Theoretical Perspective on Families at the Bedside

The family’s close, protective involvement with hospitalized relatives, has become a common occurrence in U.S. inpatient settings.  Prior to the 1960's, visiting policies restricted family presence at the bedside.  However, in the 1960's and 1970's changes in visiting policies encouraged parents to stay with their hospitalized children.  Family members are now often visibly present with hospitalized relatives in a multitude of acute care settings.  Questions about the family’s perspective of vigilance led this researcher to conduct three qualitative studies to explore the meanings, patterns, and day-to-day experience of family members staying with hospitalized relatives.  The inductive development of a middle range theory of vigilance is a product of the three research studies.  Concept synthesis will be discussed in relation to vigilance and its categories of meaning and defining characteristics.  Statements about probable relationships that exist among categories of meaning will be presented and hypotheses will be suggested.  Finally, direct and indirect linkages among categories and an overall pattern of relationships will be described through the process of theory synthesis.  A systematic view about vigilance enhances professionals’ understanding of vigilance, provides theoretical direction for interventions, and has implications for further research.