Family Engagement in Paediatric Acute Care Settings: A Realist Review

Authors

Teresa Jerofke-Owen, Marquette UniversityFollow
Natalie S. McAndrew, University of Wisconsin - Milwaukee
Joan P. Totka, Marquette UniversityFollow
Karen S. Gralton, Children's Hospital of Wisconsin
Kathleen J. Sawin, University of Wisconsin - Milwaukee
Alissa V. Fial, Marquette UniversityFollow
Marianne E. Weiss, Marquette UniversityFollow

Document Type

Article

Publication Date

2-2024

Publisher

Wiley

Source Publication

Journal of Advanced Nursing

Source ISSN

0309-2402

Original Item ID

DOI: 10.1111/jan.15833

Abstract

Aim

To create a programme theory of family engagement in paediatric acute care to explicate the relationships between contexts and mechanisms of family engagement that align with family, direct care providers and healthcare organization outcomes.

Design

Realist review and synthesis.

Data Sources

PubMed, CINAHL, PsycINFO and Web of Science searches for the 2.5-year period (July 2019–December 2021) following our 2021 scoping review.

Review Methods

Following methods described by Pawson and Rycroft-Malone, we defined the scope of the review, searched for and appraised the evidence, extracted and synthesized study findings and developed a supporting narrative of our results.

Results

Of 316 initial citations, 101 were included in our synthesis of the final programme theory. Contexts included family and direct care provider individualism, and the organizational care philosophy and environment. Mechanisms were family presence, family enactment of a role in the child's care, direct care providers facilitating a family role in the child's care, unit/organizational promotion of a family role, relationship building and mutually beneficial partnerships. Outcomes were largely family-focussed, with a paucity of organizational outcomes studied. We identified four context–mechanism–outcome configurations.

Conclusion

This realist review uncovered underlying contexts and mechanisms between patients, direct care providers and organizations in the family engagement process and key components of a mutually beneficial partnership. Given that successful family engagement requires direct care provider and organizational support, future research should expand beyond family outcomes to include direct care providers, particularly nurses and healthcare organization outcomes.

Impact

The final programme theory of family engagement in paediatric acute care provides a roadmap for clinicians to develop complex interventions to engage families and evaluate their impact. The components of our final programme theory reflect family engagement concepts that have been evolving for decades.

Patient or Public Contribution

The team conducting this review included members from the practice setting (JT & KG). In the future, as we and others use this model in practice, we will seek input for refinement from clinicians, patients and caregivers.

Comments

Accepted version. Journal of Advanced Nursing, Vol. 80, No. 2 (February 2024): 446-464. DOI. © 2024 Wiley. Used with permission.

Recommended Citation

Jerofke-Owen, Teresa; McAndrew, Natalie S.; Totka, Joan P.; Gralton, Karen S.; Sawin, Kathleen J.; Fial, Alissa V.; and Weiss, Marianne E., "Family Engagement in Paediatric Acute Care Settings: A Realist Review" (2024). College of Nursing Faculty Research and Publications. 993.
https://epublications.marquette.edu/nursing_fac/993