Family Experience in Making the Decision to Be Present With the Child During Invasive Procedures and/or Cardiopulmonary Resuscitation: A Qualitative Systematic Review.

Abstract

Introduction: Family presence during invasive procedures and cardiopulmonary resuscitation has been studied, emphasizing the benefits for children, families, and the health care team. Therefore, there are several aspects that need deeper understanding such as values, beliefs, long-term effects, and relevant information for the family's decision-making process. The aim was to understand the family's decision-making process regarding whether or not to be present with the child during invasive procedures and cardiopulmonary resuscitation in the neonatal and pediatric inpatient and emergency departments.

Methods: A qualitative systematic review was conducted according to the JBI evidence synthesis manual. The databases MEDLINE, CINAHL, Embase, PsycINFO, Web of Science Core Collection, LILACS, and Scopus were searched. Studies were grouped using the JBI meta-aggregation method. The emerging themes were reviewed using the ConQual approach to establish confidence in the results.

Results: Ten studies were included in the review. Data analysis revealed 5 synthesized findings: vulnerability, choice, beliefs, family's needs to support their decision, and resolution, which shows the family's preference to be with or not with the child at all times and in all circumstances, motivated by their desire to care for the child and fulfill their moral duty.

Discussion: The family's decision-making process is characterized by a commitment to the child's well-being, taking into account the family's moral obligation to care for the child in all circumstances. Institutional policies ought to encompass provisions for family presence during cardiopulmonary resuscitation and invasive procedures, thereby ensuring the preservation of family autonomy in decision making.