Patient, family-centred care interventions within the adult ICU setting: An integrative review

Mitchell, Marion; Coyer, Fiona; Kean, Susanne; Stone, Renee; Murfield, Jenny; Dwan, Toni

doi:10.1016/j.aucc.2016.08.002

Cited by 93 publications

(78 citation statements)

References 58 publications

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“…However, preliminary evidence suggests that family engagement in the ICU can increase family member presence and interaction with the patient; improve the perception of respect, collaboration, and support between family members and health care staff; and reduce family members’ anxiety and stress. 8,14,31 Thus, family outcomes also require further exploration.…”

Section: Discussionmentioning

confidence: 99%

“…2,19–21 Nurses have expressed concerns regarding the safety of family engagement in care in relationship to patients’ severity of illness and their fluctuations in acuity while receiving care in the ICU. 2,4,14,18,20,22,23 …”

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confidence: 99%

“…2,4,14,18,20,22,23 Further exploration of these factors will help inform the promotion of patient and family engagement in the ICU and identify strategies to help nurses embrace family caregivers as active participants in patient care.…”

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confidence: 99%

“…To guide this study, a conceptual model (Figure 1) was developed with evidence from empirical studies of factors that facilitate the inclusion of caregivers in direct patient care activities in the ICU and beyond. 2,4,14,18,20,22,23 Model assumptions are that the ICU environment of care and patient acuity affect nursing workflow and nurses’ attitudes toward family engagement in care. Individual, intrinsic nurse and organizational factors may also influence nurses’ attitudes toward family engagement in care.…”

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confidence: 99%

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Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Hetland

Hickman

McAndrew

et al. 2017

AACN Advanced Critical Care

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Critical care nurses are vital to promoting family engagement in the intensive care unit. However, nurses have varying perceptions about how much family members should be involved. The Questionnaire on Factors That Influence Family Engagement was given to a national sample of 433 critical care nurses. This correlational study explored the impact of nurse and organizational characteristics on barriers and facilitators to family engagement. Study results indicate that (1) nurses were most likely to invite family caregivers to provide simple daily care; (2) age, degree earned, critical care experience, hospital location, unit type, and staffing ratios influenced the scores; and (3) nursing workflow partially mediated the relationships between the intensive care unit environment and nurses' attitudes and between patient acuity and nurses' attitudes. These results help inform nursing leaders on ways to promote nurse support of active family engagement in the intensive care unit.Keywords critical care; family caregivers; family-centered nursing; family engagement An increasing number of Americans require treatment in the intensive care unit (ICU), and a proportional increase in family caregivers will assume caregiving responsibilities that can have persistent negative effects on their health and overall quality of life. [1][2][3][4][5][6] The conventional ICU care paradigm has primarily targeted the informational needs of family Breanna Hetland is Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH (bdh66@case.edu). HHS Public AccessAuthor manuscript AACN Adv Crit Care. Author manuscript; available in PMC 2017 September 07. Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript caregivers of the critically ill, but has not addressed how to actively engage caregivers in other aspects of the ICU experience such as symptom assessment and the direct provision of care. [7][8][9][10] Although critical care research, policy, and practice guidelines 9,10 increasingly recognize family caregivers as part of a larger patient-provider interaction during critical illness, the literature on family caregiver engagement in this context mainly focuses on passive forms of involvement such as family presence, communication, and decisionmaking. Few studies address family caregivers' active contributions to patient care. 7,8,[11][12][13][14][15][16][17][18] Patient and family engagement are defined as active partnerships among health care providers, patients, and families. 7 Identifying effective ways to implement patient and family engagement is paramount to improving the patient and family experience as well as improving safety, quality, and delivery of care. [7][8][9] In the ICU, critical care nurses are the frontline providers of life-sustaining care and key staff members in promoting patient and family engagement. However, the literature provides evidence that critical care nurses express resistance to involving family caregivers because of misconception...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Hetland

Hickman

McAndrew

et al. 2017

AACN Advanced Critical Care

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“…While a tension exists between addressing the needs of family vs. the needs of the client, especially when these are conflicting, the current study's findings suggest the need for greater acknowledgement of the impact on family within therapeutic approaches. The importance of family-centred practice has been highlighted in other areas of practice (Ewart, Moore, Gibbs & Crozier, 2014;Mitchell et al, 2016). Hanna and Rodger (2002) promote a collaboration between the therapist and caregivers.…”

Section: Discussionmentioning

confidence: 99%

Understanding the lived experiences of Parkinson's disease and deep brain stimulation (DBS) through occupational changes

Liddle

Phillips

Gustafsson

et al. 2017

Aus Occup Therapy J

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Background: Deep brain stimulation (DBS), a surgically based treatment for people living with Parkinson's disease (PD), can result in a significant improvement of motor symptoms. However, the broader impact of DBS and the changes it creates are not well understood. Greater understanding of the experiences and needs related to DBS would enable development of relevant outcome measures and supports. Objectives: To explore the lived experiences of people undergoing DBS for Parkinson's disease. Methods: A descriptive phenomenological study was undertaken exploring experiences, perspectives and outcomes with key stakeholders. Semi-structured, audiotaped interviews were undertaken with people with PD who have had DBS, their family members and health professionals across four states and territories in Australia. Results: Perspectives and experiences of 14 people with PD undergoing DBS, 10 family members and 11 health professionals were analysed. Occupations emerged as a key aspect throughout the DBS experience. Two major themes captured the role of occupation in relation to DBS: Occupations as a barometer, where occupational experiences and performances shaped people's understanding of their condition, the impact of treatments and their overall adjustment; and Shifting occupational identity where the life transition of DBS altered the occupational experiences of relationships, volition, roles and responsibilities of people with PD and their family members. Conclusion: Occupational experiences and changes served as an important way for people with PD and their families to understand and communicate their experiences of PD and related treatments. There is an identified need for outcome measures and clinical education and interventions to reflect this.

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Challenges in implementation of patient‐centred care in cardiac care unit: A qualitative study

et al. 2022

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Aim This study aimed to explore the barriers to the implementation of patient‐centred care (PCC) in the cardiac care unit (CCU) from the perspectives of patients, nurses, physicians and nursing managers. Design This study was performed with a descriptive qualitative study approach. Methods In this study, the data were collected through face‐to‐face in‐depth semi‐structured interviews with 10 cardiac care nurses, one assistant nurse, two cardiologists, seven patients admitted to the CCU and nine nursing managers and analysed by Graneheim and Lundman content analysis method. Results After analysing the data, eight subcategories and three main categories were extracted. The main categories included challenges related to: organization, healthcare providers and patients. This study demonstrated the barriers to the implementation of PCC in the CCU. Insights into these barriers can guide interventions aimed at improving the quality of PCC in the CCU, which in turn can lead to improved disease outcomes.

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Patient, family-centred care interventions within the adult ICU setting: An integrative review

Cited by 93 publications

References 58 publications

Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Understanding the lived experiences of Parkinson's disease and deep brain stimulation (DBS) through occupational changes

Challenges in implementation of patient‐centred care in cardiac care unit: A qualitative study

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