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The expressed support needs of families of adults who have survived critical illness: A thematic synthesis

Millward, K. ORCID: 0000-0002-4457-6226, McGraw, C. and Aitken, L. M. (2021). The expressed support needs of families of adults who have survived critical illness: A thematic synthesis. International Journal of Nursing Studies, 122, 104048. doi: 10.1016/j.ijnurstu.2021.104048

Abstract

Background
Surviving critical illness can result in ongoing psychological, physical and cognitive impairments for both survivors and families. During the time from the critical illness through to the period of adaptation back to community living, families, alongside survivors, have support needs.

Objectives
This systematic review aimed to provide an in-depth insight into the expressed support needs of families of adults who survived an admission to an intensive care unit and returned to a home environment. It also aimed to explore how these needs change over time, and what support provisions families perceived to be helpful.

Methods
This was a systematic review using thematic synthesis methodology. Predefined searches were conducted in CINAHL, Medline, PsychINFO, SocIndex, EMbase, Academic Search Complete, EThOS and OpenGrey to locate studies published in English from 2000. Two reviewers screened each study against the inclusion criteria. Quality appraisal was undertaken using Joanna Briggs Institute tools. Extracted data were managed in Nvivo12® and analysed to identify descriptive and analytical themes. The Timing it Right Framework was used to frame changes in need across the recovery continuum.

Results
Thirty-nine studies were included, 30 qualitative, eight quantitative and one mixed methods. Five key family needs were identified across the recovery continuum: for security; to make sense of the situation; finding a balance; holding everything together; and for trust.

Discussion
Families found the following interventions helpful: written information; care coordination and navigation; input from intensive care staff after discharge to support continuity; and provision of family support groups. Although there are similarities between the needs of families and survivors, there are sufficient differences to warrant the development of processes to identify and address family need throughout the recovery continuum.

Conclusion
More research is required to develop a tool to better identify the needs of families across the recovery continuum, identify gaps in current service provision, and design interventions to meet these needs.

Publication Type: Article
Additional Information: © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: Critical care, Family, Care-givers, Social support, Critical care outcomes
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RT Nursing
Departments: School of Health Sciences > Nursing
Date available in CRO: 20 Aug 2021 10:25
Date deposited: 20 August 2021
Date of acceptance: 20 July 2021
Date of first online publication: 26 July 2021
URI: https://openaccess.city.ac.uk/id/eprint/26627
[img] Text - Accepted Version
This document is not freely accessible until 26 July 2022 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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