Aim To analyze and examine the concept of uncertainty of the patient's illness among family caregivers. Background Promoting family caregivers’ health is significant in nursing. Family caregivers may experience uncertainty related to their loved ones’ illness. A lack of clarity exists regarding the uncertainty concept among family caregivers and its implications in nursing. Data Source A review of the literature that focused on family caregivers of adult patients using PubMed, CINAHL, and Scopus databases was completed. Methods The Walker and Avant framework was applied to identify the attributes, antecedents, and consequences of family caregivers’ uncertainty. Results Eight articles were analyzed. Attributes of family caregivers’ uncertainty included the patient's illness probability and family caregivers’ perception of the illness. Antecedents included the characteristics of the patient's illness, factors associated with the family caregivers’ perception of the illness, and family responsibilities of caregiving. The consequences included family caregivers’ emotional, psychological, and financial outcomes. Family caregivers’ uncertainty is defined as the perception of the inability to process information regarding the patient's illness trajectory when caring for significant others’ illness. Conclusions Individuals can perceive uncertainty differently as a patient‐facing uncertainty in illness versus a family caregiver facing uncertainty of their loved ones’ illness.
Background Delirium as a sudden cognitive and behavioral change can be traumatic for family caregivers. An understanding of family caregivers’ experiences with delirium in their loved one in an intensive care unit (ICU) will help clinicians provide family-centered care. Objective To explore the impact of delirium on, and the needs of, family caregivers of ICU patients with delirium. Methods A comprehensive search was done of literature in the PubMed, CINAHL, and Scopus databases published from 2000 to 2020. Primary studies written in English and done in critical care settings were included. Studies that did not focus on the family experience of delirium were excluded. Additional studies were identified by reviewing the reference lists of selected articles. Evidence was synthesized, and common themes were identified. Results Among 210 studies, 7 were included after irrelevant and duplicate studies had been removed. Findings were categorized as (1) psychological impacts of a patient’s delirium on family caregivers and (2) family caregivers’ needs. Common psychological impacts included anxiety, depression, concern, fear, anger, uncertainty, shock, insecurity, and disappointment. Family caregivers reported needing informational and emotional support from, and effective communication with, health care professionals. Conclusions Family caregivers’ health is crucial to ensuring the effectiveness of family engagement in delirium management. Future studies should consider family caregiver characteristics that could be used to predict psychological symptoms when caregivers are exposed to a patient’s delirium and explore whether specific types of delirium cause more psychological impacts and needs among family caregivers than other types of delirium cause.
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