Structured communication interventions for families of patients in the intensive care unit: A scoping review

The aim of this study was to map structured communication interventions for families or surrogate decision-makers of adult intensive care unit (ICU) patients, describe their main characteristics and reported outcomes, and organise reported intervention components into a descriptive communication-domain map.

A scoping review using descriptive evidence mapping and a combined deductive-inductive synthesis of communication domains.

Sources of evidence included PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, ClinicalTrials.gov, and reference list screening.

Eligibility criteria included primary studies reporting structured communication protocols, frameworks, checklists, bundles, tools, or reproductible interventions implemented by ICU clinical teams to support communication with families or surrogate decision-makers of adult ICU patients. Two reviewers independently extracted study and intervention characteristics, outcomes, measurement approaches, and quantitative findings, and reported limitations using a standardised form. Reported intervention components were charted and organised into descriptive communication domains through a combined deductive-inductive synthesis process; disagreements were resolved by consensus.

Nine studies (2010-2022) were included and grouped into structured communication frameworks, educational/training interventions, and multicomponent bundles. Reported communication components were unevenly represented across included sources. Empathy/emotional support, knowledge transmission, summarisation, and value elicitation were among the most frequently described components, whereas ethical considerations, cultural adaptation, time management, nonverbal communication, and supportive aids were less frequently reported in published intervention descriptions. Outcomes were predominantly perceptual and process related.

Structured ICU family communication interventions are heterogeneous in design, delivery, and outcome assessment. This review provides an evidence map of intervention types and a descriptive-domain map of reported communication components. These findings may support the development and reporting of more comprehensive, context-sensitive ICU family communication interventions.