Development of a structured family reception procedure in adult intensive care
DOI:
https://doi.org/10.29352/mill0229.44825Keywords:
critical care nursing; professional-family relations; humanization of assistanceAbstract
Introduction: Family reception in adult intensive care units is a critical yet inconsistently structured practice, despite recommendations for family-centered care.
Objective: To develop a structured procedure for family reception in adult intensive care and achieve expert consensus on its content.
Methods: A two-phase methodological study was conducted. Phase 1 comprised a focus group with nine experienced intensive care professionals to explore current reception practices and key procedural components. Phase 2 used a two-round e-Delphi technique with ten expert critical care nurses to evaluate item relevance and clarity. Predefined consensus criteria were applied.
Results: Focus group analysis identified four thematic areas that informed the draft procedure. e-Delphi consensus was achieved for 42 items, organized into three components: a pre-visit reception moment, a post-visit communication moment, and provision of standardized written information.
Conclusion: This study produced a structured, expert-agreed family reception procedure for adult intensive care. Further studies should examine the feasibility, effectiveness, and family perspectives in clinical settings.
Downloads
References
Archer, E., & Meyer, I. S. (2021). Applying empathic communication skills in clinical practice: Medical students’ experiences. South African Family Practice, 63(1), e1–e5. https://doi.org/10.4102/safp.v63i1.5244
Azoulay, É., Kentish‐Barnes, N., Boulanger, C., Mistraletti, G., Mol, M. van, Calle, G. H., Estenssoro, E., van Heerden, P. V., Delgado, M.-C. M., Perner, A., Arabi, Y. M., Myatra, S. N., Laake, J. H., De Waele, J. J., Darmon, M., & Cecconi, M. (2024). Family centeredness of care: A cross-sectional study in intensive care units part of the European Society of Intensive Care Medicine. Annals of Intensive Care, 14(77). https://doi.org/10.1186/s13613-024-01307-0
Bardin, L. (2011). Content analysis. Edições 70.
Barrett, D., & Heale, R. (2020). What are Delphi studies? Evidence-Based Nursing, 23(3), 68–69. https://doi.org/10.1136/ebnurs-2020-103303
Blok, A. C., Gauntlett, L., Jayaram, M., & Krein, S. L. (2025). Caregiver and care team perspectives of caregiver psychological distress and well-being during critical care hospitalization: A qualitative study. BMC Geriatrics, 25(1), 167. https://doi.org/10.1186/s12877-025-05769-0
Camões, J., Lobato, C. T., Carvalho, D., Gomes, E., & Araújo, R. (2022). Family satisfaction in intensive care during the COVID-19 pandemic using the FS-ICU24 questionnaire. Acta Médica Portuguesa, 35(12), 859–865. https://doi.org/10.20344/amp.17128
Capelas, M. L., Simões, A. S. A. W. F., Teves, C. F. T. M., Durão, S. A. P., Coelho, S. P. F., Silva, S. C. F. S. da, Silva, A. E., & Afonso, T. dos S. (2018). Indicadores de qualidade prioritários para os serviços de cuidados paliativos em Portugal. Cadernos de Saúde, 10(2), 11–24. https://doi.org/10.34632/cadernosdesaude.2018.7245
Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative and mixed methods approaches (5th ed.). SAGE Publications.
Davidson, J. E., Aslakson, R. A., Long, A. C., Puntillo, K. A., Kross, E. K., Hart, J., Cox, C. E., Wunsch, H., Wickline, M. A., Nunnally, M. E., Netzer, G., Kentish-Barnes, N., Sprung, C. L., Hartog, C. S., Coombs, M., Gerritsen, R. T., Hopkins, R. O., Franck, L. S., Skrobik, Y., … Curtis, J. R. (2017). Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Critical Care Medicine, 45(1), 103–128. https://doi.org/10.1097/CCM.0000000000002169
Davidson, J. E., & Zisook, S. (2017). Implementing family-centered care through facilitated sensemaking. AACN Advanced Critical Care, 28(2), 200–209. https://doi.org/10.4037/aacnacc2017102
Dijkstra, B. M., Schoonhoven, L., & Vloet, L. C. M. (2025). Family involvement in the intensive care unit, moving to decision-making and family participation. Intensive and Critical Care Nursing, 87, 103964. https://doi.org/10.1016/j.iccn.2025.103964
Dong, J., Sui, W., & Zhuang, Y. (2025). Patients’ and family members’ dyadic experience of post-operative delirium in the intensive care unit: A qualitative study. Nursing in Critical Care, 30(2), e13297. https://doi.org/10.1111/nicc.13297
Fortunatti, C. P., De Santis, J. P., & Munro, C. L. (2021). Family satisfaction in the adult intensive care unit. Advances in Nursing Science, 44(4), 291–305. https://doi.org/10.1097/ans.0000000000000360
Fortunatti, C. P., Munro, C. L., & Gattamorta, K. (2022). Psychological distress, social support, and family satisfaction among family members of non-COVID-19 critical care patients: A cross-sectional study. Journal of Nursing Scholarship, 55(1), 33–44. https://doi.org/10.1111/jnu.12812
Giannarou, L., & Zervas, E. (2014). Using Delphi technique to build consensus in practice. International Journal of Business Science and Applied Management, 9(2), 65–82. https://doi.org/10.69864/ijbsam.9-2.106
He, X., Song, Y., Cao, Y., Miao, L., & Zhu, B. (2024). Post intensive care syndrome: A review of clinical symptoms, evaluation, intervention. Heliyon, 10(10), e31278. https://doi.org/10.1016/j.heliyon.2024.e31278
International Council of Nurses. (2019). ICNP Browser: Family. https://www.icn.ch/icnp-browser
Julia, G. J., Romate, J., Allen, J. G., & Rajkumar, E. (2024). Compassionate communication: A scoping review. Frontiers in Communication, 8. https://doi.org/10.3389/fcomm.2023.1294586
Kentish‐Barnes, N., Cohen-Solal, Z., Morin, L., Souppart, V., Pochard, F., & Azoulay, É. (2021). Lived experiences of family members of patients with severe COVID-19 who died in intensive care units in France. Jama Network Open, 4(6), e2113355. https://doi.org/10.1001/jamanetworkopen.2021.13355
Kesecioglu, J., Rusinova, K., Alampi, D., Arabi, Y. M., Benbenishty, J., Benoit, D., Boulanger, C., Cecconi, M., Cox, C., Van Dam, M., Van Dijk, D., Downar, J., Efstathiou, N., Endacott, R., Galazzi, A., Van Gelder, F., Gerritsen, R. T., Girbes, A., Hawyrluck, L., … Azoulay, E. (2024). European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit. Intensive Care Medicine, 50(11), 1740–1766. https://doi.org/10.1007/s00134-024-07579-1
Koçyiğit Kavak, H., & Demirci, S. (2025). Interaction experiences of family members with their unconscious relatives on mechanical ventilation in the intensive care unit: A phenomenological Qualitative Study. Nursing in Critical Care, 30(4), e70115. https://doi.org/10.1111/nicc.70115
Krueger, R. A., & Casey, M. A. (2015). Focus Groups: A Practical Guide for Applied Research (5th ed.). SAGE Publications.
Kvande, M. E., Angel, S., & Højager Nielsen, A. (2022). Humanizing intensive care: A scoping review (HumanIC). Nursing Ethics, 29(2), 498–510. https://doi.org/10.1177/09697330211050998
Marques, I. R., & Souza, A. R. de. (2010). Tecnologia e humanização em ambientes intensivos. Revista Brasileira de Enfermagem, 63, 141–144. https://doi.org/https://doi.org/10.1590/S0034-71672010000100024
Meleis, A. (2010). Transitions theory—Middle range and situation specific theories in nursing research and practice. Springer Publishing Company. https://doi.org/10.4324/9781315451176-5
Mendes, A. P. (2018). Impact of critical illness news on the family: Hermeneutic phenomenological study. Revista Brasileira De Enfermagem, 71(1), 170–177. https://doi.org/10.1590/0034-7167-2016-0163
Naef, R., Jeitziner, M.-M., Riguzzi, M., von Felten, S., Verweij, L., Rufer, M., Safford, J., Sutter, S., Bergmann-Kipfer, B., Betschart, U., Boltshauser, S., Brülisauer, N., Brunner, C., Bühler, P. K., Burkhalter, H., Dullenkopf, A., Heise, A., Hertler, B., Hoffmann, J. E., … FICUS Study Group. (2025). Nurse-Led Family Support Intervention for Families of Critically Ill Patients: The FICUS Cluster Randomized Clinical Trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.3406
Naldan, M. E., Ibrahimoğlu, Ö., & Mersin, S. (2025). The relationship between the anxiety levels of relatives of patients in intensive care units and perceived respect from healthcare professionals. Perspectives in Psychiatric Care, 2025. https://doi.org/10.1155/ppc/6405095
Nasa, P., Jain, R., & Juneja, D. (2021). Delphi methodology in healthcare research: How to decide its appropriateness. World Journal of Methodology, 11(4), 116–129. https://doi.org/10.5662/wjm.v11.i4.116
Reifarth, E., Garcia Borrega, J., & Kochanek, M. (2023). How to communicate with family members of the critically ill in the intensive care unit: A scoping review. Intensive and Critical Care Nursing, 74, 103328. https://doi.org/10.1016/j.iccn.2022.103328
Scarparo, A. F., Laus, A. M., Gabriel, S., & Chaves, L. D. P. (2012). Reflections on the use of Delphi Technique in Research in Nursing. Revista da Rede de Enfermagem do Nordeste, 13(1), 242–251. https://shre.ink/AHPY
Smith, A. C., Ferguson, H. N., Russell, R. M., Savsani, P., & Wang, S. (2025). Post-intensive care syndrome family. Critical Care Clinics, 41(1), 73–88. https://doi.org/10.1016/j.ccc.2024.08.008
van Beusekom, I., Bakhshi-Raiez, F., de Keizer, N. F., Dongelmans, D. A., & van der Schaaf, M. (2016). Reported burden on informal caregivers of ICU survivors: A literature review. Critical Care, 20, 16. https://doi.org/10.1186/s13054-016-1185-9
Wang, G., Antel, R., & Goldfarb, M. (2023). The impact of randomized family-centered interventions on family-centered outcomes in the adult intensive care unit: A systematic review. Journal of Intensive Care Medicine, 38(8), 690–701. https://doi.org/10.1177/08850666231173868
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Millenium - Journal of Education, Technologies, and Health
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who submit proposals for this journal agree to the following terms:
a) Articles are published under the Licença Creative Commons (CC BY 4.0), in full open-access, without any cost or fees of any kind to the author or the reader;
b) The authors retain copyright and grant the journal right of first publication, allowing the free sharing of work, provided it is correctly attributed the authorship and initial publication in this journal;
c) The authors are permitted to take on additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, post it to an institutional repository or as a book), with an acknowledgment of its initial publication in this journal;
d) Authors are permitted and encouraged to publish and distribute their work online (eg, in institutional repositories or on their website) as it can lead to productive exchanges, as well as increase the impact and citation of published work
Documents required for submission
Article template (Editable format)
