The symphony of open-heart surgical care: A mixed-methods study about interprofessional attitudes towards family involvement

ABSTRACT

Purpose

The overall aim of this study was to describe the attitudes towards family involvement in care held by nurses and medical doctors working in open-heart surgical care and the factors influencing these attitudes.

Methods

Mixed-methods convergent parallel design. A web-based survey was completed by nurses (n = 267) using the Families’ Importance in Nursing Care-Nurses Attitudes (FINC-NA) instrument and two open-ended questions, generating one quantitative and one qualitative dataset. Qualitative interviews with medical doctors (n = 20) were conducted in parallel, generating another qualitative dataset. Data were analysed separately according to each paradigm and then merged into mixed-methods concepts. Meta-inferences of these concepts were discussed.

Results

The nurses reported positive attitudes in general. The two qualitative datasets from nurses and medical doctors resulted in the identification of seven generic categories. The main mixed-methods finding was the attitude that the importance of family involvement in care depends on the situation.

Conclusions

The dependence of family involvement on the situation may be due to the patient’s and family’s unique needs. If professionals’ attitudes rather than the family’s needs and preferences determine how the family is involved, care runs the risk of being unequal.

KEYWORDS:

• Attitude
• cardiac surgical procedures
• family
• family nursing
• interprofessional research

Acknowledgments

The authors wish to thank all participating nurses and MDs for providing their perspectives and taking time from their clinical duties during the COVID-19 pandemic.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author controbutions

Study conception and design was performed by AD, EE, SÅ and ASS. AD collected the data. All authors participated in data analysis. The first draft of the manuscript was written by AD, and all authors gave critical feedback and edited previous versions of the manuscript. All authors read and approved the final version of the manuscript.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

This work was supported by the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (OLL-934445; OLL-960017); and the Research Committee at Örebro County Council, Örebro, Sweden.

Notes on contributors

Anna Drakenberg

Anna Drakenberg, RN, MSc, is a doctoral student in the Department of Medical Sciences, School of Health Sciences at Örebro University, Sweden. Her research focuses on family-centered care in the context of open-heart surgery.

MiaLinn Arvidsson-Lindvall

Mialinn Arvidsson-Lindvall, RPT, PhD, is affiliated with the School of Health Sciences in the Faculty of Medicine and Health, Örebro University, Sweden. Her research is related to elderly and physical activity, effect and experiences.

Elisabeth Ericsson

Elisabeth Ericsson, RNA, PhD, Associate Professor in anesthesia care, is a senior lecturer at Örebro university, Sweden. Her research focus is on pre-operative preparation and postoperative support for the families of patients undergoing anesthesia, surgery, and medical procedures with the aim of minimizing negative emotional reactions, achieving optimal pain and distress control in patients, and improving the quality of care.

Susanna Ågren

Susanna Ågren RN, PhD, Senior associate professor in intensive care nursing at Linköping university, Sweden. Her research focus has been to meet the family individually, as a group, but also interactive. By evaluating this in randomized studies, focus groups and individual interviews in different research groups; burden, strain, relationship, health-related quality of life, hope, self-care, empowerment.

Ann-Sofie Sundqvist

Ann-Sofie Sundqvist, RNA, PhD is affiliated with the School of Health Sciences in the Faculty of Medicine and Health, Örebro University, Sweden. Her research is related to family involvement after cardiac surgery, children’s health and well-being, surgical site infections and bacteria contamination in the operating room, as well as daily life as perceived by people with funnel chest.