Family satisfaction with involvement in decision making in the intensive care unit: A scoping review

Abstract

Background: Decision making in the intensive care unit (ICU) is often complex, involving frequent interactions between patients, families, and health care professionals. Family members play an important role as surrogate decision markers because patients admitted in ICU lack decision- making capacity due to their critical state. Lack of regular, timeous, up to date and honest information provided by the ICU healthcare professionals may negatively influence the family members’ decision making ability and overall satisfaction. Aim: To identify existing literature that describe family satisfaction with involvement in decision making in the intensive care unit. Methods: A scoping review of literature guided by Arksey and O ‘Malley’s framework was conducted. Literature search was completed using five databases. Primary studies published in English between 2010 and 2023 were retrieved and analyzed using thematic analysis. Results: Of the 152 studies identified during the search, 23 were eligible for inclusion. Most of the studies (n = 19; 83%) focused on family satisfaction with care and decision making and four (n=4; 17%) focused on strategies aimed at enhancing family involvement in decision making. These strategies included: testing the effects of using information booklets, structured attendance of interdisciplinary ward rounds, development and implementation of evidence-based communication algorithm and exploring the culture of interprofessional collaboration. The three themes that emerged from the scoping review were: satisfaction with involvement, communication, and support. Conclusion: The use of structured communication programs as well as regular, timeous and honest information about the patient’s diagnosis, treatment plan and prognosis are vital measures to enhancing family involvement in decision making.