Family members’ experiences in adult intensive care units: a systematic review

Abstract

Background Admission to Intensive Care Units (ICU) exposures family members to a new environment, advanced monitoring systems and aggressive treatments. This is coupled with the critical condition of the patient being admitted in ICU. In such times of stress and crisis, families have varying experiences as they navigate the ICU journey. These happen more or less in chronological phases. Aim This review sought to describe the experiences of family members of patients admitted in adult ICUs. Data sources Four electronic databases (PubMed, Embase, Scopus and Web of Science) were searched, using keywords and free‐text words. Methods Curation of the review question involved problem identification, a scoping search, developing a search strategy, evaluation, data analysis, and reporting. Freehand search in reference lists of eligible articles was also done to obtain potentially eligible articles published in English language between 2007 and 2018. Studies were included if they reported on family members’ experiences in adult ICUs. This review conforms to the Preferred Reporting Items for Systematic review and Meta‐Analysis (PRISMA). Results Upon completion of the screening process, 28 studies were included. Most studies were conducted in the United States while no study was identified from Africa. We report on 717 family members. Family members’ experience of the ICU journey falls into three main themes: (i) Floating, (ii) Probing and (iii) Continuity or Closure. Conclusion As healthcare technology advances, the ICU environment consequently needs to evolve. As such, healthcare providers will need to adjust their practice, support and consider the patients’ family as the other part of the patient and members of the care team in order to meet their expectations. Further research highlighting family members’ experience of the ICU journey in Africa is needed.

Professionals' narratives of interactions with patients' families in intensive care

“… 19 , 43 ICU clinicians need to look beyond all the equipment and physical parameters towards the unique needs of the patient and family. 43 Family members’ feelings are in turmoil in the ICU setting, 2 but unfortunately many report poor emotional support from ICU clinicians. 44 – 47 The ICU environment is complex, event-driven, and time-pressured.…”

Family involvement in the intensive care unit in four Nordic countries

“…Observations of nurse-family interaction in ICU settings have the potential to further advance our knowledge about family involvement. 42,43 The implications of ICU and hospital exclusion of families and the consequences for patients, families and staff should be explored in future studies. The data of the current study were collected before the COVID-19 pandemic.…”

“…Thus, the survey provides a useful overview of the involvement practices, information and visiting practices of family members in adult ICUs. Observations of nurse-family interaction in ICU settings have the potential to further advance our knowledge about family involvement 42,43. The implications of ICU and hospital exclusion of families and the consequences for patients, families and staff should be explored in future studies.…”

The evidence base of nurse-led family interventions for improving family outcomes in adult critical care settings: A mixed method systematic review

“…The admission of a patient to the Intensive Care Unit (ICU) often triggers enormous emotional, financial and social distress in the patient and their family ( Al-Mutair et al., 2014 ; Imanipour et al., 2019 ). The experience can alter the patient's or their family members’ health by causing anxiety, depression, complicated grieving, post-traumatic stress disorder (PTSD), and Post-Intensive Care Syndrome-Family (PICS-F).…”