Facilitators and Barriers of Relatives' Involvement in Care of Patients With Acquired Brain Injury or Malignant Brain Tumour: Scoping Review

AIM: To identify and map the breadth of available evidence on nurses' perspectives of the facilitators and barriers to relatives' involvement in the care continuum of patients with acquired brain injury or malignant brain tumour.

BACKGROUND: The involvement of relatives in care and treatment may have a significant positive impact on the quality of care and treatment, leading to higher satisfaction with hospitalisation for patients, relatives and healthcare professionals. Nurses play an important role in nurturing a trusting and facilitating relatives' involvement. However, involving relatives seems complex and multifaceted, with many possible facilitators and barriers to consider.

DESIGN: This scoping review was conducted in accordance with the Joanna Briggs Institute's methodology for scoping reviews and a published a priori protocol.

DATA SOURCES: A comprehensive literature search was conducted in MEDLINE (PubMed), CINAHL (EBSCO) and Embase (OVID). Reference lists of included studies, Google Scholar and Web of Science were also searched. Literature published in the English, German or Scandinavian languages since 2010 was included.

RESULTS: The search identified 4330 studies, of which 18 were included. No studies including involvement of relatives to patients with Malignant Brain Tumour was found. Nurses' perspectives of the facilitators and barriers to relatives' involvement of patients with acquired brain injury indicates that several facilitators and barriers contribute to or hinder relatives' involvement. The facilitators for involvement were mostly related to nursing tasks within the healthcare system, acknowledging relatives in their own rights, building a trusting relationship and using communication as a tool. Contrary, barriers were organisational factors, when the patient was seen as a primary focus of care, and informational challenges.

CONCLUSIONS: The results illustrate the complex nature of involvement from the perspective of nurses. The results indicate a paradox because several of the identified aspects are not mutually exclusive but rather represent aspects of involvement that range along a continuum.

IMPLICATION FOR THE PROFESSION: Nurses' involvement of relatives in the care continuum is important, however evidence suggests that the relationships between relatives and nurses need to be strengthened to individualise the level of involvement. We suggest that the organisational and contextual factors that shape relative involvement need to be studied further.

REPORT METHOD: PRISMA-ScR.

PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. However, the review findings were shared and discussed with a panel of nurses from the neurosurgical speciality who validated and nuanced the findings into a Danish context.