Patient, family-centred care interventions within the adult ICU setting: An integrative review.
OBJECTIVE
Patient, Family-Centred Care (PFCC) is internationally advocated as a way to improve patient care. The aim of this integrative review was to extend the knowledge and understanding by synthesising empirical evidence of PFCC interventions within the adult intensive care unit (ICU) setting.


METHODS
An integrative review methodological framework was employed, permitting the inclusion of all research designs. A comprehensive and systematic search, selection, quality appraisal, and data extraction of research were conducted to synthesise knowledge and identify research gaps.


METHODS
A systematic search of the following databases was conducted: MEDLINE; CINHAL; PsycINFO; Cochrane Library; Web of Science-Current Contents Connect; Web of Science-Core Collection; The Joanna Briggs Institute EBP Database; ProQuest Sociological Abstracts; and ProQuest Dissertation and Theses Global. Primary research in adult ICUs was included.


METHODS
Data extracted from the studies included authors, year, country of origin, design, setting, sample, intervention, data collection strategies, main findings and limitations. Study quality was assessed using the Mixed Methods Appraisal Tool.


RESULTS
Forty-two articles met the inclusion criteria and were included in the review. Only a third of the papers stated the theory underpinning their study. Three themes emerged with interventions predominantly around Interacting with the target sample; Culture and Connection and Service Delivery interventions were also identified. Few studies integrated more than one dimension of PFCC.


CONCLUSIONS
Research into PFCC interventions is diverse; however, few researchers present a multi-dimensional approach incorporating a culture shift to enact PFCC throughout the ICU trajectory. There is an opportunity for future research to describe, develop, and test instruments that measure PFCC based on its multiple dimensions and not on one component in isolation. Importantly, for PFCC to successfully individualise quality patient care, a commitment and enactment of partnerships between health care professionals, patients, and family members is imperative.
NHMRC Centre for Research Excellence in Nursing, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; Princess Alexandra Hospital Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Electronic address: marion.mitchell@griffith.edu.au.
Marion L
ML
Mitchell
Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia; Intensive Care Services, Centre for Clinical Nursing, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia. Electronic address: f.coyer@qut.edu.au.
Fiona
F
Coyer
School of Health in Social Science, University of Edinburgh, Edinburgh, UK. Electronic address: Susanne.Kean@ed.ac.uk.
Susanne
S
Kean
School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Queensland, Australia. Electronic address: r.stone@griffith.edu.au.
Renee
R
Stone
Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Queensland, Australia. Electronic address: j.murfield@griffith.edu.au.
Jenny
J
Murfield
Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, Queensland, Australia. Electronic address: t.dwan@griffith.edu.au.
Toni
T
Dwan
D006801:Humans; D007362:Intensive Care Units; D018802:Patient-Centered Care; D011368:Professional-Family Relations
Adult; Critical care nursing; Family-centred care; Patient, family-centred care; Patient-centred care; Review literature; Treatment outcome