Nurses’ attitudes toward family importance in heart failure care

Abstract

Background: Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure (HF). To involve family members in HF care is thus valuable for the patients. Registered nurses (RNs) frequently meet family members to patients with HF and the quality of these encounters are likely to be influenced by the attitudes RNs hold toward families. Aims: To explore RNs' attitudes toward the importance of families' involvement in HF nursing care and to identify factors that predict the most supportive attitudes. Methods: Cross-sectional, multicentre websurvey study. A sample of 303 RNs from 47 hospitals and 30 primary health care centres (PHCC) completed the instrument Families' Importance in Nursing Care -Nurses' Attitudes. Results: Overall, RNs were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in HF nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a PHCC, a HF clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and or HF nursing care, and a competence to work with families. Conclusions: Experienced RNs in HF nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. RNs who have designated consultation time with patients and families, as in a nurse-led HF clinic, may have the most favourable condition for implementing a more supportive approach to families.

Nurses' attitudes regarding the importance of families in nursing care: A cross‐sectional study

“…Most of the participating nurses indicated that they gained a lot of valuable knowledge from families, and most of them considered family members as cooperating partners. This is in line with other studies, which found that nurses are supportive of families' involvement and view families as important in care (Gusdal et al, ; Luttik et al, ). Even though nurses considered family members as cooperating partners, only half of the nurses in our study encouraged families to use their own resources.…”

“…(Wright & Bell, ). Nurses attitudes towards involving families in nursing care has been explored in different clinical settings such as paediatrics (Angelo et al, ), obstetric care (Ribeiro, Sousa, Santos, Silva, & Sousa, ), primary health care (Oliveira et al, ), mental health care (Hsiao & Tsai, ), among nurses caring for patients with psychiatric diagnoses (Sveinbjarnardottir, Svavarsdottir, & Saveman, ), in cardiovascular care (Gusdal, Josefsson, Thors Adolfsson, & Martin, ; Luttik et al, ), in surgical units (Blondal et al, ) emergency departments (Linnarsson, Benzein, & Arestedt, ), in critical care units (Hetland, Hickman, McAndrew, & Daly, ; Hetland, McAndrew, Perazzo, & Hickman, ) and among home care nurses and hospital‐employed nurses (Broekema, Luttik, Steggerda, Paans, & Roodbol, ). Generally, the studies found that nurses hold positive attitudes towards family involvement in care (Hsiao & Tsai, ; Linnarsson et al, ; Oliveira et al, ), even without special training in approaches to family inclusion (Ribeiro et al, ).…”

“…Attending an educational course in a family system nursing approach increased nurses' positive attitudes, and the way they thought about family inclusion changed towards a more collaborative focus and readiness for applying a family system approach in clinical practice (Blondal et al, ; Broekema et al, ; Svavarsdottir et al, ; Sveinbjarnardottir et al, ). A workplace with a general approach towards families and competences to work with families predicts the most supportive attitudes among the nurses (Blondal et al, ; Gusdal et al, ; Voltelen, Konradsen, & Østergaard, ). In contrast, the attitudes of older nurses who had been in the profession for many years and had no previous contact with the concept of family nursing were less supportive of involving families in patient care (Angelo et al, ).…”

Systematic review of measurement properties of instruments assessing nurses’ attitudes towards the importance of involving families in their clinical practice

“…A total of 19 studies were included in this systematic review reporting on the following five instruments used to assess nurses’ attitudes towards the importance of involving families in their clinical practice: Families’ Importance in Nursing Care: Nurses’ Attitudes (FINC‐NA) (Benzein, Johansson, Arestedt, Berg, Johansson, Arestedt, Berg, & Saveman, ; Blöndal et al, ; Hsiao & Tsai, ; Luttik et al, ; Pascual Fernández et al, ) and three further versions of the scale: a revised version (FINC‐NA‐R) (Gusdal, Josefsson, Thors Adolfsson, & Martin, ; Linnarsson, Benzein, & Årestedt, ; Saveman, Benzein, Engström, & Årestedt, ), a short version (FINC‐NA‐S) (Mackie, Marshall, Mitchell, & Ireland, ) and a modified Portuguese version (IFCE‐AE) (Oliveira et al., ). Family Nurse Practice Scale (FNPS) (Hsiao & Tsai, ; Simpson & Tarrant, ). Family Nurse Caring Belief Scale (FNCBS) (Meiers, Tomlinson, & Peden‐McAlpin, ). Family‐Centered Care Questionnaire (FCCQ) (Bruce & Ritchie, ) and a revised version (FCCQ‐R) (Alabdulaziz, Moss, & Copnell, ; Bruce et al, ; Caty, Larocque, & Koren, ; Coyne, Murphy, Costello, O'Neill, & Donnellan, ). Measure of Beliefs about Participation in Family‐Centered Service (MBP‐FCS) (Asai, ; King et al, ). …”

“…1. Families' Importance in Nursing Care: Nurses' Attitudes (FINC-NA) (Benzein, Johansson, Arestedt, Berg, Johansson, Arestedt, Berg, & Saveman, 2008;Blöndal et al, 2014;Hsiao & Tsai, 2015;Luttik et al, 2017;Pascual Fernández et al, 2015) and three further versions of the scale: a revised version (FINC-NA-R) (Gusdal, Josefsson, Thors Adolfsson, & Martin, 2017;Linnarsson, Benzein, & Årestedt, 2015;Saveman, Benzein, Engström, & Årestedt, 2011), a short version (FINC-NA-S) (Mackie, Marshall, Mitchell, & Ireland, 2017) and a modified Portuguese version (IFCE-AE) (Oliveira et al., 2011). (Hsiao & Tsai, 2015;Simpson & Tarrant, 2006).…”