Family Involvement in Relation to Elective Open-Heart Surgery: A Critical Incident Technique Study From a Family Member Perspective

Overview

Journal Scand J Caring Sci

Specialty Nursing

Date 2025 Feb 24

PMID 39988863

Authors

Anna Drakenberg

Ann-Sofie Sundqvist

Bengt Fridlund

Elisabeth Ericsson

Affiliations

Soon will be listed here.

Abstract

Background: As open-heart surgery can be stressful for the patient and their family, the objective of this study was to generate knowledge on how to support families in relation to open-heart surgery based on important situations.

Aim: The aim was to explore and describe the experiences and actions of important situations of family involvement as expressed by family members of patients who underwent elective open-heart surgery in Sweden.

Methodological Design And Justification: The critical incident technique used is a qualitative method appropriate for identifying issues relating to clinical problems.

Ethical Issues And Approval: Ethical approval was obtained from the Swedish Ethical Review Authority. Allowance was made for the unexpected presence of the patient.

Research Methods: Individual interviews with 29 family members of patients who underwent open-heart surgery in Sweden in 2023 were analysed using the critical incidence technique, as applied in nursing and healthcare sciences.

Results: The family members experienced being-or not being-seen as significant and were fearing the loss of normal life in relation to open-heart surgery. Actions taken during important situations were building confidence to relinquish control and relieving burdens to improve well-being.

Conclusions: Family involvement, in terms of being informed and welcomed, led to an improved ability to care for their loved ones. Emotionally supportive interventions targeting families should be considered in relation to a loved one's open-heart surgery.

References

Karlsson A, Johansson M, Lidell E . Fragility--the price of renewed life. Patients experiences of open heart surgery. Eur J Cardiovasc Nurs. 2005; 4(4):290-7. DOI: 10.1016/j.ejcnurse.2005.03.009. View

van Dieen M, Paans W, Mariani M, Dieperink W, Blokzijl F . A qualitative study of the experiences and perceptions of older patients and relatives prior to cardiac surgery. Heart Lung. 2024; 65:40-46. DOI: 10.1016/j.hrtlng.2024.02.001. View

Reader T, Gillespie A, Roberts J . Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf. 2014; 23(8):678-89. PMC: 4112446. DOI: 10.1136/bmjqs-2013-002437. View

Drakenberg A, Prignitz Sluys K, Ericsson E, Sundqvist A . The Family Involvement in Care Questionnaire-An instrument measuring family involvement in inpatient care. PLoS One. 2023; 18(8):e0285562. PMC: 10426968. DOI: 10.1371/journal.pone.0285562. View

Davidson J, Aslakson R, Long A, Puntillo K, Kross E, Hart J . Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU. Crit Care Med. 2016; 45(1):103-128. DOI: 10.1097/CCM.0000000000002169. View

Jordan A, Rojnica M, Siegler M, Angelos P, Langerman A . Surgeon-family perioperative communication: surgeons' self-reported approaches to the "surgeon-family relationship". J Am Coll Surg. 2014; 219(5):958-67. DOI: 10.1016/j.jamcollsurg.2014.05.019. View

Zygouri I, Cowdell F, Ploumis A, Gouva M, Mantzoukas S . Gendered experiences of providing informal care for older people: a systematic review and thematic synthesis. BMC Health Serv Res. 2021; 21(1):730. PMC: 8306003. DOI: 10.1186/s12913-021-06736-2. View

Wessel M, Lynoe N, Juth N, Helgesson G . The tip of an iceberg? A cross-sectional study of the general public's experiences of reporting healthcare complaints in Stockholm, Sweden. BMJ Open. 2012; 2(1):e000489. PMC: 3269049. DOI: 10.1136/bmjopen-2011-000489. View

Al-Mutair A, Plummer V, Clerehan R, OBrien A . Needs and experiences of intensive care patients' families: a Saudi qualitative study. Nurs Crit Care. 2013; 19(3):135-44. DOI: 10.1111/nicc.12040. View

10.

Nors T, Sestoft B, Dreyer P . Patients' Perspectives on Relatives in the Perioperative Setting: A Danish Study. AORN J. 2020; 111(2):e1-e11. DOI: 10.1002/aorn.12941. View

11.

Drakenberg A, Arvidsson-Lindvall M, Ericsson E, Agren S, Sundqvist A . The symphony of open-heart surgical care: A mixed-methods study about interprofessional attitudes towards family involvement. Int J Qual Stud Health Well-being. 2023; 18(1):2176974. PMC: 9970227. DOI: 10.1080/17482631.2023.2176974. View

12.

Rosenstrom S, Risom S, Hove J, Brodsgaard A . Living with Atrial Fibrillation: A Family Perspective. Nurs Res Pract. 2022; 2022:7394445. PMC: 8916854. DOI: 10.1155/2022/7394445. View

13.

Falk A, Stenman M, Kahlin J, Hultgren R, Nymark C . Suffering in silence - Cardiac surgery patients recalling hypoactive delirium a qualitative descriptive study. Intensive Crit Care Nurs. 2023; 79:103493. DOI: 10.1016/j.iccn.2023.103493. View

14.

Shamali M, Esandi Larramendi N, Ostergaard B, Barbieri-Figueiredo M, Brodsgaard A, Canga-Armayor A . Nurses' attitudes towards family importance in nursing care across Europe. J Clin Nurs. 2022; 32(15-16):4574-4585. DOI: 10.1111/jocn.16456. View

15.

Ostergaard B, Mahrer-Imhof R, Wagner L, Barington T, Videbaek L, Lauridsen J . Effect of family nursing therapeutic conversations on health-related quality of life, self-care and depression among outpatients with heart failure: A randomized multi-centre trial. Patient Educ Couns. 2018; 101(8):1385-1393. DOI: 10.1016/j.pec.2018.03.006. View

16.

Soikkeli-Jalonen A, Mishina K, Virtanen H, Charalambous A, Haavisto E . Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review. J Clin Nurs. 2021; 30(15-16):2179-2201. DOI: 10.1111/jocn.15725. View

17.

Norlyk A, Haahr A, Hall E . Interviewing with or without the partner present?--an underexposed dilemma between ethics and methodology in nursing research. J Adv Nurs. 2015; 72(4):936-45. DOI: 10.1111/jan.12871. View

18.

Holloway C, Pathare N, Huta J, Grady D, Landry A, Christie C . The Impact of a Less Restrictive Poststernotomy Activity Protocol Compared With Standard Sternal Precautions in Patients Following Cardiac Surgery. Phys Ther. 2020; 100(7):1074-1083. DOI: 10.1093/ptj/pzaa067. View

19.

Friedemann M . The concept of family nursing. J Adv Nurs. 1989; 14(3):211-6. DOI: 10.1111/j.1365-2648.1989.tb01527.x. View

20.

Howe L, Wigmore D, Nelms N, Schottel P, Bartlett C, Halsey D . Perioperative Family Updates Reduce Anxiety and Improve Satisfaction: A Randomized Controlled Trial. J Patient Cent Res Rev. 2021; 8(2):107-112. PMC: 8060044. View