Intensive care nurse-family engagement from a global perspective: A qualitative multi-site exploration.
Journal article
Naef, Rahel, Brysiewicz, Petra, Mc Andrew, Natalie S, Beierwaltes, Patricia, Chiang, Vico, Clisbee, David, de Beer, Jennifer, Honda, Junko, Kakazu, Shota, Nagl-Cupal, Martin, Price, A., Richardson, Sandra, Richardson, Anna, Tehan, Tara, Towell-Barnard, Amanda and Eggenberger, Sandra 2021. Intensive care nurse-family engagement from a global perspective: A qualitative multi-site exploration. Intensive and Critical Care Nursing. https://doi.org/S0964-3397(21)00070-7
| Authors | Naef, Rahel, Brysiewicz, Petra, Mc Andrew, Natalie S, Beierwaltes, Patricia, Chiang, Vico, Clisbee, David, de Beer, Jennifer, Honda, Junko, Kakazu, Shota, Nagl-Cupal, Martin, Price, A., Richardson, Sandra, Richardson, Anna, Tehan, Tara, Towell-Barnard, Amanda and Eggenberger, Sandra |
|---|---|
| Abstract | Critical illness is distressing for families, and often results in negative effects on family health that influence a family's ability to support their critically ill family member. Although recent attention has been directed at improving care and outcomes for families of critically ill patients, the manner in which nurses engage with families is not fully understood. To describe nurses' perceptions and practices of family engagement in adult intensive care units from a global perspective. A qualitative-descriptive multi-site design using content analysis. The study was conducted in 26 intensive care units of 12 urban, metropolitan, academic medical centers in ten countries, spanning five continents. A total of 65 registered nurses (77% women, age of M = 39.5, SD = 11.4 years) participated. Most held intensive care certification (72%) and had worked on average 10 (SD = 9.6) years in the ICU. Semi-structured, individual interviews (M = 38.4 min, SD = 12.0) were held with ICU nurses at the hospital (94%) or their home using an interview guide. Qualitative interview data were analysed using inductive content analysis. We found that nurse-family engagement was an ebb and flow of relational power that needed to be carefully negotiated and balanced, with nurses holding and often exerting more power than families. Constant fluctuations in nurses' practices of engagement occurred in day-to-day practice from shift-to-shift and from nurse-to-nurse. Family engagement was dependent on individual nurses' attitudes and perceptions of family, the patient's condition, and workload. Lastly, family engagement was shaped by the ICU context, with team culture, collaborative relationships, unit structures and organizational resources either enabling or limiting nurses' ability to engage with families. This global study provides an in-depth understanding of the way nurses engage with families in ICU and reflects many different cultures and health systems. We found that nurse-family engagement was marked by a shifting, yet often unequal power distribution in the nurse-family relationship, inconsistent nurse engagement practices, both of which resulted in variable family engagement in intensive care. Our research contributes a detailed description of engagement as practiced in the everyday delivery of health care. A more concentrated team effort, based on a shared culture and defined framework of family care is needed to ensure that families of critically ill persons are fully engaged in all aspects of intensive care. [Abstract copyright: Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.] |
| Keywords | Critical care nursing; Family engagement; Family involvement; Family nursing; Family-centered care; Intensive Care Units; Qualitative content analysis |
| Year | 2021 |
| Journal | Intensive and Critical Care Nursing |
| Publisher | Elsevier |
| ISSN | 1532-4036 |
| Digital Object Identifier (DOI) | https://doi.org/S0964-3397(21)00070-7 |
| https://doi.org/10.1016/j.iccn.2021.103081 | |
| Official URL | https://www.sciencedirect.com/science/article/pii/S0964339721000707 |
| Funder | British Association of Critical Care Nurses |
| Publication dates | |
| Online | 08 Jun 2021 |
| Publication process dates | |
| Deposited | 12 Apr 2021 |
| Accepted | 05 Apr 2021 |
| Accepted author manuscript | License File Access Level Open |
| Publisher's version | License |
| Output status | Published |
| References | AKROUTE, A. R. & BONDAS, T. 2016. Critical care nurses and relatives of elderly patients in |
| Additional information | Publications router: Date 2021-04-05 of type 'accepted_date' included in notification. |
| Page range | 103081 |
https://repository.canterbury.ac.uk/item/8x70x/intensive-care-nurse-family-engagement-from-a-global-perspective-a-qualitative-multi-site-exploration
Download files
Accepted author manuscript
| 210318_Manuscript_FamEng_ICCN_final accepted.pdf | ||
| License: CC BY-NC-ND | ||
| File access level: Open | ||
Publisher's version
| 1-s2.0-S0964339721000707-main.pdf | ||
| License: CC BY-NC-ND 4.0 | ||
269
total views170
total downloads8
views this month6
downloads this month
Export as
Related outputs
A global examination of nurse practices to engage families in the intensive care unit
McAndrew, N., Clisbee, D., Brysiewicz, P., Eggenberger, S., Richardson, A., Richardson, S., Price, A., de Beer, J., Towell-Barnard, M., Honda, J. and Chiang, V. 2023. A global examination of nurse practices to engage families in the intensive care unit.Family experiences and trajectory of care received during and after a relative’s admission to ICU: A scoping review
Burns, M., De Goumoens, V., Naef, R., Brysiewicz, P., McAndrew, N., Eggenberger, S., MacPhail, K., Kiwanuka, F., Luttik, M., Nagl-Cupal, M. and Price, A. 2023. Family experiences and trajectory of care received during and after a relative’s admission to ICU: A scoping review.Factors affecting critical care nurses engagement with families
Price, A. 2023. Factors affecting critical care nurses engagement with families.Factors influencing critical care nurses' family engagement practices: An international perspective
Price, A., McAndrew, N., Thaqi, Qendresa, Kirk, M., Brysiewicz, P., Eggenberger, S. and Naef, R. 2022. Factors influencing critical care nurses' family engagement practices: An international perspective. Nursing In Critical Care. 28 (6), pp. 1031-1044. https://doi.org/10.1111/nicc.12824EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries
Hatzidimitriadou, E., Wright, T., Stirrup, V., Kuzbit, P., Thompson, T., DeBraal, P, Burton, C., Price, A., Stein, M., Wells, G., Manship, S., Martin, A. and Chung, P. 2022. EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries. International Journal of Integrated Care. https://doi.org/10.5334/ijic.ICIC22333Staff perceptions of spiritual care in intensive care: A preliminary survey.
Price, Ann M. 2022. Staff perceptions of spiritual care in intensive care: A preliminary survey. Intensive and Critical Care Nursing. https://doi.org/10.1016/j.iccn.2022.103341‘Doing the best we can’: Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID-19
Stayt L., Merriman, Clair, Bench, Suzanne, Price, A., Vollam, Sarah, Walthall, Helen, Credland, Niki, Gerber, Karin and Calovski, Vid 2022. ‘Doing the best we can’: Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID-19. Journal of Advanced Nursing. 78 (10), pp. 3371-3384. https://doi.org/10.1111/jan.15419Reflections on international research collaborations: decolonising our research approach
Price, A. M. and Southgate, A. 2021. Reflections on international research collaborations: decolonising our research approach. Council of Deans of HealthEthics in critical care research: scratching the surface
Price, A. M. 2021. Ethics in critical care research: scratching the surface . Intensive and Critical Care Nursing. https://doi.org/10.1016/j.iccn.2021.103013Nurses’ perspectives on spiritual care in ICU: results of a survey
Price, A. M. 2020. Nurses’ perspectives on spiritual care in ICU: results of a survey.Comparing undergraduate student nurses understanding of sustainability in two countries: a mixed method study
Chen, M. and Price, A.M. 2020. Comparing undergraduate student nurses understanding of sustainability in two countries: a mixed method study. Nurse Education Today.Innovative global family research: lessons learnt from the IFNA Acute Care Research Cluster
Brysiewicz, P., Naef, R., Eggenberger, S., Beierwaltes, P., Chiang, V., Clisbee, D., de Beer, J., Ewens, B., Honda, J., McAndrew, N., Meiers, S., Nagl-Cupal, M., Richardson, A., Richardson, S., Tehan, T., Towell-Barnard, A. and Price, A. M. 2019. Innovative global family research: lessons learnt from the IFNA Acute Care Research Cluster.Engaging with families during critical illness: an international study of nurses’ descriptions and practices of family engagement in intensive care units
Naef, R., Brysiewicz, P., Eggenberger, S., Beierwaites, P., Chiang, V., Clisbee, D., Honda, J., McAndrew, N., Meiers, S., Nagl-Cupal, M., Ricardson, A., Richardson, S., Tehan, T., de Beer, J., Towell-Barnard, A., Ewens, B. and Price, A. M. 2019. Engaging with families during critical illness: an international study of nurses’ descriptions and practices of family engagement in intensive care units.Engagement of families in ICU from the nursing staff perspective
Price, A. M., Brysiewicz, P., Eggenberger, S. and Naef, R. 2019. Engagement of families in ICU from the nursing staff perspective.Spiritual intelligence as a method to improve spiritual care in nursing students
Price, A. M. 2019. Spiritual intelligence as a method to improve spiritual care in nursing students.Editorial comment: Nursing in Critical Care journal survey 2018
Scholes, J., Albarran, J. and Price, A. M. 2018. Editorial comment: Nursing in Critical Care journal survey 2018. Nursing In Critical Care. https://doi.org/10.1111/nicc.12384Spiritual care: can student nurses learning contribute to leading person-centred practice?
Price, A. M. 2018. Spiritual care: can student nurses learning contribute to leading person-centred practice?First year nursing students use of social media within education: Results of a survey
Price, A. M., Devis, K., Le Moine, G., Crouch, S., South, N. and Hossain, R. 2017. First year nursing students use of social media within education: Results of a survey. Nurse Education Today. 61, pp. 70-76. https://doi.org/10.1016/j.nedt.2017.10.013Using phenomenology to explore student nurses experiences of spiritual care
Price, A. M. 2017. Using phenomenology to explore student nurses experiences of spiritual care.Exploring spiritual care in nurse education: is phenomenology the right tool for the job?
Price, A. M. 2017. Exploring spiritual care in nurse education: is phenomenology the right tool for the job?The National Competency Framework for Registered Nurses in Adult Critical Care: an overview
Deacon, K., Baldwin, A., Donnelly, K., Freeman, P., Himsworth, A., Kinoulty, S., Kynaston, M., Platten, J., Price, A. M., Rumsby, N., Witton, N. and on behalf of the Critical Care Nurse Education Review Forum (CCNERF) 2017. The National Competency Framework for Registered Nurses in Adult Critical Care: an overview. Journal of the Intensive Care Society.The significance of Personal Learning Environments (PLEs) in nursing education: extending current conceptualizations’
Patterson, C., Stephens, M., Chiang, V., Price, A. M., Work, F. and Snelgrove-Clarke, E. 2017. The significance of Personal Learning Environments (PLEs) in nursing education: extending current conceptualizations’. Nurse Education Today. 48, pp. 99-105. https://doi.org/10.1016/j.nedt.2016.09.010Oesophageal varices
Canavan, R. and Price, A. 2016. Oesophageal varices. in: Price, A., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 229-236