Family Members' Perceptions of Strategies to Support Hope in the ICU (S702)

1.Describe two types of hope as experienced by family members of seriously ill ICU patients.2.Describe how HCPs support hope for positive outcomes.3.Describe how HCPs support hope for the ability to cope regardless of outcome. As they confront complex medical decisions, family members of seriously ill patients desire information about their loved one's condition yet also wish to maintain hope. Health care providers (HCP) struggle to find the balance between this need for information with the desire to support hope. To explore the experience of family members with HCP strategies to support hope. We prospectively identified ICU patients likely to need complex decision making and recruited their family members. Using narrative style interviews, we explored perceptions of HCP strategies to support hope. We recruited 32 family members of 17 patients. Participants described two types of hope: hope for a positive outcome and hope for an ability to cope, regardless of the outcome. Examples of sources of hope for a positive outcome include: Faith in god, interpretation of factual and prognostic information, confidence in the care, and a perception that the HCPs were hopeful. Family members described HCPs being optimistic and helping them to reframe their hope. Although several family members appreciated having a glimmer of hope, at times, overly optimistic expressions led to family members being unprepared for discussions of EOL decisions. Sources of hope for an ability to cope included: Trust and reliance on others, including a higher power, family, and HCPs. Family members described HCPs supporting the family unit and providing regular communication in a compassionate manner. Family members expressed a desire for hope, even when they were aware of a poor prognosis. However, unrealistic hope contributed to distress. Families described HCPs supporting hope by helping to reframe hope, by supporting the family unit, and by being available and compassionate.