Family presence during resuscitation has been a topic of interest internationally since the first report of this practice was reported twenty-five years ago. Worldwide many studies have provided insight into the perspective of health care professionals, however there is limited research on the perspective and experiences of family members who have witnessed the resuscitation of a close relative. Therefore, an exploration of family members’ perceptions of family presence and their experiences when they have been present during resuscitation will provide health care professionals with information that can be used to formulate policy and inform practice, particularly in areas of the hospital where CPR regularly occurs. An integrative review was conducted to synthesize literature related to family perceptions and experiences of family involvement during resuscitation of a family member.
Methods: An integrative review was conducted which followed five steps: 1) identifying the research problem; 2) conducting a systematic literature search; 3) appraising the quality of the studies; 4) extracting and analyzing the data, and 5) synthesizing and presenting the findings. A comprehensive electronic database search was conducted between 1994 and 2017. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), PyschINFO, Academic Search, SocINDEX, PubMed, ProQuest databases and Google Scholar were searched with the terms family perceptions, family presence, AND resuscitation. Inclusion criteria were: 1) qualitative, quantitative, and mixed methods (including dissertations) and; 2) family members perceptions and/or experiences of family presence with pediatric or adult patients during witnessed resuscitation. Exclusion criteria were 1) studies that focused on only healthcare providers’ perceptions of family presence during resuscitation; 2) finding that only focused on invasive procedures; and 3) resuscitation efforts that occurred outside the hospital setting. Limiters applied include: 1) abstract available; 2) written in English; and 3) peer-reviewed. Initially 100 abstracts were reviewed electronically for relevance and then full-text articles were obtained and inspected for required study criteria. Both authors rated inclusion criteria independently (CT and SL) and together reached consensus. If lack of consensus occurred, a third party adjudicator would have been consulted. Following identification of articles for inclusion, data for each article was extracted. A review matrix was used to systematically organize, analyze, and synthesize data from the included studies. Data were extracted by authors independently, and then compared together. Twelve reviews met inclusion criteria.
Results: Findings suggest that family members view family presence as a fundamental right. In an international sample of studies, family presence overall was viewed positively by family members and they voiced wanting to be given an option to be present during a loved one’s resuscitation. Question one resulted in the following themes: fundamental right; psychological impact; and relationship. Question two resulted in two themes: being there for the patient, which was further divided into sharing information; and providing physical and emotional comfort to the patient; and was seeing is believing.
Conclusion: This review supports the need for stronger educational preparation of nurses and nursing students related to the practice of allowing family members to witness resuscitation of their family member. Policy initiatives include the formulation of policies that allow family presence during resuscitation of a family member and clear job descriptions and competencies needed to be an effective family presence facilitator that supports family members present during a resuscitation of a family member.
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