which have been carried out by Takman and Severinsson (2006) in Sweden and Norway; Bijtteber et al (2001) in Belgium, and Fitzpatrick and Hinkle (2011) in USA indicated that patients’ family and nurses have ranked the relevant needs in the field of proximity and accessibility at the lowest level of importance so this finding is not complied with the results of our study. In a study done by Molter (1979), 10 important needs were posited by these families where the need to “To see the patient frequently” had the lowest priority based on nurses’ view while this variable acquired the 8^th rank among our 9 purposed needs so accordingly this finding is in line with results of our investigation but patients’ families have put this need at their own fourth priority. In another investigation, the participants put the need for “To be called at home about changes in conditions (of their patients)” as the highest priority while according to findings of our study this need can be ranked at third position and based on the nurses’ view, this need is placed at sixth position of importance.

The findings in this study showed that the needs in the field of “support” are placed as fourth priority based on the attitude of patients’ family and the nurses. And among sub- categories in this field, the highest preference have been allocated to variable of “to have directions as to what to do the bedside” according to patients’ family and the nurses’ viewpoint. The investigation done by Leske (1991) indicated that the sub- category of “support” including “to know exactly what is being done for patient” is the paramount need for patient’s family with critical status since this may cause the patient to personally receive the best care from the family while in our study, this sub- category of need has been placed at third rank based on patients’ family and also at eighth rank from the nurses’ view. According to the findings of the conducted study in USA, which have dealt with review on need for the family of hospitalized patients in ICU ward, the results indicated that the relevant needs to field of “support” has been placed at third rank based on attitude of patients’ family and also it is ranked at second place according to the nurses’ opinion (Hinkle and Fitzpatrick, 2011).

In their revised study, which was concerned with the needs of hospitalized patients’ family in ICU wards in Jordan and done by Hweidi and Al-Hassan (2004), and also Naderi et al (2013), in their reviewed investigation, examined 15 studies regarding the requirement of family of the hospitalized patients in ICUs and concluded that most of studies in this regard, have posited the field of “support” at the lowest level among the needs of patients’ family. This issue has reflected that the families are too involved in care 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 treatment.

In another investigation, which dealt with the experiences of relatives of the hospitalized patients about support and participation in ICU ward, the results indicated that participation and support serve as contributory factor that is done by professional care providers for the sake of comfort and empowerment of patients’ relatives in order to take care of their patients and furthermore this may improve their self-reliance and increase participation in providing care for the patient (Bailey et al, 2010) while it has been reported from other conducted studies during recent years that hospital modern technology pay no attention to subject of support from patients and their companions and their families have not been adequately supported in such a way that in a survey that was conducted by Hussin and Hashim (2012) in Malaysia, variable of “support” had the lowest importance based on the opinion of families of ICU hospitalized patients. Probably, one could interpret its reason in that it is difficult to provide adequate and appropriate support from family members upon hospitalization of one its members, particularly if s/he suffers from a serious disease therefore one way for improving quality of support from companions of patients is that to meet their needs in another fields during period of patient’s hospitalization in ICUs.

The need to “comfort” has had the lowest important based on the opinion of patient’s family in this study while the first priority was devoted to need to “to feel accepted by the hospital staff”. In the conducted studies by Al-Hassan and Hweidi (2004) in Jordan and also the investigations done by Hinkle and Fitzpatrick (2011), the needs of this field were placed at fourth order while in USA, this need is ranked at the second priority based on attitude of patients’ families and it is ranked at third order from the nurses’ opinion. In a study that was carried out in Sweden, the most important need in this field was ascribed to “to have comfortable furniture in the waiting room” while in our study this requirement is ranked at fifth order from viewpoint of patients’ family and also as the second priority according to nurses’ opinion (Severinsson and Takman; 2006).

The findings in this study refer to the existing significant difference between demographic variables of family and fields of comfort and information. In another study done by Abazari and Abbaszadeh (2001), it has been referred to the existing difference among way of giving answers to questions and personal characteristics of family members including gender and marital status. Similarly, in the investigation which was conducted by Abazari and Abbaszadeh (2001), the significant difference was implied among way of responsiveness with working background while the findings of our study also refer to the existing significant difference among working background in ICUs and way of responsiveness in the field of “assurance”.

5. CONCLUSION:

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 status and care trend and premonition of disease. Training and receiving adequate information about several issues such as patient’s status and treatment plan is one of the important concerns and needs for family of patients. Giving information to family members may contribute to improving their knowledge about what occurs for them and if they are inclined they could help the patient more than ever. Proximity and accessibility and support may also interpret the pivotal concepts of need to frequent visits to the patient, to talk about plans for transfer of patient, need to information, and emotional support. These concepts also express some effective basic needs on individual health of the companions and their capability to continue playing care- providing role in the hospital as well as after their discharge. Paying no attention to these needs and lack of meeting these needs on time and such situations may be due to lack of perception and inappropriate review of the given situation and ignoring the value of care-taking role for care- providers. In order to reduce stress and conflict and to strengthen familial care-takers, it is required for professionals to perceive their personal experiences and to act in coordination with their concerns in order to be able to provide better care and support. The properly perception of nurses from the needs of family members of the patients may be very efficient in taking the best approach toward meeting these needs and also taking several strategies based on their important requirements.

6. ACKNOWLEDGMENTS:

The authors thank the nurses and families of ICU hospitalized patients of Shafa, Bahonar and Afzalipour Hospitals for their contribution to our data collection.

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