Families’ perspectives of participation in patient care in an adult intensive care unit

A qualitative study

Pauline Wong, Bernice Redley, Robin Digby, Anu Correya, Tracey Bucknall

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: When a relative is admitted to the intensive care unit (ICU), stress, anxiety, and failure to cope may place families, and the patient, at risk for adverse psychological outcomes. Family participation in patient care may improve patient and family outcomes. However, to date, little is known about how families perceive and participate in patient care in ICU, and there is limited research to guide clinicians about supporting family participation in this context. Objective: To describe family perspectives of participation in patient care in adult ICU. Methods: Using a qualitative design, observation and interview data were collected from a convenience sample of 30 family members in the ICU at two metropolitan hospitals in Melbourne, Australia. An independent third party was used to recruit potential participants. Naturalistic observations and semi-structured interviews explored families’ actions and perceptions of participation. Data were integrated and subject to thematic analyses. Findings: The major theme Families as part of the healthcare team reflected family perspectives of their own significant contribution to supporting their relative's recovery while they were in ICU. Families' perception of their participation in patient care was characterised by three sub-themes: 1) Motivators for family participation; 2) Family roles during recovery; and 3) Influences on family participation. Families' perceived reassurance and companionship as important contributions to patient care. Conclusion: Families perceived their contribution to the patient's psychosocial and emotional well-being to be one of the most important aspects of participation. Nevertheless, their role in the healthcare team was influenced by several motivational factors. Results of this study can inform further research to test the effectiveness of clinical practice and educational interventions aligned with family preferences to promote participation and enhance patient and family-centered care in ICU.

Original languageEnglish
Number of pages9
JournalAustralian Critical Care
DOIs
Publication statusAccepted/In press - 29 Jul 2019
Externally publishedYes

Keywords

  • Clinical decision-making
  • Consumer participation
  • Critical care
  • Critical care nursing
  • Family perspectives
  • Family-centred care
  • Patient- and family-centred care
  • PFCC
  • Qualitative research
  • Thematic analysis

Cite this

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title = "Families’ perspectives of participation in patient care in an adult intensive care unit: A qualitative study",
abstract = "Background: When a relative is admitted to the intensive care unit (ICU), stress, anxiety, and failure to cope may place families, and the patient, at risk for adverse psychological outcomes. Family participation in patient care may improve patient and family outcomes. However, to date, little is known about how families perceive and participate in patient care in ICU, and there is limited research to guide clinicians about supporting family participation in this context. Objective: To describe family perspectives of participation in patient care in adult ICU. Methods: Using a qualitative design, observation and interview data were collected from a convenience sample of 30 family members in the ICU at two metropolitan hospitals in Melbourne, Australia. An independent third party was used to recruit potential participants. Naturalistic observations and semi-structured interviews explored families’ actions and perceptions of participation. Data were integrated and subject to thematic analyses. Findings: The major theme Families as part of the healthcare team reflected family perspectives of their own significant contribution to supporting their relative's recovery while they were in ICU. Families' perception of their participation in patient care was characterised by three sub-themes: 1) Motivators for family participation; 2) Family roles during recovery; and 3) Influences on family participation. Families' perceived reassurance and companionship as important contributions to patient care. Conclusion: Families perceived their contribution to the patient's psychosocial and emotional well-being to be one of the most important aspects of participation. Nevertheless, their role in the healthcare team was influenced by several motivational factors. Results of this study can inform further research to test the effectiveness of clinical practice and educational interventions aligned with family preferences to promote participation and enhance patient and family-centered care in ICU.",
keywords = "Clinical decision-making, Consumer participation, Critical care, Critical care nursing, Family perspectives, Family-centred care, Patient- and family-centred care, PFCC, Qualitative research, Thematic analysis",
author = "Pauline Wong and Bernice Redley and Robin Digby and Anu Correya and Tracey Bucknall",
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Families’ perspectives of participation in patient care in an adult intensive care unit : A qualitative study. / Wong, Pauline; Redley, Bernice; Digby, Robin; Correya, Anu; Bucknall, Tracey.

In: Australian Critical Care, 29.07.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Families’ perspectives of participation in patient care in an adult intensive care unit

T2 - A qualitative study

AU - Wong, Pauline

AU - Redley, Bernice

AU - Digby, Robin

AU - Correya, Anu

AU - Bucknall, Tracey

PY - 2019/7/29

Y1 - 2019/7/29

N2 - Background: When a relative is admitted to the intensive care unit (ICU), stress, anxiety, and failure to cope may place families, and the patient, at risk for adverse psychological outcomes. Family participation in patient care may improve patient and family outcomes. However, to date, little is known about how families perceive and participate in patient care in ICU, and there is limited research to guide clinicians about supporting family participation in this context. Objective: To describe family perspectives of participation in patient care in adult ICU. Methods: Using a qualitative design, observation and interview data were collected from a convenience sample of 30 family members in the ICU at two metropolitan hospitals in Melbourne, Australia. An independent third party was used to recruit potential participants. Naturalistic observations and semi-structured interviews explored families’ actions and perceptions of participation. Data were integrated and subject to thematic analyses. Findings: The major theme Families as part of the healthcare team reflected family perspectives of their own significant contribution to supporting their relative's recovery while they were in ICU. Families' perception of their participation in patient care was characterised by three sub-themes: 1) Motivators for family participation; 2) Family roles during recovery; and 3) Influences on family participation. Families' perceived reassurance and companionship as important contributions to patient care. Conclusion: Families perceived their contribution to the patient's psychosocial and emotional well-being to be one of the most important aspects of participation. Nevertheless, their role in the healthcare team was influenced by several motivational factors. Results of this study can inform further research to test the effectiveness of clinical practice and educational interventions aligned with family preferences to promote participation and enhance patient and family-centered care in ICU.

AB - Background: When a relative is admitted to the intensive care unit (ICU), stress, anxiety, and failure to cope may place families, and the patient, at risk for adverse psychological outcomes. Family participation in patient care may improve patient and family outcomes. However, to date, little is known about how families perceive and participate in patient care in ICU, and there is limited research to guide clinicians about supporting family participation in this context. Objective: To describe family perspectives of participation in patient care in adult ICU. Methods: Using a qualitative design, observation and interview data were collected from a convenience sample of 30 family members in the ICU at two metropolitan hospitals in Melbourne, Australia. An independent third party was used to recruit potential participants. Naturalistic observations and semi-structured interviews explored families’ actions and perceptions of participation. Data were integrated and subject to thematic analyses. Findings: The major theme Families as part of the healthcare team reflected family perspectives of their own significant contribution to supporting their relative's recovery while they were in ICU. Families' perception of their participation in patient care was characterised by three sub-themes: 1) Motivators for family participation; 2) Family roles during recovery; and 3) Influences on family participation. Families' perceived reassurance and companionship as important contributions to patient care. Conclusion: Families perceived their contribution to the patient's psychosocial and emotional well-being to be one of the most important aspects of participation. Nevertheless, their role in the healthcare team was influenced by several motivational factors. Results of this study can inform further research to test the effectiveness of clinical practice and educational interventions aligned with family preferences to promote participation and enhance patient and family-centered care in ICU.

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KW - Consumer participation

KW - Critical care

KW - Critical care nursing

KW - Family perspectives

KW - Family-centred care

KW - Patient- and family-centred care

KW - PFCC

KW - Qualitative research

KW - Thematic analysis

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DO - 10.1016/j.aucc.2019.06.002

M3 - Article

JO - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

JF - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

SN - 1036-7314

ER -