title: Patient and family involvement in adult critical and intensive care settings: a scoping review.
abstract: Despite international bodies calling for increased patient and family involvement, these concepts remain poorly defined within literature on critical and intensive care settings.
  
  
  
  This scoping review investigates the extent and range of literature on patient and family involvement in critical and intensive care settings. Methodological and empirical gaps are identified, and a future agenda for research into optimizing patient and family involvement is outlined.
  
  
  
  Searches of MEDLINE, CINAHL, Social Work Abstracts and PsycINFO were conducted. English-language articles published between 2003 and 2014 were retrieved. Articles were included if the studies were undertaken in an intensive care or critical care setting, addressed the topic of patient and family involvement, included a sample of adult critical care patients, their families and/or critical care providers. Two reviewers extracted and charted data and analysed findings using qualitative content analysis.
  
  
  
  A total of 892 articles were screened, 124 were eligible for analysis, including 61 quantitative, 61 qualitative and 2 mixed-methods studies. There was a significant gap in research on patient involvement in the intensive care unit. The analysis identified five different components of family and patient involvement: (i) presence, (ii) having needs met/being supported, (iii) communication, (iv) decision making and (v) contributing to care.
  
  
  
  Three research gaps were identified that require addressing: (i) the scope, extent and nature of patient involvement in intensive care settings; (ii) the broader socio-cultural processes that shape patient and family involvement; and (iii) the bidirectional implications between patient/family involvement and interprofessional teamwork.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Olding
authors.affiliation: Collaborative Academic Practice, University Health Network, Toronto, ON, Canada.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: McMillan
authors.affiliation: Centre for Health and Social Care Research, Kingston University and St. George's University of London, London, UK.
authors.forename: Scott
authors.initials: S
authors.lastname: Reeves
authors.affiliation: School of Nursing, University of Rochester Medical Centre, Rochester, NY, USA.
authors.forename: Madeline H
authors.initials: MH
authors.lastname: Schmitt
authors.affiliation: Emerita, Department of Physiological Nursing, UCSF, San Francisco, CA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Puntillo
authors.affiliation: Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Kitto
mesh_terms: D022126:Access to Information; D003299:Cooperative Behavior; D003422:Critical Care; D006801:Humans; D033181:Information Dissemination; D007362:Intensive Care Units; D010358:Patient Participation; D018802:Patient-Centered Care; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D014789:Visitors to Patients
keywords: Critical care; Intensive care units; family involvement; family-centred care; patient involvement; patient-centred care; scoping review