The invisibility of the patient’s family in nursing documentation: An integrative review

Abstract

Objective: The objective of this integrative review is to present the current state of research knowledge regarding references to the patient's family in documentation in health care settings. Methods: Ten (N = 10) research articles from 1998 to 2014 were found and analyzed using inductive, thematic analysis. All articles were evaluated using the critical appraisal tools developed by the Joanna Briggs Institute (JBI). Results: Two main themes were revealed: the content and the structural aspects of family documentation. Quantitative, qualitative and mixed methods were used in generating the data of the reviewed articles. Reference to families in documentation was considered important in all the articles. Structural aspects consisted of semi-structured forms, summary notes and a tick-box system for marking the issues which were discussed with families. The classification system and outcomes assessment regarding family documentation were investigated, and their importance was highlighted. The content of family documentation was typified, for example, by parenting issues in mental health status and how the parents cope when a child is ill. Difficult life situations and advanced care planning brought families into the documentation, albeit rather infrequently. Similarly, references to counseling families or considering their psychosocial, spiritual and cultural dimensions were rarely found in the literature. Additionally, the family's importance in supporting the patient's care was often missed in documentation. Conclusions:The results show the necessity of developing both family nursing and its documentation. Consequently, in order to improve the quality of both of these, more investigation from multiple perspectives is needed.