Developing conceptual guidelines for Family-Centered Care for standard ICU practice: A constructivist grounded theory.

Abstract

Purpose: To explore the constructs of family-centered care (FCC) from the perspectives of nurses, doctors, and families in the intensive care units (ICU) and to develop FCC guidelines for ICUs.

Design: A constructivist grounded theory (CGT) design was employed.

Methods: We conducted 12 individual interviews and triangulated the data with 12 focus group discussions (FGDs) using an interview guide from February to December 2020. The interviews and the FGDs were conducted face-to-face. Data was analyzed using CGT analysis. The data analysis was assisted by MAXQDA version 2020 plus. The study was guided by the 32-COREQ checklist.

Results: The participants (72) were nurses (n = 28), doctors (n = 8), and family (n = 36). Four themes were generated: respect, family support, participation, and collaboration. Each theme had subthemes to illuminate the participants' perspectives of the FCC constructs.

Conclusion: This study revealed that nurses and doctors had positive perspectives of FCC in the ICU and are willing to accept and implement it into standard ICU practice. Four main constructs of FCC emerged from this CGT study: respect, family support, participation, and collaboration and were used to develop a conceptual guideline.

Practice implication: FCC implementation in the ICU may be facilitated by designing family-inclusive ICUs with spacious subunits, kangaroo rooms, family areas, provision of counselling, as well as adopting regular and effective communication guidelines, and adequate staff training. Conceptual guidelines for FCC have been developed to promote FCC in standard ICU practice.