The impact of interventions that promote family involvement in care on adult acute-care wards: An integrative review

Abstract

Background Healthcare that involves patients and their families in care has been recommended to improve patient safety and quality. With limited direction on care partnerships for adult acute care patients, their families and healthcare teams, there is a need for a review of interventions that have been used to promote family in patient care within adult acute care wards. Aim The aim of this integrative review was to describe interventions that have been used to promote family involvement in patient care within adult acute care wards. Method Electronic databases of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, PubMed, and PsycINFO were searched between 1994 and 2016 using key search terms and word variations ‘family involvement’, ‘family nursing’, family centred care’, family interventions’, ‘family therapies’. Additional literature was sourced from reference lists of relevant original publications. The Mixed Methods Appraisal Tool and Template for Intervention Description and Replication informed study and intervention assessment. Findings Eleven single centered studies were included with interventions designed to improve functional capacity, cognitive function, and communication. Nurses were involved in intervention delivery for six of the 11 interventions. Outcomes of interest included patient outcomes (n = 8) and intervention acceptability and feasibility (n = 3). Improved patient outcomes were reported for seven studies. Intervention design and implementation were generally poorly described. Conclusion Interventions designed to promote family in patient care on adult acute care wards improved patient outcomes in some instances, however, methodological limitations confound the evidence base for family involvement having a direct and positive impact on patient outcomes. Allowing patients and family members to partner in intervention design may enhance uptake and improve outcomes. Process and economic evaluations should also be included in future studies to allow assessment of clinical feasibility.