Family Involvement Strategies on Health Outcomes of Critically Ill Patients in Hospitals in Africa- A Scoping Review
Abstract
Background: Critically ill patients, especially intubated, sedated, or delirious patients lying in ICUs, may not be able to express their care needs. For these specific patients, family participation in care has been recognised as a fundamental component of patient-centred care. Nonetheless, the effects of specific family participation approaches on these patients are a relatively unexplored area of research. Answering to these unsatisfied needs, family-centred care (FCC) frameworks have been elaborated on with the inclusion of family members in decision-making processes and emotional support in the care. Objective: This scoping review seeks to examine the family participation approaches researched in ICUs and their effects on patients’ outcomes, particularly on their mental and physical health. It aims to synthesise the existing knowledge, identify the evidence gaps, and propose directions for future studies. Methods: In accordance with the PRISMA-ScR protocols, a systematic search for the period between 2016 and 2025 was carried out in the PubMed, CINAHL, and Scopus databases. The search focused on peer-reviewed studies for the inclusion of family participation in the ICU care and family participation on health outcomes. Key themes, methodological approaches and gaps in the literature were identified through data charting and synthesis. Results: The strategies of family involvement in African ICUs were dominated by information sharing, involvement in decision making, emotional and psychosocial support, and closeness to the patients. Organised family practice was related to less anxiety, enhanced emotional stability, and enhanced care experiences. Implementation was, however, mainly informal and inconsistent, and there was little evidence to indicate how family involvement supported direct clinical outcomes. Conclusion: These results suggest that family engagement is useful to seriously ill patients largely via psychosocial mechanisms, yet its applicability in African ICUs is restricted by the presence of dysfunctional communication, subordinate care societal cultures, staffing issues, and formal frameworks of family-centred care. More studies are required to come up with context-appropriate models, as well as to evaluate their effects on psychosocial and clinical outcomes
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