The need for intensive care services and survival from critical illnesses continue to increase (Maguire & Carson, 2013). This is due to advances in intensive care, expansion of capacity to cater for the ongoing novel coronavirus virus disease 2019 (COVID–19) pandemic and the increasing older population. Consequently, as the number of patients requiring treatment in Intensive Care Units (ICU) increases, a proportional number of family members will experience the journey of admission of a family members in ICU (Hetland, Hickman, McAndrew, & Daly, 2017). Nurses will have more encounters with the patients’ families. As such, it is imperative for nurses to recognize these trends and to support the families using various interventions. This calls for more demands on nurses to utilize family nursing practices in all care settings (Simpson & Tarrant, 2006).
Critical illnesses or injuries not only affect the patient. They also have substantial impact on the whole family, owing to the fact that the patient forms half of the patient while the other half is the patient’s family unit (Bell, 2013). Occasionally, illness of one of the family members influences the family’s health, perceptions and behaviors in various ways (Minton, Batten, & Huntington, 2018; Oliveira et al., 2011). The family-ICU journey is characterized by various family experiences. Initially, the family floats in a turmoil of unpleasant emotional responses to illness. Family members probe to understand the illness and complex treatment plans. (Imanipour, Kiwanuka, Akhavan Rad, Masaba, & Alemayehu, 2019). The unfamiliar ICU environment also exposes the family to psychosocial stress an unfamiliar visitation practices (Barth et al., 2016). Following discharge from ICU, the family further experiences a combination of psychological disorders termed as Post-Intensive Care Syndrome-Family (PICS-F) (Kiwanuka & Rad, n.d.).
Nurses and other ICU personnel should recognize the importance of fulfilling family needs (Olding et al., 2016). Meeting family healthcare needs is a cardinal goal of family nursing. It is a way of thinking about and working with families (Kaakinen, Coehlo, Steele, & Robinson, 2018). Family nursing practice (FNP) can be observed in various ways such as involving the family in care planning, direct delivery of care, and evaluation of health care in a mutualistic relationship that benefits both healthcare providers and families (Finlayson, Dixon, Smith, Dykes, & Flacking, 2014). Other practices include psychosocial and informational support (Al-Mutair, Plummer, Clerehan, & O’Brien, 2014; Gaeeni, Farahani, Seyedfatemi, & Mohammadi, 2014). Perception of family nursing practice is correlated with various factors. FNP is correlated with clinical experience, empathy and supportive attitude towards the importance of family in care (Hsiao & Tsai, 2015).
Nurses’ positive attitudes towards family importance in care can be observed through promotion of effective relationships with the family, commitment, appreciation, and effective communication with the family (Oliveira et al., 2011). Since nurses have the most frequent encounters with the patient’s family; their attitude towards family importance in care could translates into their understanding of family members concerns and the importance of integrating families into care processes. This generates practices that are more conducive to the functional empowerment and supportive to the families (Gusdal, Josefsson, Thors Adolfsson, & Martin, 2017). Furthermore, the family also has a vital role in caring for hospitalized patients (Tabootwong & Kiwanuka, 2020). Indeed, there is notable advocacy for consideration of the family as an important component of care across care settings. The International Family Nursing Association (IFNA) advocates for and has outlined competencies for nurses in attempt to enhance family importance in care (Association International Family Nursing, 2015). Nonetheless, family nursing practice is seldomly realized in acute care settings (Kiwanuka, Shayan, & Tolulope, 2019). This is partly influenced by nurses’ attitudes towards family importance in care (Bell, 2013; Curtis, Downey, & Engelberg, 2016; Harris, 2016). Luttik (2017) argued that an effective encounter between nurses and family members is notably influenced by attitude of nurses towards family importance in care. Additional research highlighting the link between FNP and FINC-NA needs to be nuanced. Therefore, this study aimed to assess the correlation between family nursing practice and nurses’ attitude towards family importance in care in adult intensive care units. This study adds to the growing body of literature emphasizing family nursing practice and family importance in care. To the best of our knowledge, this was the first study to report on the family nursing practice and nurses’ attitude towards family importance in care in adult ICUs of Uganda. This could be an initial step that avails evidence needed to advocate for more family centeredness of care and policy.