[Complex family interventions in intensive care units: state of knowledge and future directions]

Family members of critically ill or severely injured patients experience considerable distress, which may negatively affect mental health and family functioning. Family-focused interventions are therefore needed and form an essential part of intensive care.

This article defines evidence-informed family interventions and engagement practices, highlights their complexity, identifies implementation challenges, and describes approaches to establishing state-of-the-art family care that reaches families in reliable ways.

Theoretical framing and narrative overview of the current state of knowledge on the implementation of complex family interventions in adult intensive care units.

Family interventions engage patients and close others in care activities and address their cognitive, affective, and behavioral needs. They are often delivered in combinations and are therefore classified as complex health interventions. Despite the evidence base being incomplete in some areas, a consensus has emerged on best practices for involving, informing, communicating with, and supporting families. The integration of these evidence-informed practices is influenced by factors at the individual, team, and organizational levels, which often act as barriers. Thus, systematic, theory-guided, and empirically grounded implementation process is crucial.

The integration of evidence-informed recommendations for working with families in intensive care units requires a communal effort. Implementation science offers systematic, theory-driven models to support the sustainable integration of context-specific family-focused interventions in intensive care units.