Disclosure(s): No relevant financial relationship(s) to disclose.
Introduction: Family engagement in patient and family-centered interdisciplinary rounds (PFCC-IR) in the intensive care unit (ICU) is a challenging and under-researched issue in critical care. Despite evidence that family presence can provide benefits to patients and their family members, the current literature still shows that family members are often excluded. We sought to explore how the family resilience framework may help us understand the relationship between PFCC-IR and the stressors, resources, organizational, and systems contexts during critical illness in patients, their families, and the healthcare professionals providing care in the intensive care unit.
Methods: We examined qualitative data from patients, families, and healthcare professionals involved in a multisite experimental study using the family resilience framework, as well as Braun and Clarke’s (2006) constructionist, contextualist approach to thematic analysis.
Results: One hundred seventy-nine healthcare professionals (n = 179) responded to the open-ended questions in the survey. We learned that the participants’ experiences and perceptions of family engagement during PFCC-IR are centered around the family as the “synchronizer,” achieved with family acting as “moderator,” as an advocate, and as “therapeutic” that assisted the patients, family members, and health care professionals to be “feeling happy,” which also aided in providing “forewarning and mindfulness of the impermanence of life and the imminence of death.”
Conclusions: The findings of this study suggest that critical care could integrate family resilience into the care plan, admission, and discharge processes. Aspects that should be included are communication factors, family dynamics related to needs, care, and support in the home or other settings, the patient’s and family’s social environment or community, the resources that the patient and family require, and the patient’s wishes and preferences for end-of-life care. Processes and support for communication with patients and families should be incorporated into the daily PFCC-IR, plan of care, and discharge process. Incorporating these changes will benefit the ICU team and promote family resilience.
