Transforming Family Engagement: Nurses' Practices and Barriers to Empowerment in Adult <scp>ICUs</scp>

Abstract

BACKGROUND: Admission to the intensive care unit threatens the family's internal equilibrium. Nurses play a key role in families' adaptation and empowerment. Considering the lack of nurses' training on family empowerment and the scarcity of research in this area, assessing the current practice of nurses and the barriers is very imperative to get an idea about family empowerment. AIM: To examine the practice of intensive care unit nurses toward family empowerment and focus on the barriers that might face them. STUDY DESIGN: This is a cross-sectional study was conducted. Data were collected using a self-administered questionnaire comprising three sections: sociodemographic and professional data, a 12-item family empowerment scale assessing professional, emotional and self-support practices and a 19-item scale evaluating perceived barriers. Responses were rated on a 5-point Likert scale, with higher scores indicating more frequent empowerment practices or greater perceived barriers. Descriptive and inferential analyses were performed to examine nurses' reported practices and to identify the most significant barriers to family empowerment. RESULTS: A total of 80 bedside nurses participated in the study, representing 51.9% of the ICU nursing workforce (N = 154). The achieved sample size slightly exceeded the required estimate of 77 nurses, yielding a response rate of 51.9%. Nurses reported high levels of agreement with the self-support, emotional and professional support categories of the family empowerment scale (19.91 ± 3.14, 16.24 ± 1.93 and 11.85 ± 2.28, respectively). Barriers to family empowerment were reported as work pressure (4.64 ± 0.60), instability of the patient's condition (4.36 ± 0.62), multiple requests from treating physicians (4.26 ± 0.88), time limitation (4.24 ± 0.80) and wrestling with priorities (4.18 ± 0.73). RELEVANCE TO THE CLINICAL PRACTICE: Relevance to the clinical practice. Recognizing these factors allows healthcare institutions to prioritize interventions to mitigate these challenges, such as reducing workloads and improving nurse-to-patient ratios. The study suggests the need for additional training on family empowerment and potentially re-evaluating policies such as visiting hours, which can influence family involvement and support. CONCLUSIONS: The study highlights that nurses acknowledge the importance of empowering families in intensive care units. The research identifies significant barriers, such as work pressure, time constraints, patient condition instability and multiple demands from physicians. Addressing these barriers can improve family-centred care.