Systematic review of family engagement interventions in neonatal, paediatric, and adult ICUs

Abstract

Aims and objectives: The purpose of this systematic review was to evaluate interventions that have been used to engage families in direct care activities (active family engagement) in adult, paediatric, and neonatal intensive care unit (ICU) settings.Background: Family engagement is universally advocated across ICU populations and practice settings; however, appraisal of the active family engagement intervention literature remains limited. Search strategy: Ovid Medline, PsycArticles & PsycInfo, Scopus, and CINAHL were searched for family interventions that involved direct care of the patient to enhance the psychological, physical, or emotional well-being of the patient or family in neonatal, paediatric, or adult ICUs. Inclusion/exclusion criteria: Studies were included if an active family engagement intervention was evaluated. Studies were excluded if they were not published in English or reported non-interventional research. Results: A total of 6210 abstracts were screened and 19 studies were included. Most studies were of low to moderate quality and were conducted in neonatal ICUs within the United States. Intervention dosage and frequency varied widely across studies. The interventions focused on developmental care (neonatal ICU) and involved families in basic patient care. Family member outcomes measured included satisfaction, stress, family-centred care, confidence, anxiety, and depression. Most studies found improvements in one or more outcomes.

Family Caregiver Preferences and Contributions Related to Patient Care in the ICU

“…Interventions that enable caregivers to actively participate in patient care in the ICU are urgently needed to mitigate the negative symptom sequelae experienced by family caregivers during and after the ICU and to better prepare them for new caregiving demands after hospital discharge (Davidson et al, 2017; McAndrew et al, 2020a). Because ICU family engagement science is still emerging, evidence-based, standardized tools to evaluate family caregiver characteristics and preferences have yet to be established, leaving clinicians with few tools and resources to support family involvement in care.…”

Practice of family-centred care in intensive care units before the COVID-19-pandemic: A cross-sectional analysis in German-speaking countries

“…This approach was extended to families in subsequent years ( Davidson & Strathdee, 2019 ). Parallel changes can be observed since 1955 in paediatric care, when attention focused on the importance of parents' presence in enhancing the sensorimotor and emotional development of new-born children (Gomez-Cantarino et al, 2020; McAndrew et al, 2020 ). Family-centred care considers patients’ complexity, including the psychosocial, economic and genetic context of their families, with consequences for their medical history and present condition ( Davidson et al, 2017 ).…”

“I’ll Be There”: Informal and Formal Support Systems and Mothers’ Psychological Distress during NICU Hospitalization

“…In the FCC, clinician and family engagement is informed by mutual respect and shared decision-making, generating psychosocial support and allowing for the allocation of hospital resources to attain the goal of family well-being and involvement [ 14 ]. Indeed, a recent systematic review indicated that the FCC approach contributes to improvements in mothers’ mental health [ 42 ]. As such, the FCC model is the basis of the approach taken by the NICU where the current study was conducted.…”