www.sciedu.ca/cns Clinical Nu sing S udies 2015, Vol. 3, No. 3
REVIEWS
Sho - e m pa ien and amily counselling o acu e
heal h change - an in eg a i e li e a u e e iew
K is iina Rai anen ∗1,2, Ja i Kylmä1, Eija Paa ilainen1,2
1School o Heal h Sciences, Uni e si y o Tampe e, Finland
2E elä-Pohjanmaa Hospi al Dis ic , Finland
Recei ed: Janua y 8, 2015 Accep ed: Ap il 12, 2015 Online Published: May 3, 2015
DOI: 10.5430/cns. 3n3p96 URL: h p://dx.doi.o g/10.5430/cns. 3n3p96
ABSTRACT
The pu pose o his in eg a i e li e a u e e iew is o desc ibe exis ing esea ch knowledge on sho - e m counselling o pa ien s
and amily membe s unde going acu e heal h change. The da a consis ed o 25 esea ch a icles and i e li e a u e e iews om
he yea s 2003-2015, analysed using induc i e con en analysis. The esea ch knowledge was ound o desc ibe elemen s o
good pa ien counselling, sa is ac ion wi h he elemen s o good pa ien counselling, de eloping he elemen s o good pa ien
counselling and impac o he pa ien counselling elemen s. Focussing on he pa ien ’s indi idual li e si ua ion, use o mul iple
counselling me hods and p o ision o in o ma ion in good in e ac ion con ibu e o high quali y pa ien counselling. Some pa ien s
and amily membe s we e sa is ied wi h he pa ien counselling elemen s while o he s exp essed needs o he de elopmen o
he elemen s. The con lic ing esul s indica e a need o de elop a uni o m, sys ema ic pa ien counselling me hod, wi h special
a en ion paid on he quali y o counselling.
Key Wo ds: Pa ien counselling, Family counselling, Sho - e m, Acu e heal h change, In eg a i e li e a u e e iew
1. INTRODUCTION
An acu e change in heal h is an expe ience ha a ouses emo-
ions, wi h each indi idual eac ing di e en ly o illness and
he ensuing loss o independence. The expe ience is a ec ed
by he acu eness, se e i y and a ali y o he si ua ion. Acu e
illness o en occu s d ama ically, wi hou wa ning signs o
p eceding e en s. Pa ien s and hei amily membe s may
ace a c isis imbued wi h mixed emo ions and expec a ions.
[1]
Du ing acu e illness, cha ac e ized by unp edic abili y and
uncon ollabili y, he e is a isk ha he pa ien ’s basic needs
will no be me .[1]
Pa ien educa ion and counselling a e concep s commonly
used in nu sing science and p ac ice o desc ibe a p o es-
sional ac i i y o p ocess, bu he e a e no single commonly
ag eed de ini ions. The concep s a e used pa allelly and syn-
onymously o desc ibe ad ising, counselling, eaching and
in o ming pa ien s. Typical ea u es o pa ien counselling
in ol e he con ex , in e ac ion and he ela ionship be ween
he p o ide and ecipien o counselling, who a e engaged in
an ac i e, goal-o ien ed unde aking.
[2]
This s udy uses he
mo e comp ehensi e e m pa ien counselling h oughou he
ex , e en when e e ing o s udies, which ha e employed
he e m pa ien educa ion.
As a planned p ocess, pa ien counselling in ol es de in-
ing counselling needs, se ing goals as well as planning,
e alua ing and documen ing he ac i i y. A success ul pa-
ien counselling p ocess will secu e pa ien commi men
∗Co espondence:
K is iina Rai anen; Email: [email p o ec ed]; Add ess: E elä-Pohjanmaa Hospi al Dis ic , Hanneksen inne 7, 60220
Seinäjoki, Finland.
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and con inui y o ca e.
[3]
I has been p oposed ha essen ial
componen s in high quali y pa ien counselling include he
nu se’s p o essional esponsibili y, he pa ien ’s and nu se’s
backg ound ac o s, hei in e ac i e ela ionship, ac i e and
goal-o ien ed ac i i y, as well as he esou ces, adequacy
and impac o counselling.
[4]
High quali y counselling has
been ound o p omo e pa ien s’ heal h, o example by im-
p o ing hei unc ional capaci y, li e quali y, commi men
o ca e, coping a home and independen decision-making. I
can also dec ease anxie y,
[5,6]
dep ession and loneliness and
help clien s o be e unde s and and emembe in o ma ion
ela ed o hei ca e.[7]
A pe son’s heal h a ec s he whole amily’s well-being and,
ecip ocally, he amily’s unc ionali y a ec s he pe son’s
li e. The ole o he amily becomes e en mo e p onounced
when one amily membe ge s ill.
[8]
Acu e illness imposes
s ess on he amily.
[9]
In ol ing amily membe s in pa ien
counselling can p omo e he coping o pa ien s,
[10]
especially
since amily membe s may no be amilia wi h he heal h
se ice and i s p ac ices and ha e an inc eased need o in-
o ma ion. The e m amily membe e e s membe s o he
amily, companions o o he pe sons ha a e close o he
pa ien . In his li e a u e e iew, pa ien s hemsel es ha e
de ined who hei amily membe s a e.[8,11]
Mul iple me hods should be used o maximize he impac o
pa ien counselling. The choice o me hods is a ec ed by a
numbe o ac o s, o example by he clien ’s abili y o as-
simila e in o ma ion and by he goal de ined o counselling.
Mos commonly, pa ien counselling is p o ided o ally and
suppo ed by ma e ial in a w i en o m.
[7]
To be e ec i e,
he w i en ma e ial mus be easy o ead and comp ehend.
[12]
Indi idualised counselling is o en he mos e ec i e lea n-
ing me hod and i is commonly app ecia ed by pa ien s. I
is based on he indi idual’s needs and makes i easie o
nu ses o mo i a e and encou age pa ien s o become ac i e.
Indi idualised counselling also allows con inuous eedback
and acili a es he c ea ion o an open a mosphe e. Good e-
cip ocal in e ac ion p o ides pa ien s wi h an oppo uni y o
ask ques ions, co ec misunde s andings and ecei e suppo
om nu sing s a .[7]
In his in eg a i e li e a u e e iew, he e m sho - e m pa-
ien and amily counselling e e s o a con ac o limi ed
du a ion be ween nu sing s a , pa ien s and hei amily
membe s. The o e all ime a ailable o in o ming and coun-
selling pa ien s and amily membe s is limi ed. Sho - e m
counselling no only occu s in acu e ca e se ings, bu also
a ou pa ien clinics and in in ensi e ca e uni s, as pa ien s
unde go sudden changes. Consequen ly, he da a selec ed o
his s udy co e s eme gency clinics, ou pa ien clinics and
in ensi e ca e uni s.
Counselling has been s udied ex ensi ely, bu no ye ex-
haus i ely om he iewpoin p esen ed in his e iew. This
in eg a i e li e a u e e iew, sys ema ically sea ching and
in eg a ing all a ailable esea ch e idence on wha is known
on his opic will be use ul in de eloping sho - e m pa ien
and amily counselling o acu e changes in heal h. Mo e
han e e , nu ses a e expec ed o demons a e compe ence in
pa ien and amily counselling. Acco ding o Kää iäinen,
[4]
o example, pa ien s and hei amily membe s equi e sup-
po and adequa e in o ma ion and counselling o be able o
cope wi h he changing si ua ions. Pa ien s ha e he igh
o ecei e counselling and nu ses ha e he du y o p o ide
i , based on good p o essional p ac ice and on he p inciple
o heal h p omo ion. Nowadays, p omo ing pa ien au on-
omy by counselling is impe a i e, as hospi alisa ion pe iods
a e sho e and pa ien s mo e he e ogeneous, o en su e ing
om mul iple p oblems.[4]
Pu pose o he s udy
This in eg a i e li e a u e e iew aims a desc ibing exis ing
esea ch knowledge o sho - ime counselling o pa ien s and
amily membe s, who ace an acu e change in heal h. The e-
sea ch ques ion is: Wha is known o sho - ime counselling
o pa ien s and hei amily membe s o acu e changes in
heal h?
2. METHODS
This s udy uses he i e-s age in eg a i e e iew me hod p o-
posed by Whi emo e and Kna l
[13]
in ol ing p oblem iden i-
ica ion, li e a u e sea ch, da a e alua ion, da a analysis and
epo ing he esul s. Acco ding o Poli and Beck,
[14]
in e-
g a i e e iews can be used o comp ehensi ely b inging
oge he da a on a gi en subjec a ea om di e en pe -
spec i es a ound he opic, o e alua ing he unde pinning
e idence base and o d awing conclusions ega ding he
p e ailing s a e o esea ch. In eg a i e me hods a e use ul
o gaining an ex ensi e o e all pic u e o a subjec a ea
[15]
and hey can be used as a basis o u he esea ch o de el-
opmen al ac i i ies.
2.1 Da abase sea ch and choice o a icles
Da a sea ch was pe o med wi h assis ance om an in o ma-
ion specialis using he da abases Melinda, Medic, Cinahl,
Pubmed and Psycin o. The ini ial sea ch yielded a limi ed
numbe o a icles, so a wide pe spec i e wi h new sea ch
e ms was adop ed and se e al sea ches ca ied ou o all
da abases, excep ing Pubmed. A manual sea ch was also
pe o med in ol ing na ional nu sing scien i ic jou nals and
e e ence lis s o a icles al eady selec ed o he e iew.
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Figu e 1 lis s he da abases, sea ch e ms and numbe o a i-
cles accep ed h oughou he p ocess. Only esea ch a icles
published in he yea s 2003-2015 in Finnish o English we e
deemed eligible. Fu he inclusion c i e ia o a icles we e
ha hey p o ided an answe o he esea ch ques ion and a -
ge ed adul pa ien s wi h adul amily membe s. O e lapping
s udies we e excluded, as well as esea ch conduc ed in a
wa d o in o he long- e m ca e. The o he exclusion ac o s
we e end-o -li e pa ien counselling, child o psychia ic pa-
ien s and pa ien counselling p o ided by medical s a only.
Some s udies ound o be o poo quali y we e also excluded.
Figu e 1. Da abase sea ch o a icles
2.2 Sea ch esul s
The esea ch da a (n= 30) consis s o quali a i e (n= 7) and
quan i a i e (n= 18) s udies and li e a u e e iews (n= 5)
conduc ed in Finland (n= 15), Uni ed S a es (n= 8), Belgium
(n= 2), Sweden (n= 2), Taiwan (n= 1), Aus alia (n= 1) and
Canada (n= 1). The sample size a ied be ween 6 and 62 in
quali a i e s udies and be ween 50 and 3,301 in quan i a i e
s udies. The numbe o a icles included in he i e li e a u e
e iews anged be ween 12 and 22, excep ha one e iew
did no s a e he numbe o a icles discussed. The s udies
had used g ounded heo y, phenomenology, con en analysis
and a ious s a is ical me hods o analyse da a.
2.3 Da a e alua ion
All esea ch a icles we e c i ically app aised using he c i e-
ia ou lined by Joanna B iggs Ins i u e.
[16]
The a icles inally
selec ed a e o high quali y; hey all eached a minimum
o 60% o o al poin s in he e alua ion. In he app aisals
conduc ed using he Quali a i e Assessmen and Re iew In-
s umen (QARI), he quan i a i e MAS ARI Ins umen o
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andomized con ol/pseudo- andomized ials and he Ins u-
men o Sys ema ic Re iews, he sco e a ied be ween 6 and
10 ou o 10 poin s, wi h a majo pa o he a icles gaining
8 poin s. In he app aisal conduc ed using he quan i a i e
MAS ARI Ins umen o desc ip i e and case s udy designs,
he sco e a ied be ween 6 and 8 ou o 9, wi h nea ly hal o
he a icles gaining 8 poin s and he es 6 o 7 poin s.
2.4 Da a analysis
Induc i e con en analysis was used o analyse he da a.
[17,18]
Tex segmen s ha answe ed he esea ch ques ion we e iden-
i ied, educed and assigned o ca ego ies acco ding o hei
con en . The ca ego ies we e app op ia ely labelled and hen
combined in o b oade ca ego ies acco ding o con en . Fi-
nally, he uppe le el ca ego ies we e gi en labels.[19]
3. RESULTS
As a esul o he li e a u e e iew, sho - e m pa ien and
amily counselling o acu e heal h changes was ound o
in ol e he ollowing: Elemen s o good pa ien counselling,
sa is ac ion wi h he elemen s o good pa ien counselling, de-
eloping he elemen s o good pa ien counselling and impac
o he pa ien counselling elemen s. The elemen s depic ed
in he uppe mos pa o he igu e cons i u e a ounda ion
o counselling. These elemen s a e associa ed wi h he o he
main ca ego ies: sa is ac ion wi h he elemen s o good pa-
ien counselling as well as he de elopmen and impac o
pa ien counselling (see Figu e 2).
Figu e 2. Elemen s o good pa ien counselling
3.1 Elemen s o good pa ien counselling
In s udies analysed o his li e a u e e iew, pa ien -cen ed,
indi idualised counselling was p esen ed as a good pa ien
counselling me hod. S udies e ealed, among o he hings,
ha hospi al s a we e ound compe en in p o iding indi id-
ual counselling o ally
[20]
and ha mos counselling si ua ions
we e indi idualised.
[21]
Acco ding o a s udy, e en amily
membe s ecei ed ace- o- ace in o ma ion in he wai ing
oom.
[22]
Kää iäinen, e al.
[20]
epo ha a majo pa o
he pa ien s we e gi en pa ien -cen ed counselling. Acco d-
ing o ano he s udy, pa ien s we e app oached as indi id-
uals, wi h di e en capaci ies o assimila e in o ma ion.
[23]
Koonce, Giuse and S o ow
[24]
epo ha hose pa ien s
who had ecei ed counselling ailo ed o hei lea ning s yle,
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ound he in o ma ion use ul and gained in unde s anding o
hei condi ion. I was also ound ha pa ien s’ willingness
o in o m amily membe s a ied; in a s udy by Paa ilainen,
e al.
[25]
app oxima ely hal o he pa ien s ag eed ha hei
amily membe s should be in o med o hei illness, cu en
s a us and ca e by elephone.
Va ious counselling me hods we e ound o be e ec i e in
mee ing he clien s’ lea ning goals. Among hem we e lec-
u es and ins uc ional ools,[26] w i en ins uc ions and dis-
cussion,
[21,26]
demons a ion and p ac ice echniques.
[26]
Us-
ing a wide a ie y o counselling me hods demands ha s a
membe s p epa e hemsel es well o he counselling si u-
a ions. The compa ibili y o in o ma ion gi en by medical
and nu sing s a was ound impo an , wi h a ious p o es-
sional g oups complemen ing each o he .
[23]
Ins uc ions in
a w i en o m we e essen ial o coping a home,
[27,28]
espe-
cially o olde pa ien s.
[21,25,28]
I was ound ha a gene al
pa ien counselling b ochu e had helped pa ien s o unde -
s and he s ages o hei ca e and he easons o ha ing o
wai .
[29]
Se e al s udies asse ha pa ien s ound he w i en
ins uc ions easy o unde s and
[28,30,31]
and e ec i e due o
uncomplica ed language.[26]
Counselling p o ided by a ious p o essionals means ha
acco ding o a numbe o s udies, pa ien s and amilies e-
cei ed counselling om bo h nu ses and doc o s,
[20,30,32,33]
mainly in he con ex o ca e.
[21]
Family membe s ound
he in o ma ion p o ided a he bedside comp ehensible and
conc e e, because hey we e able o obse e he pa ien ’s
si ua ion and see he ca e equipmen and ins umen s.[23]
Good in e ac ion, as an elemen o good pa ien counselling,
had a posi i e impac acco ding o Nikki and Paa ilainen;
[34]
clien s desc ibed he a mosphe e in he counselling si ua ion
using wo ds like compe en , eliable,
[20,30]
compassiona e,
encou aging and success ul.
[20]
Open, clea communica ion
and p o ision o explana ions helped o mee he needs o
amily membe s.
[35]
One s udy epo s ha a ious modes o
communica ion we e used in counselling, in ol ing o mal,
di e ing and humo is ic communica ion.[33]
High quali y p o ision o in o ma ion was impo an o am-
ily membe s. Acco ding o he li e a u e e iewed, in o -
ma ion has o be p o ided openly,
[23,34]
u h ully
[23,32]
and
accu a ely.
[36]
P o ision o in o ma ion is an essen ial pa
o pa ien counselling, as he need o in o ma ion is one o
he mos impo an needs,
[34,37,38]
especially in amily mem-
be s o c i ically ill pa ien s.
[34,38]
In a s udy, nea ly hal o
nu ses’ wo kload du ing ou pa ien isi s consis ed o coun-
selling
[39]
and i was ound impe a i e ha pa ien s should
ecei e adequa e in o ma ion.
[23]
Repe i ion and clea , in o -
mal language made in o ma ion easie o comp ehend.
[23]
Timeliness o in o ma ion and keeping clien s up o da e we e
also ound o be o impo ance. Especially a he beginning
o he ca e, he in o ma ion needed o be clea and uncompli-
ca ed.
[23,34]
A s udy epo s ha pa ien counselling s a ed
a he e y beginning o he illness p ocess.
[40]
Acco ding
o Ve haeghe, e al.
[38]
in o ma ion p o ided as co ec ly
and comple ely as possible c ea ed a ounda ion o ealis ic
hope.
3.2 Sa is ac ion wi h he elemen s o good pa ien coun-
selling
Sa is ac ion wi h in e ac ion in ol es amily membe s’ sa -
is ac ion wi h he encoun e and pa ien s’ sa is ac ion due
o he p esence o amily membe s du ing counselling. Ac-
co ding o Au a, e al.
[41]
amily membe s we e con en wi h
he manne hey we e ea ed and wi h he s a ’s help ul-
ness, iendliness and p o essional suppo . In ano he s udy,
nea ly all pa ien s wished o hei companions o be p esen
when ca e ins uc ions we e p o ided.[28]
Pa ien s’ and amily membe s’ sa is ac ion wi h counselling
me hods means ha hey we e con en wi h he counselling
si ua ion. Repo ed sou ces o sa is ac ion among pa ien s in-
cluded pe sonal counselling,
[30]
cla i y o ins uc ions,
[28,30]
unhu ied a mosphe e,
[28]
nu ses’ heo e ical and p ac ical
counselling compe ence,
[28,30]
nu ses’ a i ude,
[30]
adequacy
o counselling,
[20,21,30,42]
ime alloca ed o discussion wi h
nu ses
[28]
and pa ien counselling se ing.
[20,25,30]
Se e al
s udies asse ha he majo i y o pa ien s app ecia ed pa ien
counselling.
[20,25,30,39]
Almos all amily membe s ega ded
hei p esence in he counselling si ua ion as impo an .[43]
Some s udies epo ha pa ien s
[25]
and amily mem-
be s
[43]
we e sa is ied wi h he counselling du ing wai -
ing ime. Bo h pa ien s and amily membe s we e con-
en ha he e was adequa e counselling o he ca e
o he illness. Pa ien s we e also ound o be sa -
is ied wi h su icien counselling conce ning examina-
ions,
[25,28,30,39]
p ocedu es,
[25,28,44]
ca e
[20,28,30,31]
and pha -
maceu ical ca e.[25,28,31]
Sa is ac ion wi h counselling o ollow-up ca e means ha
acco ding o some s udies, pa ien s we e con en wi h he
counselling conce ning home and ollow-up ca e. Pa ien s e-
cei ed adequa e counselling a discha ge om hospi al.
[25,28]
Has ings, e al.,
[31]
o example, epo ha pa ien s we e
pleased wi h discha ge planning. Also amily membe s we e
sa is ied wi h counselling conce ning ollow-up ca e and,
acco ding o Salminen-Tuomaala, e al.
[43]
hey ound he
counselling su icien . One s udy asse s ha amily membe s
exp essed sa is ac ion wi h counselling conce ning a ious
se ices; hey app ecia ed he a ious o ms o suppo o -
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e ed o pa ien s and amilies by hospi al.
[32]
Clien s had
been bes in o med o he heal h se ices a ailable.[45]
3.3 De eloping he elemen s o good counselling
The li e a u e e iew also e ealed dissa is ac ion wi h he
counselling p o ided o pa ien s and amily membe s. Se -
e al a ge s o de elopmen we e iden i ied. To s a wi h,
pa ien s wished o mo e esou ces o pa ien counselling,
including addi ional acili ies, ime, s a esou ces and coun-
selling compe ence.
[20]
Lack o esou ces esul ed in dis-
con en ; pa ien s obse ed, among o he hings, ha he e
was a lack o ins umen s and ha he pe sons who p o ided
counselling kep changing
[20]
and he ime alloca ed o coun-
selling was limi ed.[20,30]
Some s udies s a e ha pa ien s wished o mo e in o ma ion
du ing he wai ing ime. They wan ed o ha e an es ima e o
how long hey would be equi ed o wai
[25,46,47]
and in o -
ma ion o how o ac du ing he wai ing ime.
[25,28,30]
No
knowing he expec ed leng h o he wai ing pe iod o easons
o ha ing o wai caused some discon en .[44]
A ew s udies disclosed a need o mo e counselling o he
ca e o heal h p oblems. In one s udy, pa ien s wished o
mo e in o ma ion conce ning hei illness, p ognosis, p oce-
du es, insu ance eimbu semen ,
[30]
medica ion and e ec
o medicines.
[25]
Fu he s udies e ealed ha pa ien s we e
dissa is ied wi h counselling conce ning he cause o hei
illness, hei p ognosis, isk ac o s, ea men op ions, com-
plica ions ollowing he ea men , examina ion esul s,
[20]
he illness, i s symp oms and ollow-up ca e.
[46]
Family mem-
be s wished o mo e in o ma ion conce ning changes in he
pa ien ’s condi ion
[34,36]
and eco e y.
[37]
Family membe s
we e also ound o expec mo e counselling ega ding he
ca e o illness, including ca e o he pa ien ,
[35–38]
medica-
ion[34] and he expec ed ou comes.[37]
Bo h pa ien s and amily membe s wished o mo e high
quali y p o ision o in o ma ion. This means ha amily
membe s’ wished o he in o ma ion o be u h ul,
[35,38]
comple e
[38]
and open.
[34]
The need o de elop o al coun-
selling was also men ioned.
[41]
Dissa is ac ion and insecu i y
we e oiced by hose who el ha he in o ma ion p o ided
was lacking,
[34,38,44,47]
nu ses’ non- e bal communica ion in
con lic wi h e bal in o ma ion
[48]
and he o al and w i en
ins uc ions
[41]
o ins uc ions gi en by a ious s a mem-
be s[30] incompa ible.
Pa ien s and amily membe s wished o mo e counselling
o ollow-up ca e. Acco ding o Chin-Yen, e al.
[27]
o be
able o cope a home, bo h pa ien s and amily membe s e-
qui e in o ma ion o he pa ien ’s condi ion and ca e. Mo e
speci ically, some amily membe s wan ed mo e in o ma ion
abou ans e plans,
[36,41]
o ally p o ided counselling con-
ce ning he ollow-up ca e,
[45]
e en mo e w i en ins uc ion
on he ollow-up ca e.[21,34,43,45]
Family membe s’ wish o mo e good in e ac ion in ol es
hei wish o in e ac wi h hospi al s a and o be lis ened o
du ing he wai ing ime; acco ding o pa ien s, nu ses should
pay a en ion o he quali y o he in e ac i e si ua ions.
[34]
Family membe s’ wish o a human encoun e in ol ed an
idea o posi i e in e ac ion. I also became e iden ha amily
membe s’ capaci y o ecei e in o ma ion should be assessed
be o ehand.
[48]
Family membe s wan ed o know how hey
could assis he pa ien
[34]
and wha could be done a he
bedside.
[36,37]
On he o he hand, amilies’ nega i e a i ude
owa ds counselling de e io a ed in e ac ion and counselling
ac i i y.
Finally, amily membe s wished o mo e counselling o sup-
po hei own coping. Acco ding o se e al s udies, amily
membe s we e dissa is ied wi h he suppo p o ided o pe -
sonal coping, unde s anding emo ions
[41]
and dealing wi h
ea s[30] and el ha hey did no ecei e su icien in o ma-
ion ega ding hei coping.[41,45]
3.4 Impac o he pa ien counselling elemen s
The in o ma ion deli e ed had a good impac , as he amoun
o esponsible in o ma ion inc eased. Chin-Yen, e al.
[27]
epo ha pa ien counselling was he co ne s one o sel -
ca e. Acco ding o o he s udies, oo, pa ien counselling
inc eased clien s’ in o ma ion and esponsibili y o ca e
[20]
and acili a ed hei decision-making.[37,49]
Pa ien counselling had a posi i e psychological impac . Fam-
ilies epo ed ha being suppo ed
[48]
and becoming awa e
o one’s esou ces and s eng hs
[25]
we e empowe ing ex-
pe iences. Pa ien counselling was also ound o imp o e
pa ien s’ a i udes
[20,30]
and commi men o ca e.
[25]
As o
amily membe s, in o ma ion conce ning pa ien s a ec ed
hem in mul iple posi i e ways, o example by educing
hei anxie y,
[37,49]
dep ession and pos - auma ic s ess.
[49]
In o he wo ds, pa ien counselling was ound o dec ease
nega i e mood.
Finally, acco ding o some s udies, pa ien counselling also
had some impac on pa ien ’s in luence o e ca e and on
in o ma ion ecei ed by amily membe s. Counselling was
o some ex en ound o be o bene i o decision-making
conce ning ca e.
[20,30]
A s udy sugges s ha he leas use ul
counselling in ol ed being in o med o he exis ence o w i -
en ma e ial a he clinic and lea ning whe e one could seek
u he in o ma ion i equi ed.[32]
Published by Sciedu P ess 101
www.sciedu.ca/cns Clinical Nu sing S udies 2015, Vol. 3, No. 3
4. DISCUSSION
4.1 Conside a ion o he esul s
The e is cu en ly li le esea ch on sho - e m counselling
o pa ien s and amily membe s and on counselling du ing
acu e heal h changes. The a icles discussed in his e iew
deal wi h pa ien counselling gi en in eme gency and ou -
pa ien clinics and in ensi e ca e uni s; ha is, in se ings
whe e counselling can be assumed o be o sho du a ion
and pa ien s ha e unde gone an acu e change in heal h s a us.
The elemen s desc ibed in his a icle seem o ep esen he
ollowing co ne s ones o good pa ien counselling: indi id-
ualized, pa ien -cen ed ac i i y, mul iple me hods, con i-
bu ion o a ious p o essional g oups, in e ac ion and p o i-
sion o in o ma ion. E en in indi idualized, pa ien -cen ed
counselling, howe e , he pa ien s’ willingness o in ol e
amily membe s may a y. In one s udy,
[25]
app oxima ely
hal o he pa ien s wan ed hei amily membe s o be in-
o med o hei illness, s a us o ca e. In o he s udies, he
majo i y o he pa ien s we e pleased o ha e hei amily
membe s p esen du ing pa ien counselling.
[25,28]
Ano he
inding is he essen ial ole o w i en ins uc ions as a pa-
ien counselling me hod. The s udy con i ms ha ecei ing
in o ma ion is a undamen al ea u e o counselling,
[35–38]
which makes i all he mo e impo an o p o ide high quali y,
su icien , comp ehensible and imely in o ma ion.
The s udy e eals bo h con en and discon en wi h he el-
emen s o pa ien counselling. Fo example, pa ien s and
amily membe s o en exp ess sa is ac ion wi h pa ien coun-
selling si ua ions, bu also dissa is ac ion due o insu icien
in o ma ion and con lic ing aspec s o counselling. Family
membe s wish o mo e high quali y p o ision o in o ma ion
and o he de elopmen o o al pa ien counselling. Pa ien s
commonly seem pleased wi h nu sing s a ’s counselling
compe ence, bu a s udy by Kää iäinen, e al.
[20]
epo s
pa ien s’ wish o he imp o emen o nu ses’ counselling
skills. Some s udies documen pa ien s’ sa is ac ion wi h
he ime esou ces, scope and se ing o pa ien counselling,
whe eas o he s epo pa ien s’ expe iences o lacking e-
sou ces and limi ed counselling ime. Acco ding o some
indings, pa ien s a e pleased wi h he counselling p o ided
du ing wai ing ime, while o he s e eal dissa is ac ion and
an expec a ion o mo e in o ma ion. Bo h pa ien s and am-
ily membe s gene ally appea o be sa is ied wi h counselling
o he ca e o illness, bu an analysis o hei de elopmen
ideas also e eals some discon en and a need o ecei e mo e
in o ma ion conce ning illness. In a simila ein, many pa-
ien s seem pleased wi h home ca e counselling, bu some
wish o mo e in o ma ion on home ca e ins uc ions. Family
membe s also exp ess con en wi h ollow-up ca e coun-
selling, bu many o hem s ill wish o mo e counselling and
w i en ins uc ions on he pa ien ’s ollow-up ca e. The con-
lic ing iews ega ding he elemen s o counselling could be
associa ed wi h di e ences in he quali y o counselling bu
also wi h clien s’ di e en manne s o p o iding eedback.
The in o ma ion ha pa ien s and amily membe s ecei ed
du ing counselling had a posi i e impac , no only in he
o m o inc eased unde s anding bu also psychologically.
These esul s con i m he impo ance o pa ien counselling.
4.2 Resea ch eliabili y and e hics
This li e a u e e iew in ol es knowledge om 30 scien i ic
publica ions on sho - e m amily and pa ien counselling
du ing acu e heal h change. The sea ch e ms, selec ed on
he basis o he esea ch ques ion, we e as b oad as possible.
The elec onic sea ch p ocess was conduc ed wi h assis ance
om an in o ma ion specialis using he da abases Melinda,
Medic, Cinahl, Pubmed and Psycin o. Se e al sea ches wi h
a wide pe spec i e and addi ional sea ch e ms we e neces-
sa y o collec su icien da a. The s udy is an in eg a i e li e -
a u e e iew, which acco ding o To aco
[50]
enables gaining
in o ma ion om mul iples sou ces and pe spec i es. This
inc eases he eliabili y o he s udy. The sea ch and ana-
ly ical p ocess we e desc ibed ca e ully o u he inc ease
eliabili y. Only s udies w i en in Finnish o English we e
included, which may be seen as a limi ing ac o .
[20]
How-
e e , he eliabili y o his s udy is s eng hened by good
esul s in he quali y e alua ion o he publica ions, ca ied
ou sys ema ically ollowing he quali y c i e ia p oposed by
he Joanna B iggs Ins i u e.[16]
The eliabili y o he esul s may be a ec ed by he inclusion
o some s udies,
[20,21,30,41,45]
in which pa o he pa ien s
and amily membe s had ecei ed counselling in a wa d.
Secondly, al hough counselling p o ided by medical s a
only was one o he exclusion c i e ia, one o he a icles[23]
in ol ed doc o s (n= 2) besides nu ses (n= 18) and amily
membe s (n= 26). On he o he hand, eliabili y is enhanced
by he inclusion o i e li e a u e e iews
[26,34,36,37,40]
as pa
o he da a. Ca e ul induc i e con en analysis was conduc ed
o analyse he da a. The p ima y au ho pe o med a p elimi-
na y analysis, whose esul s we e discussed in he esea ch
eam a se e al poin s du ing he analysis. The esea ch
p ocess has been conduc ed hones ly, using e hically sound
esea ch me hods.[51]
5. CONCLUSION
The esea ch esul s: elemen s o good pa ien counselling,
sa is ac ion wi h he elemen s o good pa ien counselling, de-
eloping he elemen s o good pa ien counselling and impac
o he pa ien counselling elemen s, can be gene alised and
102 ISSN 2324-7940 E-ISSN 2324-7959
www.sciedu.ca/cns Clinical Nu sing S udies 2015, Vol. 3, No. 3
applied o a ious pa ien and amily counselling si ua ions in
heal h se ices. The con lic ing esul s ega ding counselling
elemen s and hei de elopmen indica e a need o de elop a
uni o m, sys ema ic pa ien counselling me hod. The quali y
o counselling appea s o a y a g ea deal; e o s should
be made o imp o e counselling by using mul iple me hods,
by ocussing on indi idual pa ien s’ li e si ua ion and by
p o iding in o ma ion in good in e ac ion wi h pa ien s and
amilies. Success in hese e o s will inc ease he impac
o counselling. Fu he mo e, a shi is equi ed om pa ien
counselling owa ds amily counselling. In u u e, he e will
be g ea e in ol emen o amilies in he ca e o pa ien s, as
he popula ion is ageing, hospi al pe iods a e ge ing sho e
and he need o home ca e is inc easing. Nu ses will be
expec ed o de elop hei compe ence in amily counselling
me hods. The de elopmen o an e alua ion ins umen is
also p oposed o examine he quali y o pa ien counselling,
o s udy and de elop counselling in e en ions and possi-
bly o e alua e how a u u e, sys ema ic counselling me hod
migh con ibu e o he quali y o counselling and ca e.
REFERENCES
[1]
Kuisma M, Holms öm P, Nu mi J, e al. Eme gency ca e. [3 d en.
ed.] Helsinki: Sanoma P o Oy; 2013. 783 p.
[2]
Kää iäinen M, Kyngäs H. Concep analysis o counselling in nu sing
science. Hoi o iede. 2005; 17(5): 250-8.
[3]
Elo an a T, Vi kki S. Ohjaus hoi o yössä. [Educa ion and counselling
in nu sing.] La ia: Li onia P in ; 2011. 112 p.
[4]
Kää iäinen M. Po ilasohjauksen laa uun aiku a a ekijä . [The
ac o s associa ed wi h he quali y o pa ien counseling.] Tu ki a
Hoi o yö. 2008; 6(4): 10-5.
[5]
Johansson K, Nuu ila L, Vi anen H, e al. P eope a i e educa ion
o o hopaedic pa ien s: sys ema ic e iew. J Ad anced Nu s. 2005;
50(2): 212-23.
[6]
Wong EM, Chan SW, Chai S. E ec i eness o an educa ional in e -
en ion on le els o pain, anxie y and sel -e icacy o pa ien s wi h
musculoskele al auma. J Ad anced Nu s. 2010; 66(5): 1120-31.
[7]
Kyngäs H, Kää iäinen M, Poskipa a M, e al. Educa ing and coun-
selling in nu sing. 1s ed. Po oo, Finland: Wsoy; 2007. 160 p.
[8]
Ås ed -Ku ki P, Jussila A-L, Koponen L, e al. Towa ds good nu sing
ca e o he amily. 1s ed. Helsinki, Finland: WSOY Oppima e iaali
Oy; 2008. 158 p.
[9]
Chui WY-Y, Chan SW-C. S ess and coping o Hong Kong Chinese
amily membe s du ing a c i ical illness. J Clin Nu s. 2007; 16: 372-
81. PMID:17239073.
h p://dx.doi.o g/10.1111/j.1365-2
702.2005.01461.x
[10]
Hubley J. Pa ien educa ion in he de eloping wo ld – a discipline
comes o age. Pa ien Educ Couns. 2006; 61: 161-4. PMID:16533684.
h p://dx.doi.o g/10.1016/j.pec.2005.02.011
[11]
Paa ilainen E. Pe he ie aana sai aalassa [The amily as a isi o
in hospi al] in: Jallinoja R (ed.) Vie as pe heessä. [S ange in he
amily.] Helsinki: Gaudeamus; 2009. 291 p.
[12]
G i in J, McKenna K, Too h L. W i en heal h educa ion ma e ials:
making hem mo e e ec i e. Aus Occup The J. 2003; 50: 170-7.
h p://dx.doi.o g/10.1046/j.1440-1630.2003.00381.x
[13]
Whi emo e R, Kna l K. The in eg a i e e iew: upda ed me hodol-
ogy. J Ad Nu s. 2005; 52 (5): 546-53.
h p://dx.doi.o g/10.
1111/j.1365-2648.2005.03621.x
[14]
Poli DF, Beck CT. Nu sing Resea ch. Gene a ing and assessing e i-
dence o nu sing p ac ice. 9 h ed. Philadelphia: Lippinco Williams
& Wilkins; 2012. 796 p.
[15]
Flinkman M, Salan e ä S. In eg oi u ka saus – e i me odeilla ehdyn
u kimuksen yhdis äminen ka sauksessa [In eg a i e e iew- com-
bining esea ch conduc ed by di e en me hods] in: Johansson K,
Axelin A, S ol M, Ää i R-L (eds.) Sys emaa inen ki jallisuuska saus
ja sen ekeminen. [A sys ema ic li e a u e e iew and how o w i e i ]
Tu un yliopis o. Hoi o ie een lai oksen julkaisuja. Tu kimuksia ja a-
po eja A: 51. Tu ku, Finland: Digipaino Tu un yliopis o [Uni e si y
o Tu ku]; 2007. 120 p.
[16]
The Joanna B iggs Ins i u e. Joanna B iggs Ins i u e Re iewe s’ Man-
ual: 2011. A ailable om:
h p://www.joannab iggs.edu.au/
Documen s/suma i/Re iewe s%20Manual-2011.pd
[17]
Elo S, Kyngäs H. The quali a i e con en analysis p ocess. J Ad
Nu s. 2008; 62(1): 107-15.
h p://dx.doi.o g/10.1111/j.1
365-2648.2007.04569.x
[18]
Kylmä J, Rissanen ML, Laukkanen E, e al. Aineis oläh öisellä sisäl-
lönanalyysilla ie oa näy öön pe us u an hoi o yön kehi ämiseen.
[Induc i e con en analysis as a me hod o gene a ing knowledge o
de elopmen o nu sing.] Tu ki a Hoi o yö. 2008; 6(2): 23-9.
[19]
Kylmä J, Ju akka T. Laadullinen e eys u kimus. [Quali a i e heal h
esea ch.] Helsinki, Finland: Edi a; 2012. 190 p.
[20]
Kää iäinen M, Kyngäs H, Ukkola L, e al. Po ilaiden käsi yksiä hei-
dän saamas aan ohjaukses a. [The concep ions o pa ien s conce ning
counselling.] Tu ki a Hoi o yö. 2005; 3(1): 10-5.
[21]
Johansson K, Leino-Kilpi H, Salan e ä S, e al. Need o change in
pa ien educa ion: a Finnish su ey om he pa ien ’s pe spec i e.
Pa ien Educ Couns. 2003; 51: 239-45.
h p://dx.doi.o g/10.
1016/S0738-3991(02)00223-9
[22]
Ku ash M, No h op L. Family membe s’ expe iences o he in-
ensi e ca e uni wai ing oom. J Ad Nu . 2007; 60(4): 384-8.
h p://dx.doi.o g/10.1111/j.1365-2648.2007.04388.x
[23]
Po inka a H, Ås ed -Ku ki P. Tiedon an aminen k ii ises i sai aan
po ilaan läheisille. [In o ma ion gi en o a c i ical pa ien ’s nex o
kin.] Suomen Lääkä ileh i. 2005; 60(25-26): 2779-82.
[24]
Koonce T, Giuse NB, S o ow AB. A pilo s udy o e alua e lea n-
ing s yle- ailo ed in o ma ion p esc ip ions o hype ensi e eme -
gency depa men pa ien s. J Med Lib Assoc. 2011; 99(4): 280-9.
h p://dx.doi.o g/10.3163/1536-5050.99.4.005
[25]
Paa ilainen E, Salminen–Tuomaala M, Ku ikka S, e al. Expe iences
o counselling in he eme gency depa men du ing he wai ing pe iod:
impo ance o amily pa icipa ion. J Clin Nu s. 2009; 18: 2217-24.
h p://dx.doi.o g/10.1111/j.1365-2702.2008.02574.x
[26]
Szpi o KM, Ha ison MB, Van Den Ke kho EG, e al. Pa ien educa-
ion in he eme gency depa men : a sys ema ic e iew o in e en-
ions and ou comes. Ad Eme g Nu s J. 2008; 30(1): 34-49.
h p:
//dx.doi.o g/10.1097/01.TME.0000311544.03280.79
[27]
Chin-Yen H, Ba na d A, Chapman H. Eme gency depa men nu ses’
unde s anding and expe iences o implemen ing discha ge planning.
J Ad Nu s. 2009; 65(6): 1283-92.
h p://dx.doi.o g/10.1111
/j.1365-2648.2009.04988.x
[28]
Salminen-Tuomaala M, Kaappola A, Ku ikka S, e al. Po ilaiden
käsi yksiä ohjaukses a ja ki jallis en ohjeiden käy ös ä päi ys yspo-
Published by Sciedu P ess 103
www.sciedu.ca/cns Clinical Nu sing S udies 2015, Vol. 3, No. 3
liklinikalla. [Pa ien s‘ pe cep ions o counselling and w i en home
ca e ins uc ions a he eme gency depa men .] Tu ki a Hoi o yö.
2010; 8(4): 21-8.
[29]
Messne ER, Reck DL, Cu ci KM. E ec i eness o a pa ien educa-
ion b ochu e in he eme gency depa men . Top Eme g Med. 2005;
27(4): 251-5.
[30]
Isola A, Backman K, Saa nio R, e al. Iäkkäiden kokemuksia saa-
mas aan po ilasohjaukses a e ikoissai aanhoidossa. [Elde ly pe sons’
expe iences o pa ien counseling in specialized ca e.] Hoi o iede.
2007; 19(2): 51-62.
[31]
Has ings S, S ecguchak K, Oddone E, e al. Olde e e ans and eme -
gency depa men discha ge in o ma ion. BMJ Qual Sa . 2012; 21:
835-42. h p://dx.doi.o g/10.1136/bmjqs-2011-000538
[32]
Ne alainen A, Kaunonen M, Ås ed -Ku ki P. Syöpäpo ilaan läheisen
hoi ohenkilökunnal a saama iedollinen uki polikliinisessa hoidossa.
[In o ma ional suppo ecei ed by cance ou pa ien s‘ signi ican
o he s om he nu sing pe sonnel.] Hoi o iede. 2007; 19(4): 192-201.
[33]
Wiman E, Wikbland K, Id all E. T auma pa ien s’ encoun e s wi h
he eam in he eme gency depa men -a quali a i e s udy. In J Nu s
S ud. 2007; 44: 714-22. PMID:16549070.
h p://dx.doi.o g/1
0.1016/j.ijnu s u.2006.01.014
[34]
Nikki L, Paa ilainen E. Läheis en hoi oon osallis uminen
päi ys yspoliklinikalla – ki jallisuuska saus. [Family membe s‘ pa -
icipa ion in ca e in an eme gency depa men : e iew.] Hoi o iede.
2010; 22(4): 312-23.
[35]
Maxwell KE, S uenkel D, SAylo C. Needs o amily membe s
o c i ically ill pa ien s: a compa ison o nu se and amily pe -
cep ions. Hea Lung. 2007; 36: 367-76. PMID:17845883.
h p:
//dx.doi.o g/10.1016/j.h lng.2007.02.005
[36]
Ve haege S, De oo T, Van Zuu en F, e al. The needs and expe-
iences o amily membe s o adul pa ien s in an in ensi e ca e
uni : a e iew o he li e a u e. J Clin Nu s. 2005; 14: 501-9.
h p://dx.doi.o g/10.1111/j.1365-2702.2004.01081.x
[37]
Van Ho n ER, Kau z D. P omo ion o amily in eg i y in he acu e
ca e se ing: a e iew o he li e a u e. Dimens C i Ca e Nu s.
2007; 26(3): 101-7.
h p://dx.doi.o g/10.1097/01.DCC.00
00267803.64734.c1
[38]
Ve haeghe STL, Van Zuu en FJ, De loo T, e al. How does in-
o ma ion in luence hope in amily membe s o auma ic coma
pa ien s in in ensi e ca e uni ? J Clin Nu s. 2007; 16: 1488-97.
h p://dx.doi.o g/10.1111/j.1365-2702.2006.01807.x
[39]
Palonen M, Aho AL, Koi is o A-M, e al. Hoi oisuuden yh eys
po ilaiden a ioihin ohjaukses a e ikoissai aanhoidon aikuispolik-
linikoilla. [The associa ion be ween pa ien acui y and pa ien s‘
assessmen s abou counselling in adolescen ambula o y ca e.]
Hoi o iede. 2012; 24(2): 114-24.
[40]
Kaila A. Ai o e enkie ohäi iöön sai as uneen ja hänen omaisensa
ukeminen ja ohjaus hoi o yössä -me asyn eesi. [Suppo and coun-
selling o s oke pa ien s and ca egi e s in nu sing li e a u e – me a-
syn hesis.] Hoi o iede. 2009; 21(1): 3-12.
[41]
Au a M, Paa ilainen E, Asikainen P, e al. Aikuispo ilaiden läheis en
kokemuksia hoi o yön ekijöil ä saadus a ues a. [Expe iences o he
amily membe o an adul pa ien on he suppo ecei ed om he
nu sing s a .] Tu ki a Hoi o yö. 2010; 8(2): 14-21.
[42]
Ekwall A, Ge d z M, Manias E. Anxie y as a ac o in luencing
sa is ac ion wi h eme gency depa men ca e: pe spec i es o accom-
panying pe sons. J Clin Nu s. 2009; 18: 3489-97.
h p://dx.doi
.o g/10.1111/j.1365-2702.2009.02873.x
[43]
Salminen-Tuomaala M, Ku ikka S, Ko kiamäki K, e al. Po ilaiden
saa ajien ohjauksen a e päi ys yspoliklinikalla. [Pa ien s’ esco s’
need o counselling in he eme gency clinic.] Hoi o iede. 2008; 20(5):
258-66.
[44]
Pellikka H, Lukka inen H, Isola A. Po ilaiden käsi yksiä hy äs ä
hoidos a yh eispäi ys yksessä. [Pa ien s’ iews o good nu sing ca e
in an eme gency uni .] Hoi o iede. 2003; 15(4): 166-79.
[45]
Ma ila E, Kaunonen M, Aal o P, e al. Sai aalapo ilaiden läheis en
uki ja siihen yh eydessä ole a ekijä . [Suppo o hospi al pa ien s’
signi ican o he s and ac o s associa ed wi h i .] Hoi o iede. 2009;
21(4): 294-303.
[46]
Vi anen P, Paa ilainen E, Helminen M, e al. Ai o e enkie opo i-
laan iedonsaan i ensiapupoliklinikalla. [How s oke pa ien s ge in-
o ma ion a he eme gency uni .] Hoi o iede. 2010; 22(4): 302-11.
[47]
Elmq is C, F idlund B, Ekebe gh M. On a hidden game boa d: he
pa ien ’s i s encoun e wi h eme gency ca e a he eme gency de-
pa men . J Clin Nu s. 2012; 21(17-18): 2609-16.
h p://dx.doi
.o g/10.1111/j.1365-2702.2011.03929.x
[48]
Fon ana JS. A sudden, li e- h ea ening medical c isis: he amily’s
pe spec i e. Ad Nu s Sci. 2006; 29(3): 222-31. PMID:17139204.
h p://dx.doi.o g/10.1097/00012272-200607000-00005
[49]
Cu is JR, Ciechanowski PS, Dowey L, e al. De elopmen and e alu-
a ion o an in e p o essional communica ion in e en ion o imp o e
amily ou comes in he ICU: Con emp Clin T ials. 2012; 33: 1245-54.
h p://dx.doi.o g/10.1016/j.cc .2012.06.010
[50]
To aco R. W i ing in eg a i e li e a u e e iews: Guidelines and
examples. Hum Resou ce De Re . 2005; 4(3): 356-367.
h p:
//dx.doi.o g/10.1177/1534484305278283
[51]
TENK, Tu kimusee inen neu o elukun a. [The Finnish Ad iso y
Boa d on Resea ch In eg i y] Hy ä ie eellinen käy än ö ja sen
loukkausepäilyjen käsi eleminen Suomessa. [Responsible conduc
o esea ch and p ocedu es o handling allega ions o misconduc in
Finland.] 2012. A ailable om:
h p://www. enk. i/si es/ e
nk. i/ iles/HTK_ohje_2012.pd (24.3.2014)
104 ISSN 2324-7940 E-ISSN 2324-7959