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Keywords

family presence, family-witnessed CPR, emergency medicine, patient needs, patient perceptions, patient comfort, psychosocial care, cardiopulmonary resuscitation, invasive procedures

 

Authors

  1. Eichhorn, Dezra J. MS, RN, CNS
  2. Meyers, Theresa A. BSN, RN, CCRN, CEN
  3. Guzzetta, Cathie E. PhD, RN, HNC, FAAN
  4. Clark, Angela P. PhD, RN, CS, FAAN
  5. Klein, Jorie D. RN
  6. Taliaferro, Ellen MD, FACEP
  7. Calvin, Amy O. PhD, RN

Overview:

How do patients react to the presence of family during invasive procedures (IPs) or cardiopulmonary resuscitation (CPR)? Until recently, surprisingly little research had addressed the issue of family presence at all, and to our knowledge, no other studies have been published that delineate patients' perspectives.

 

In February 2000, we first reported in this journal findings from our pioneering study, which demonstrated numerous benefits that bedside visitation confers on the families of patients undergoing these procedures. This article presents our further investigation-aimed at describing the experiences of the patients-using a qualitative research approach to analyzing data collected during that study.

 

The study took place in the emergency department (ED) of a university-affiliated, regional, level-I trauma center. The protocol for family presence was adapted from guidelines developed by the Emergency Nurses Association (ENA). Nine patients (eight who had IPs and one who underwent CPR) were also interviewed approximately two months after the emergency event. A semistructured questionnaire was used to determine their perceptions of the family presence experience.

 

Seven themes emerged from the data. Three of these relate to the positive effects that family presence had on patients: it comforted them; provided help; and served, the patients believed, to remind providers of a patient's "personhood"-he wasn't just a patient; he was a person and had a family. Two themes involve how family presence reflects the reciprocal nature of patient-family bonds and the patient's right to have family members present. The remaining two themes characterize how patients perceived the effects of the experience on their family members and on the health care environment. Patients saw both positive and negative effects on those who were present but believed the benefits to families outweighed the potential problems. Although further study is needed, family presence indeed appears to deliver many benefits, with apparently few drawbacks or adverse effects, to patients, their families, and their providers. In 1999, our institution, Parkland Health & Hospital System, approved a hospital-wide protocol for family presence during IPs and CPR.

 

Corresponding author:

 

Theresa Meyers

 

Presbyterian Hospital of Dallas, Emergency Department

 

8200 Walnut Hill Lane

 

Dallas, TX 75231

 

TheresaMeyers@texashealth.org