cns.sciedup ess.com Clinical Nu sing S udies 2017, Vol. 5, No. 3
REVIEWS
The in isibili y o he pa ien ’s amily in nu sing
documen a ion: An in eg a i e e iew
Heleena Lai inen∗1, Eija Paa ilainen2,3
1Tampe e Uni e si y o Applied Sciences, Tampe e, Finland
2Facul y o Social Sciences/Hea h Sciences, Uni e si y o Tampe e, Tampe e, Finland
3Sou h Os obo hnia Hospi al Dis ic , Seinäjoki, Finland
Recei ed: Ap il 2, 2017 Accep ed: July 4, 2017 Online Published: July 17, 2017
DOI: 10.5430/cns. 5n3p54 URL: h ps://doi.o g/10.5430/cns. 5n3p54
ABSTRACT
Objec i e:
The objec i e o his in eg a i e e iew is o p esen he cu en s a e o esea ch knowledge ega ding e e ences o
he pa ien ’s amily in documen a ion in heal h ca e se ings.
Me hods:
Ten (N = 10) esea ch a icles om 1998 o 2014 we e ound and analyzed using induc i e, hema ic analysis. All
a icles we e e alua ed using he c i ical app aisal ools de eloped by he Joanna B iggs Ins i u e (JBI).
Resul s:
Two main hemes we e e ealed: he con en and he s uc u al aspec s o amily documen a ion. Quan i a i e, quali a i e
and mixed me hods we e used in gene a ing he da a o he e iewed a icles. Re e ence o amilies in documen a ion was
conside ed impo an in all he a icles. S uc u al aspec s consis ed o semi-s uc u ed o ms, summa y no es and a ick-box
sys em o ma king he issues which we e discussed wi h amilies. The classi ica ion sys em and ou comes assessmen ega ding
amily documen a ion we e in es iga ed, and hei impo ance was highligh ed. The con en o amily documen a ion was ypi ied,
o example, by pa en ing issues in men al heal h s a us and how he pa en s cope when a child is ill. Di icul li e si ua ions and
ad anced ca e planning b ough amilies in o he documen a ion, albei a he in equen ly. Simila ly, e e ences o counseling
amilies o conside ing hei psychosocial, spi i ual and cul u al dimensions we e a ely ound in he li e a u e. Addi ionally, he
amily’s impo ance in suppo ing he pa ien ’s ca e was o en missed in documen a ion.
Conclusions:
The esul s show he necessi y o de eloping bo h amily nu sing and i s documen a ion. Consequen ly, in o de o
imp o e he quali y o bo h o hese, mo e in es iga ion om mul iple pe spec i es is needed.
Key Wo ds:
Pa ien ’s amily, Family nu sing, Nu sing documen a ion, Family documen a ion, Pa ien eco ds, In eg a i e
li e a u e e iew
1. INTRODUCTION
The aim o amily nu sing is o help bo h pa ien s and ami-
lies main ain a suppo i e ela ionship in heal h ca e.
[1,2]
The
ocus o amily nu sing is on bo h he pa ien ’s and he amily
membe s’ conce ns in a ious heal h/illness si ua ions.
[2,3]
I
is also impo an o unde s and ha amily nu sing includes
he en i e y o a pe son’s li espan, hus applying o pa ien s
om child ca e o elde ly ca e in all heal h ca e se ings.
[3]
The impo an goal in all i s phases is o p omo e he well-
being o he whole amily.
[3]
In his in eg a i e li e a u e
e iew, he ocus is on e ealing how he p esence o he
pa ien ’s amily is documen ed in pa ien eco ds.
The impo ance o collabo a ion be ween hospi al s a and
pa ien s’ amily membe s has been s udied widely.
[4–7]
The
bond be ween amily membe s is undamen al. When pa-
ien s a e in hospi al, hey a e s ill membe s o hei am-
∗Co espondence: Heleena Lai inen; Email: [email p o ec ed]; Add ess: Vellamonka u 22 A 21, 33500 Tampe e, Finland.
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ily. Pa ien s wo y abou hei amily membe s, and ice
e sa.
[8]
Being sepa a ed om amily membe s can lead o
dis ess as well as physical and psychological diso de s.
[9]
The impo ance o amily p esence and isi a ion is also
much app ecia ed in acu e c i ical si ua ions.
[10,11]
Smi h e
al.
[12]
indica ed ha open and lexible isi ing imes in in en-
si e ca e uni s inc eased bo h pa ien s’ and amily membe s’
sa is ac ion, leading o posi i e changes o all he amily.
Mo eo e , i is impo an ha adul pa ien s hemsel es de-
ine hei close amily membe s
[10]
and make he decisions
ega ding amily membe s’ pa icipa ion in hei ca e.
[13]
Family membe s a e o en he pa ien s’ legal ep esen a i es
and hus ac as ad oca es o he pa ien s in di icul heal h
si ua ions.
[14]
Fu he mo e, bo h pa ien s and amily mem-
be s need in o ma ional and emo ional suppo in o de o
cope a home.
[15]
In a s udy by Ma ila e al.,
[15]
he nu ses
suppo ed pa ien s and amilies, e.g., by ca ing, gi ing in o -
ma ion, and dealing wi h emo ional si ua ions. By ha ing a
suppo i e ela ionship wi h he nu ses, he amily membe s
el accep ed and a ailable o be in ol ed wi h hei close
one’s ea men . Howe e , when he suppo was inadequa e,
he amily membe s el hemsel es “ou side s” ega ding
he ea men gi en hei close ones.
[15]
Sha ing in o ma ion
wi h he amily membe s gi es hem an unde s anding o how
hey can cope in he a -home collabo a ion.
[16]
Ne e heless,
acco ding o Majasaa i e al.,
[17]
he pa ien ’s amily mem-
be s seem o be qui e in isible, e.g., in discha ge counseling
si ua ions.
Genuine pa ien - ocused documen a ion e eals he oice
o he pa ien s
[18]
and, as an in eg al pa o nu sing, docu-
men a ion has a c ucial place om he amily pe spec i e
as well.
[8,18,19]
B owning
[20]
s esses he impo ance o am-
ily documen a ion, which may be ad anced by elec onic
eco ds; documen a ion is a bene icial way o collec da a
om amily membe s o in e disciplina y collabo a ion.
Documen a ion o ele an in o ma ion in pa ien eco ds is a
legal esponsibili y wo ldwide. W i ing pa ien eco ds con-
ce ns all heal h ca e p o essionals.
[21]
The e a e occasions
in heal h ca e when au ho ized amily membe s ha e o ake
esponsibili y o making decisions on behal o he pa ien s,
e.g., because o he pa ien ’s heal h condi ion. In si ua ions
when pa ien s canno communica e, he e a e signi ican am-
ily issues which need o be documen ed.
[10]
When amily
membe s ake esponsibili y o he pa ien ’s ca e, he doc-
umen ed in o ma ion is essen ial.
[22]
Fo example, in he
coun y o he p esen au ho s, Finland, he s a us o close
ela i es o legal ep esen a i es as pa ien s’ ad oca es is
spelled ou in he law.[23]
Cu en heal h sys ems a e complex.
[8,24]
In he o ali y o
one ca e p ocess, pa ien s can be ea ed in nume ous uni s
wi h mul iple heal h p o essionals pa icipa ing.
[24]
In such
agmen ed and complex si ua ions, an e o needs o be
made o in ol e amily membe s in he pa ien ca e.
[24]
To suppo he con inui y, e ec i e documen a ion is e-
qui ed
[8,25,26]
and i is a way o bo h communica e wi h he
in e disciplina y p o essionals
[20]
and p omo e he pa ien s’
sa e y.[27]
Pa ien s hemsel es app ecia e when nu ses in ol e hei
amily membe s in hei ca e.
[19,28]
I has been shown ha i
was o en he pa ien s’ own ini ia i e in es ablishing ha hei
spouse could come o an admission mee ing wi h a nu se o
o a doc o ’s appoin men . This was a way o ha e emo ional
and in o ma ional suppo .
[8]
Family membe s’ pa icipa ion
in he pa ien ’s li e can be c ucial in he ime ahead,
[2,7,29]
as
hey a e he ones who p ima ily ake ca e o he pa ien s a
home a e discha ge; hence, hey need guidance and suppo
om compe en p o essionals.
[11,28,29]
When pa ien s and
hei amily membe s li e hei li es ou side o hospi als,
bu using heal h ca e se ices, he con inui y o high-quali y
ea men can be asce ained by means o accu a e documen-
a ion.
[8]
Such documen a ion is also needed when amily
membe s a e he pe manen ca egi e s o hei lo ed ones, in
o de o suppo all he pa ies in coping.[29–32]
In se e al p e ious s udies conce ning documen a ion, he
impo ance o amily membe s has been men ioned.
[33–35]
Also, amilies’ pa icipa ion was documen ed in ega d o
coo dina ing he con inui y o ca e.
[18]
Howe e , he ac ual
pa icipa ion o amily membe s in he pa ien ca e is, in gen-
e al, qui e b ie ly no ed in such documen a ion, e en hough
i has a c ucial ele ance o he pa ien ’s discha ge om
hospi al and su i al a home.
[36]
As pa o hei ac ion
esea ch, Okaisu e al.
[37]
included he amily nu sing pe -
spec i e in he hospi al admission p ocess in o de o imp o e
he documen a ion. So, he impo ance o pa ien s’ amily
membe s has been no iced as pa icipan s in he ea men ,
bu hei isibili y in documen a ion has emained on he
le el o men ioning.
Nu sing documen a ion has been ex ensi ely s udied and
many li e a u e e iews ha e p omo ed a as body o knowl-
edge om mul iple iewpoin s.
[34,38–43]
Howe e , he in-
e es o he au ho s o his pape has been piqued by he
appa en absence o any p e ious li e a u e e iew speci i-
cally ocusing on amily documen a ion. The e o e, he aim
o he au ho s he e is o conduc an in eg a i e li e a u e
e iew o he exis ing knowledge on his opic.
Pu pose o he s udy
This in eg a i e li e a u e e iew aims o desc ibe exis ing e-
sea ch knowledge ega ding documen a ion which has been
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done conce ning he amily while one o hem is a clien o
pa ien in some heal h ca e se ing.
The esea ch ques ion is: Wha is known abou amily docu-
men a ion in heal h ca e se ings?
2. METHODS
This s udy is based on an in eg a i e e iew me hod which
includes p oblem iden i ica ion, a li e a u e sea ch, da a e al-
ua ion, da a analysis and epo ing he esul s.
[44]
The in e-
g a i e e iew me hod is e y sui able o syn hesizing da a
a ailable in opics which ha e sca cely been s udied, such
as amily documen a ion. S udies included in an in eg a i e
e iew can be done by di e en esea ch me hods and he
esul s a e p esen ed in na a i e o m, o en by hema ic anal-
ysis. This app oach acili a es he acquisi ion o a de ailed
gene al unde s anding o a esea ch ocus. This unde s and-
ing can gene a e addi ional s udies o de elopmen in he
a ea.[45]
2.1 Da abase sea ch and selec ion o a icles
Da a sea ches we e pe o med wi h assis ance om an in o -
ma ion specialis a he Uni e si y o Tampe e lib a y. The
sea ch e ms we e ca e ully selec ed by he esea che s and
he in o ma ion specialis and he sea ches we e planned
and conduc ed oge he in he da abases Cinahl and Medline.
The sea ch e ms a e desc ibed in Figu e 1. The e ms we e
used in all possible combina ions, o enhancing inding o
all s udies which answe ou esea ch ques ion. A manual
sea ch was also conduc ed in e e ence lis s o a icles al-
eady selec ed o he e iew. Figu e 1 desc ibes he sea ch,
sea ch e ms and selec ion p ocesses o he da a o his s udy.
Da a sea ch and selec ion we e qui e complex, due o he lack
o s udies conce ning he opic, i.e., amily documen a ion.
Many s udies i s showed p omising bu a e eading hem,
hey we e no abou he opic o in e es . Excluded a icles
did no mee he inclusion c i e ia and a e no p esen ed.
Da a o he included a icles we e analyzed and desc ibed
in Table 1. The able consis s o he au ho s o he a icle,
coun y, c i ical app aisal; aims; me hods and pa icipan s o
he s udy; and he esul s ela ed o amily documen a ion,
educed om he o iginal s udies selec ed in his in eg a-
i e e iew. Da a included only o iginal a icles o hose
which we e pa o a la ge s udy bu epo ed as an indi-
idual s udy. The a icles we e published in Japan (n = 1),
Canada (n = 2), Aus alia (n = 2), Sweden (n = 1), he USA
(n = 2), No way (n = 1) and he Ne he lands (n = 1). Mixed-
me hod s udies (n = 2) used bo h a quan i a i e and quali a i e
app oach. The esea ch da a (N = 10 s udies) also include
s udies using only quali a i e (n = 5) o quan i a i e (n = 3)
app oaches. Resea ch conce ning amily documen a ion was
done in he con ex s o pa ien educa ion, heal h p omo ion,
ch onic illness, pallia i e ca e and men al heal h, conce ning
bo h child en and adul s.
2.2 Da a e alua ion
All selec ed a icles we e c i ically app aised using he c i e-
ia p esen ed by he Joanna B iggs Ins i u e (JBI). Sepa a e
assessmen c i e ia a e ou lined o quali a i e, quan i a i e
and mixed-me hod s udies.
[46]
Each assessmen ool has up
o 11 c i e ia s a emen s which we e hen e alua ed. The
quali y o a icles was accep able, a ying om 4 o 10
poin s; he poin s o each s udy a e desc ibed in mo e de ail in
Table 1. Howe e , hey we e he bes which we e a ailable
o his li le-s udied opic.
2.3 Da a analysis
Thema ic analysis
[47]
allows ecogni ion o signi ican opics
o p ominen hemes, as well as o ganized and s uc u ed
ways o dealing wi h he con en unde hese hemes. I also
allows in eg a ing he da a om quali a i e and quan i a i e
s udies, while summa izing he esul s o di e en s udies
unde hema ic headings, based on he da a. Thema ic, induc-
i e da a analysis was conduc ed o e eal he hemes among
he e iew a icles, based on he esea ch ques ion. In o de
o iden i y he hemes, he chosen a icles we e ead mul i-
ple imes.
[44,45,47,48]
Tex segmen s answe ing he esea ch
ques ion we e i s educed in Table 1 and a e ha named
and combined, acco ding o hei con en . Two main hemes
we e e ealed, desc ibing he con en and s uc u al aspec s
o he amily documen a ion.
3. RESULTS
In gene al, documen ing di e en aspec s o amilies, besides
he pa ien , was conside ed impo an in all pape s included
in his s udy. Two main hemes a e p esen ed in he ollow-
ing.
3.1 S uc u al aspec s o amily documen a ion
Family ca e was conside ed as one cen al domain o doc-
umen a ion.
[49]
Family ela ionships, desc ibing key pe -
sons in pa ien ca e, a e c ucial.
[50]
I is impo an ha he
documen ing sys em equi es who in he amily should be
included in he ca e o he pa ien .[51]
Nu ses’ no es, bo h in a semi-s uc u ed o ma and as sum-
ma y no es, a e essen ial o desc ibing high-le el amily-
cen e ed wo k.
[51]
Also, he use o ick boxes, while dis-
cussing impo an poin s o ca e wi h amilies, is essen ial.
[52]
A classi ica ion sys em in documen a ion is needed o s uc-
u ing he documen ed issues in a o ma which ad ances
hei use as he basis o ca e. Quali y indica o s
[49]
and de-
sc ibing ca e ou comes conce ning amilies
[53]
a e means o
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he assessmen o ca e. Heimendigge ’s s udy
[53]
con ained
a ious measu es, hus he indings om he documen a ion
we e no di ec ly wi hin each. Howe e , he s udy gi es
a wo hy pa e n o he use o documen a ion, including a
s anda dized me hodology o how issues a e discussed wi h
a pa ien ’s amily membe s and how hey a e documen ed.
Figu e 1. Da abase sea ches and da a selec ion, by inclusion and exclusion
3.2 Con en o amily documen a ion
Pa en ing issues comp ise an impo an aspec o he wo k
o communi y men al heal h nu ses, and he e is a need o
highligh he sys ema ic iden i ica ion o pa en al s a us in
men al heal h pa ien s.
[54]
Documen ing pa en ing issues is
conside ed impo an , e.g., pa en s exp essing di icul ies
in coping wi h hei ole in he con ex whe e hei child is
ill.
[54]
Miyashi a e al.
[49]
ound ha expec a ions o he am-
ily in discussing c ucial issues, e.g., abou do-no - esusci a e,
a e e y impo an o documen . Simila ly, Heyland e al.
[55]
emphasized he impo ance o documen ing ad anced ca e
planning o end-o -li e ca e. Howe e , e en hough pa ien s
and amily membe s exp essed p e e ences when asked abou
end-o -li e ca e, in almos 30% o he included da a hei
iews we e no documen ed.[55]
Family p esence du ing counseling,
[50]
amily- ocused nu s-
ing diagnoses
[56]
and psychosocial, spi i ual and cul u al
aspec s o pa ien and amily ca e
[57]
we e ound o be impo -
an o documen , howe e in equen ly his is ac ually done.
I was ound ha amily membe s a e a suppo i e esou ce
in ca e; howe e , his is no as well documen ed as i should
be.
[56]
Heimendigge
[53]
ound i impo an o documen
amily isi s and coaching con e sa ions wi h hem. Family
ad iso s documen ed he ime, da e, and loca ion o he isi ,
as well as amily membe pa icipa ion, pe sonal in ol emen
and amily dynamics du ing hose con e sa ions.[53]
Acco ding o Ro egå d,
[58]
he amily was men ioned in doc-
umen a ion om mo i a ional and p o ec i e pe spec i es
o how he pa ien el abou he amily, and especially con-
ce ning (1) he pa ien ’s child en, e.g., he wish o see hem
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g ow, and (2) he spouse, in ega d o issues such as wo y
and exhaus ion. Thus, i was an impo an aspec o desc ibe
he pa ien s’ eelings abou hei amily membe s.
The in ol emen o amilies in documen a ion o he ed-
uca ion p o ided a pa ien discha ge was in es iga ed by
Cook e al.
[50]
In he elec onic medical eco ds o pa ien
educa ion documen ed mos o en (n = 173), he equency
o pa ien and amily oge he was 23, while he equency
in ol ing he amily alone was qui e low (n = 3).
This li e a u e e iew showed disc epancies be ween nu sing
ca e and i s documen a ion. Hega y e al.
[57]
no ed ha he
amilies’ conce ns we e pa o he nu sing ca e, bu hese
conce ns only a ely showed up in he documen a ion. Ac-
co ding o Heyland e al.,
[55]
he p e e ences which pa ien s
and amilies exp essed we e no consis en wi h wha was
w i en in he documen a ion.
In he s udy by Ziege ,
[56]
he e ealed hemes emphasized
he amily membe s’ suppo i e esou ces, enabling hei
eadiness o con ibu e o he pa ien s’ home ca e and o
co-ope a e wi h hem in ha ca e.
4. DISCUSSION
4.1 Discussion o he esul s
I is impo an o emphasize ha he p esen au ho s’ ocus
was especially on amily nu sing documen a ion. While, in
gene al, pa ien documen a ion has been ho oughly in es i-
ga ed, cu iously, amily documen a ion
[18]
has no . Howe e ,
he e a e many s udies
[18,59]
which s ess he need o amily
documen a ion and ha e con ibu ed o he de elopmen o
amily documen a ion.
Wi h he excep ion o he s udy by Ziege e al.,
[56]
he e
we e no o he s udies concen a ing pu ely on amily doc-
umen a ion. Documen a ion was used as a da a collec ion
me hod, among o he s, in se e al s udies. Myashi a e al.
[49]
used medical cha s o ind quali y indica o s o cance pa-
ien s’ end-o -li e. Heimendinge e al.
[53]
assessed he ou -
comes o a coaching p og am, wi h he pu pose o p omo ing
a heal hy li es yle among schoolchild en. Ro egå d e al.[58]
in es iga ed he heal h asse s o cance pa ien s.
When a pa ien alls ill, he signi icance o he amily is
c ucial. On he basis o he esul s e ealed in he p esen
s udy, he impo ance o amily in ol emen in documen a-
ion should be s ongly emphasized. Howe e , he esul s o
his in eg a i e e iew, as well as o o he p e ious s udies,
ound ha he amilies in ac seem o be in isible in he
documen a ion. This was con i med in he li e a u e e iew
pe o med by Sa an o and Kinnunen.
[34]
The amily mem-
be s’ p esence was o en no ed in documen a ion, a some
le el, bu hey we e objec i ied. This is consis en wi h he
esul s o a s udy by Lai inen e al.[26]
Fu he mo e, Ree es e al.
[60]
obse ed ha e en hough
amily membe s a e o dina ily p esen in he ICU, hei day-
o-day in e ac ions wi h he in e p o essional ca e eam ha e
no been explo ed o documen ed. Documen ing cen al is-
sues conce ning he amily, besides he pa ien , is c ucial o
eamwo k enhancing high-quali y ca e. I is impo an o un-
de s and ha p o essional compe ence is no only knowledge
and skills in a specialized clinical a ea. The compe ence
needs o be shown in he skills o in e ac ion o communica-
ion wi h he pa ien s and in e disciplina y pa ne s.[8]
S udies included in his e iew desc ibe amily documen a-
ion as pa o he di e se in o ma ion e ie al. Pe sonal
expe ience as well as belie s, a i udes and mindse a e e-
lec ed in he w i ing.
[61,62]
The e is an old saying “i i is
no documen ed, i is no done”. This may e lec he ac
ha some heal h ca e p o essionals a e mo e ask-o ien ed
han pa ien - o amily-o ien ed. I heal h ca e p o essionals
and, e en mo e, he o ganiza ional hie a chies a e no ac-
coun able o hei pa ien s’ and amily membe s’ well-being
and ela ed documen a ion in he i s ins ance, hen a huge
amoun o aluable in o ma ion o he con inui y o ca e is
lacking.
[8]
The complexi y and agmen a ion o heal h ca e
a e acknowledged in p e ious li e a u e.
[8,11]
Consequen ly,
wi hou se ious concen a ion on amily membe s’ in ol e-
men in nu sing documen a ion, he sa e y and quali y o
he ca e p ocesses a e diminished. By aking ac ion owa ds
bo h amily nu sing p ac ice and ela ed documen a ion, he
con inui y o ca e would be imp o ed.
4.2 E hics and he eliabili y o he s udy
The au ho s o his pape ha e ollowed he guidelines o
esea ch e hics.
[63]
Since his is an in eg a i e e iew, he
ocus has been on anspa ency in he s udy p ocess.
[44]
The
wo au ho s bo h conduc ed he li e a u e e iew. The da a
sea ch was ca ied ou i s in collabo a ion wi h an in o -
ma ion specialis a he uni e si y lib a y. A wide ange o
key wo ds and sea ch e ms was used in a ious sea ch en-
gines. The au ho s decided o use only English language
e ms, a e no icing ha hei na i e language, Finnish, did
no gi e any esul s in ega d o he esea ch ques ion. Also,
a hand-sea ch was pe o med, which yielded one mo e a i-
cle. This can be conside ed as enhancing he eliabili y o
he da a sea ch, since he o al numbe o esea ch pape s
abou he opic emained small. All he s ages o he e iew
we e conduc ed in ag eed collabo a ion by bo h au ho s. This
e iew is he e o e limi ed o he su p isingly small numbe
o s udies pe aining o he e iew ques ion. Signi ican ly, o
he included a icles only one was pu ely ocusing on amily
nu sing documen a ion.
[56]
Howe e , his can be conside ed
as a esul , gi ing a wide-open ield o u he in es iga ions.
58 ISSN 2324-7940 E-ISSN 2324-7959

cns.sciedup ess.com Clinical Nu sing S udies 2017, Vol. 5, No. 3
Table 1. The s udies included in he in eg a i e e iew
Au ho (s), yea , coun y,
c i ical app aisal esul
Aims
Me hods and pa icipan s
Resul s desc ibing amily documen a ion
Ziege K, e al.[56]
2007, Sweden
8/10
To examine he p o essional suppo o
he nex o kin (NoK) o ch onic
haemodialysis pa ien s, as documen ed
in he pa ien eco ds.
 To al o i y (N = 50) pa ien eco ds, each
app oxima ely 100 pages. VIPS-model was he
o ganiza ion o he eco ds.
 Con en analysis
 amily’s ole should be documen ed in amily- ocused
nu sing diagnoses
 amily membe s a e a suppo i e esou ce in he nu sing
ca e
Cook L, e al.[50]
2008, USA
4/9
To assess he equency and na u e o
documen a ion o pa ien educa ion by
in e disciplina y s a in elec onic
medical eco ds.
 Re iew o elec onic medical eco ds o discha ged
inpa ien s (N = 244).
 Teaching in e en ion
 Quan i a i e analysis
 mos elec onic pa ien eco ds lack any pa ien educa ion
 i documen ed, was done by nu ses
 also some amily p esence du ing educa ion was
documen ed
 he sys em equi es who in he amily should be included
in he educa ional p ocess
Feeley N, e al.[51]
1998, Canada
6/10
To desc ibe he de elopmen o h ee
classi ica ion sys ems heal h conce ns o
he amilies, s a egies
o a ain he goals and he obse ed
ou comes.
 In e en ion
 Rec ui ed and consen ed amilies (N = 332)
andomly selec ed amilies wi h ch onically ill
child, assigned o in e en ion g oup (n = 171) o
con ol g oup (n = 161)
 Con en analysis
 documen a ion should be done abou he ac ions he
nu ses ake o help amilies achie e hei goals
 nu ses’ no es (semi-s uc u ed o ma ): desc ip ion o he
amily’s cu en si ua ion, he nu se’s assessmen ,
s a egies o in e en ion, any ou comes o changes
no ed
 summa y no e: b ie summa y o he majo ea u es o he
wo k wi h each amily
Hega y M, e al.[57]
2005, Aus alia
9/10
To explo e di e gences be ween nu ses'
knowledge and hei documen a ion in
pallia i e ca e.
 Re ospec i e case-no es o deceased pa ien s
(n = 20)
 in e iews o he nu ses who we e in ol ed wi h
pa ien s’ ca e
 Quali a i e in e iews
 Quan i a i e audi
 psychosocial, spi i ual and cul u al aspec s o ca e a e
in equen ly documen ed
Heimendinge J, e al. [53]
2007, USA
7/10
To assess he ou comes o a coaching
p og amme, aiming o p omo e heal hy
die s and physical ac i i ies among
school child en.
 Eigh y-eigh (N = 88) ec ui ed amilies we e
andomly chosen o an in e en ion g oup and a
‘delayed-con ol condi ions’.
 S a is ical analysis
 Quali a i e in e iews
 Cha e iew.
 documen ing he isi s, coaching con e sa ions
 amily ad iso s documen ed ime, da e, loca ion o he
isi , amily membe a endance, indi idual deg ee o
in ol emen , and amily dynamics
Van Loo M, e al.[52]
2008, UK
7/10
To assess he equency o ini ia ion and
non-ini ia ion o discussion abou issue
dona ion wi h suddenly be ea ed
ela i es, by eme gency nu ses.
 Pa ien s’ compu e ized case no es (n = 242)
 S a is ical analysis
 nu ses eco ded no es on he compu e , using a ick box
when hey discussed issue dona ion wi h he ela i es
 he ini ia ion episodes by indi idual nu ses occu ed
occasionally om one episode o eigh ; he non-ini ia ion
episodes occu ed om one o eigh een
Ro egå d A, e al.[58]
2012, No way
7/10
To desc ibe heal h asse s based on
analysis o nu sing documen a ion in
cance pa ien s’ eco ds.
 Con en analysis
 amily was men ioned in documen a ion ega ding
ela ional, mo i a ional, and p o ec i e pe spec i es
conce ning how he pa ien el abou he amily
 we e connec ed wi h child en (wish o see hem g ow,
says ha hey handle he illness well), and spouse (is
wo ied abou he /him, sees ha he spouse is exhaus ed)
Heyland DK, e al.[55]
2013, Canada
6/9
To de e mine he p e alence o an
ad anced ca e plan and i s componen s,
om he pe spec i es o acu ely ill
pa ien s and hei amily membe s,
To de e mine he conco dance be ween
he pa ien s’ wishes and he ca e plan
documen ed in he medical eco d.
To assess he pa ien s’ and amily
membe s’ o e all sa is ac ion wi h end
o li e communica ion and decision
making du ing he las ou weeks.
 278/513 pa ien s (54.2%)
 225/366 amily membe s (61.5%) in 12 acu e ca e
hospi als
 In e iews wi h pa ien s and amily membe s using
a ques ionnai e;
 The medical eco d e iew immedia ely a e he
in e iew
 less han a hi d o he pa ien s and amilies we e asked
abou he ad anced ca e plans (ACP)
 pa ien s’ p e e ences abou end o li e ca e we e poo ly
documen ed and he e we e disc epancies be ween he
p e e ences and hei documen a ion; amily membe s
ha e exp essed p e e ences o medical ea men s a he
EOL
 communica ion wi h heal h ca e p o essionals and
documen a ion o EOL ca e p e e ences is inadequa e
Liangas G, e al.[54]
2014, Aus alia
6/10
To audi pa en al eco ds abou he
issues o pa en al conce ns ega ding
hei child en’s men al heal h issues.
 Audi ed iles (N = 280),
 175 (n = 175) wi h pa en al conce ns aining
in e en ion
 Quan i a i e analysis
 pa en ing issues a e a signi ican pa o he wo k load o
men al heal h eams
 need o highligh sys ema ic ecogni ion o pa en al
s a us in ol ing men al heal h pa ien s
 pa en ing issues documen ed: pa en s exp essing
di icul ies in coping wi h pa en al ole, pa en s ely on
child en o suppo , pa en ing suppo , child en’s
wel a e and sa e y, pa en ing issue men ioned as a
p oblem
Miyashi a M, e al.[49]
2008, Japan
9/10
To iden i y quali y indica o s (QI) o
end-o -li e o cance ca e by e iewing
medical cha s.
 Modi ied Delphi me hod, based on sys ema ic
li e a u e e iew abou QI using communica ion in
he in e ne ; pa icipan s mul i-p o essional
specialis s (n = 17); pallia i e ca e physicians
(n = 5); medical oncologis (n = 1); gene al
medicine physician (n = 1); psycho-oncologis s
(n = 3); sociologis s (n = 2); medical e hicis
(n = 1); expe on Delphi me hodology (n = 1)
 amily ca e as one cen al domain o documen a ion:
amily ela ionships, key pe son in pa ien ca e, amily’s
p e e ence o place o ca e/explana ion o medical
condi ion, explana ion o medical condi ion o pa ien o
amily, expec a ions o amily, discussion abou a
do-no - esusci a e o de , explana ion o amily abou :
cou se o disease un il dea h, pa ien ’s impending dea h,
one week p io o dea h, ca e s a egy o amily
Published by Sciedu P ess 59
cns.sciedup ess.com Clinical Nu sing S udies 2017, Vol. 5, No. 3
5. CONCLUSIONS
Documen a ion ela ed o amily nu sing is qui e sca ce. This
may pa ly demons a e how heal h ca e s a eel abou he
amily as a collabo a i e companion in pa ien ca e. On he
o he hand, i may also demons a e de iciencies in docu-
men a ion in gene al. This could be imp o ed by means o
basic and con inuing educa ion and by de eloping p ac ices
and wo king condi ions which enable a amily p esence and
in ol emen in pa ien ca e and, consequen ly, ela ed docu-
men a ion. Wi h comp ehensi e documen a ion, in ol ing
he pa ien s and hei amilies, he quali y and con inui y o
ca e can be imp o ed. In addi ion, mo e esea ch is needed
in o de o imp o e amily documen a ion.
ACKNOWLEDGEMENTS
We a e g a e ul o Ma k Ma son o e ising he language o
his pape .
CONFLICTS OF INTEREST DISCLOSURE
The au ho s decla e hey ha e no con lic o in e es .
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