Defining Priorities for Canadian PICU Family Presence Policies Under Changing Contexts: A Qualitative Focus Group Study.

Abstract

Introduction: Recognizing the importance of parental presence for seriously ill children's well-being, many pediatric intensive care units (PICUs) have adopted policies encouraging family presence. However, PICU family presence policies remain varied, with gaps in policy development and implementation across Canadian hospitals. We aimed to determine patient, family, clinician, and policymaker-identified priorities for family presence policies under baseline and emergency (e.g., pandemics, disease outbreaks) contexts.

Methods: Between January and August 2023, we conducted focus groups with PICU youth, families, clinicians, and policymakers. Using the Theoretical Domains Framework (TDF) and inductive analysis, we explored key themes.

Results: Seven focus groups included youth (n = 4), family members (n = 7), clinicians (n = 14), and policymakers (n = 4). Nearly all TDF domains were significant, leading to three primary categories: policy development (e.g., transparency, adaptability), implementation (e.g., communication, roles), and future lessons.

Discussion: Key priorities included bedside access for two people, sibling presence, and flexible, equitable policies developed with diverse community engagement.