What Is Known About Family-Inclusive Inpatient Care From Patient and Family Perspectives? An Integrative Review

Area of Science:

• Healthcare quality improvement
• Patient and family-centered care
• Cultural safety in healthcare

Background:

• Family/whānau inclusion in bedside care is a person-centered practice, vital for cultural diversity and Indigenous inclusivity.
• Despite the established principles of patient-and-family/whānau-centered care, variability exists in its implementation within adult inpatient settings.
• Patient and whānau feedback highlights inconsistencies in providing inclusive care, necessitating a deeper understanding of experiences.

Purpose of the Study:

• To synthesize current understanding of family-inclusive adult inpatient care through a systematic integrative literature review.
• To identify factors influencing the inclusion of families/whānau in acute hospital settings.
• To explore patient and family/whānau experiences related to care inclusivity.

Main Methods:

• An integrative literature review methodology was employed, synthesizing qualitative and quantitative evidence from 2000-2024.
• Systematic searches were conducted across five major databases (MEDLINE, CINAHL Plus, Web of Science, Scopus, PsycINFO) in January 2025.
• Thematic analysis was used to synthesize data from 27 included studies, following quality assessment.

Main Results:

• Three key themes emerged: (1) Culturally safe behaviors and relational care foster family inclusion.
• (2) Culturally unsafe behaviors and unwelcoming environments hinder family inclusivity.
• (3) Communication practices are inconsistent, with poor communication being a frequent negative experience for families/whānau.

Conclusions:

• Evidence on family/whānau inclusion in acute care is limited and highly variable, dependent on healthcare professionals' willingness, cultural competence, and environmental factors.
• Experiences are negatively impacted by perceived risks, including culturally unsafe care, environments, and poor communication.
• Further research is needed on the experiences of non-Māori populations within family-inclusive care models.