Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review.

Anu Soikkeli‐Jalonen,Kaisa Mishina,Elina Haavisto,Heli Virtanen,Andreas Charalambous

doi:10.1111/jocn.15725

Anu Soikkeli‐Jalonen, Kaisa Mishina + Show 3 more

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https://doi.org/10.1111/jocn.15725

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Abstract

To systematically review existing literature exploring supportive interventions for family members of very seriously ill patients in inpatient care. Being around a patient with a very serious illness in inpatient care setting is stressful and burdensome for family members. There is little information available on interventions that support family members of very seriously ill patients in inpatient care. A systematic review. The literature review was conducted in May 2020 using four databases: PubMed (Medline), CINAHL, PsycINFO and Cochrane. A quality assessment was performed using the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group by the National Heart, Lung, and Blood Institute. The PRISMA checklist was used to support specific reporting and the TIDieR checklist to form detailed descriptions of the interventions. Of the 7165 identified studies, 11 studies were included in the review based on predetermined criteria. Interventions were based on meetings with family members, education or therapy. Mindfulness- and therapy-based interventions and multiple-session tailored interventions showed beneficial outcomes for psychological symptoms and educational interventions on preparedness and self-efficacy. Several different measuring instruments to evaluate similar outcomes, such as psychological symptoms and coping, were used. Only a few supportive interventions for family members of very seriously ill patients in inpatient care were found, which made comparing the differences in the varying study methods and outcomes difficult. More studies on supportive interventions and their feasibility and effectiveness are essential. Further evaluation of instruments is necessary to identify the most valid and reliable ways of measuring symptoms and coping. The results of this study can be used in clinical practice when selecting effective interventions or assessing family members' need for support. Additionally, the results can be used for guidance when developing new, effective interventions.

Highlights

A serious illness describes a condition that poses a high risk of mortality for the patient (Kelley & Kelley, 2014)
We considered studies to include very seriously ill patients if the patients were in palliative care or other critical care in an inpatient unit so that the risk of mortality was high, and the family needed to prepare for the possibility of the patient's death
This is probably due to the facts that studies have commonly concentrated on viewpoints other than families (Aoun et al, 2013; Chi et al, 2016; Hasson et al, 2020; Henoch et al, 2016), that intervention studies have been mainly conducted in home and community care (Becqué et al, 2019; Candy et al, 2011; Chi et al, 2016; Hudson et al, 2010; Northouse et al, 2010; Sutanto et al, 2017), and that the involvement of families in research has increased over the last decade

Summary

Introduction

A serious illness describes a condition that poses a high risk of mortality for the patient (Kelley & Kelley, 2014). This study involved family members of very seriously ill patients, that is, patients with either a terminal or critical illness with a very high risk of mortality, and with an even more severe situation than patients with serious illness. Members of such patients often experience high emotional stress and decreased psychological well-being and quality of life (Fujinami et al, 2015). Relatives, friends or partners of patients are often referred to as caregivers, informal caregivers or family caregivers, especially when they are taking care of their loved ones and participating in care (Candy et al, 2011; Hudson et al, 2011). For patients receiving care in a hospital, the term family member is used to refer to the people who have personal relationships with the patient during inpatient care and can include very close friends, romantic partners, children or spouses

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