Developing a theory of family care during critical illness

BACKGROUND: The critical illness of a loved one can negatively affect all family members (FMs), leading to the interruption of family functioning and integrity. Hospitalisation is a stressful, unplanned event for both the patient and FMs and is associated with psychological disturbances, emotional distress and altered family roles and functioning. OBJECTIVES: To develop a theory of family care in critical care units (CCUs) for the South African setting. METHODS: Grounded theory, based on Strauss and Corbin’s school of thought, was used. Audio-recorded in-depth interviews were conducted with 32 participants (9 FMs, 17 critical care nurses and 6 doctors) at a private hospital (3 CCUs) and a state hospital (10 CCUs). Data analysis involved open, axial and selective coding. RESULTS: The theory of family care during critical illness was identified. The core concept of the theory is empowerment, informed by the underlying constructs of information sharing, proximity, garnering resources, and cultural and religious cooperation. CONCLUSION: The concepts of this theory can equip healthcare professionals in CCUs to provide appropriate family care for meeting the needs of patients’ FMs and, in so doing, contribute to families having a more manageable critical care experience during the illness of their loved one. CONTRIBUTIONS OF THE STUDY: This study adds to the limited body of knowledge regarding family care within the South African context. The study provides a theory to promote therapeutic partnerships between health care professionals, patients and FMs that will provide support for both the patient and FMs. It is further anticipated that the findings of the study will contribute not only to nurses’ critical care curriculum, which currently includes very limited family support content, but also be helpful to doctors working in intensive care units.