Elements of Family-Centered Care in the Pediatric Intensive Care Unit: An Integrative Review.
Claire A Richards, Helene Starks, M Rebecca O'Connor and 1 others
PMID 28496382WHAT IT FOUND
Parents wanted more involvement than they perceived PICU clinicians gave them.
Clinicians often controlled information timing, end-of-life decisions, and bedside presence, and did not actively ask parents about preferences.
Key findings
01PICU clinicians often controlled information timing, end-of-life decisions, and whether parents could remain at the bedside.
02Parents wanted more involvement than they perceived clinicians gave them, and clinicians did not actively ask parents how much they wanted to participate.
03Parental preferences varied: some wanted full detail about uncertainty, others wanted basic information or a single spokesperson.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included qualitative and mixed methods studies only, so it describes experiences and practice rather than testing whether communication changes improve outcomes. Most data were collected through focus groups, interviews, or open-ended survey questions; 81% of studies used these methods, and 19% used observation. Study designs were mostly cross-sectional; 19% used longitudinal designs, and some longitudinal data were not analyzed over time. Parental views were included in 30 of the 33 studies. Only 12 articles reported race, ethnicity, or nationality among 30 articles that included parents. Only 4 articles reported race, ethnicity, or nationality among 17 articles that included clinicians. Samples were mostly non-Hispanic White, and few studies discussed culture, language, or socioeconomic status. The review required some description of family voice, so it may not cover settings where clinicians only gave information one way.
The easy way to misread this
Do not read this as evidence that family-centered communication improves PICU outcomes. It synthesized reports of what parents wanted and what clinicians did, not a tested communication intervention with patient outcomes.