The Role of Family in Caring for Critically Ill Children in the Intensive Care Unit: A Narrative Review
DOI:
https://doi.org/10.35568/healthcare.v7i2.6528Keywords:
caring, children, critically ill, intensive care unit, role of familyAbstract
Critically ill children admitted to intensive care units experience complex physical and emotional challenges, not only for themselves but also for their families. Family-centered care (FCC) has become a cornerstone in children's critical care, emphasizing collaboration, respect, and shared decision-making between healthcare teams and families. Despite growing recognition of its benefits, the practical roles of families in children's intensive care unit settings remain diverse and sometimes underutilized across different healthcare systems and cultural contexts. This research aims to identify the family's role in caring for critically ill children in the intensive care unit. This research method uses narrative review. Articles were collected from Pubmed, ScienceDirect, EBSCOhost, and Google Scholar. The keywords used were critically ill children OR children in PICU OR children in NICU AND family involvement OR role of family OR family participation OR family-centred care OR FCC AND intensive care unit OR critical care with boolean "OR" and "AND". Inclusion criteria were free full-text, years of publication between 2020-2025, and articles in Indonesian or English. The search results obtained 11.345 articles, and only 10 articles met the criteria, which were then analyzed. Across various studies, families, particularly parents, emerged as essential components in the care of critically ill children. Their roles extended beyond traditional caregiving and encompassed several interconnected domains: emotional support and security, physical and emotional presence, advocacy and care partnership, participation in daily care, communication and shared decision-making, creating a sense of home and normalcy, coping and post-discharge involvement. Families contribute not only emotional and physical support but also advocacy, caregiving participation, and partnership in decision-making, all of which enhance patient outcomes and support holistic care delivery. Nurses are pivotal in operationalizing family-centred care principles and ensuring meaningful family involvement in caring for critically ill children in the intensive care unit.
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Abukari, A. S., & Schmollgruber, S. (2023). Concepts of family-centered care at the neonatal and paediatric intensive care unit: A scoping review. Journal of Pediatric Nursing, 71, e1–e10. https://doi.org/10.1016/j.pedn.2023.04.005
Abukari, A. S., & Schmollgruber, S. (2024). Perceived barriers of family-centred care in neonatal intensive care units: A qualitative study. Nursing in Critical Care, 29(5), 905–915. https://doi.org/10.1111/nicc.13031
Aljawad, B., Miraj, S. A., Alameri, F., & Alzayer, H. (2025). Family ‑ centered care in neonatal and pediatric critical care units : a scoping review of interventions , barriers , and facilitators. BMC Pediatrics. https://doi.org/10.1186/s12887-025-05620-w
Anggraini, D., Nurhaeni, N., & Wanda, D. (2023). Parental involvement in child care on parental stress and anxiety in the intensive care unit. Journal of Telenursing (JOTING), 5(1), 610–620. https://doi.org/10.31539/joting.v5i1.5466
Artal, R., & Rubenfeld, S. (2017). Ethical issues in research. Best Practice & Research Clinical Obstetrics & Gynaecolog, 43, 107–114. https://doi.org/https://doi.org/10.1016/j.bpobgyn.2016.12.006
Butler, A. E., Krall, F., Shinewald, A., Manning, J. C., Choong, K. M. B., & Dryden-Palmer, K. (n.d.). Family-Centered Care in the PICU: Strengthening Partnerships in Pediatric Critical Care Medicine. Pediatric Critical Care Medicine, 25(12), 1192–1198. https://doi.org/10.1097/PCC.0000000000003621
Davidson, J. E., Aslakson, R. A., Long, A. C., Puntillo, K. A., Kross, E. K., Hart, J., Cox, C. E., Wunsch, H., Wickline, M. A., Nunnally, M. E., Netzer, G., Kentish-Barnes, N., Sprung, C. L., Hartog, C. S., Coombs, M., Gerritsen, R. T., Hopkins, R. O., Franck, L. S., Skrobik, Y., … Curtis, J. R. (2017). Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU. Critical Care Medicine, 45(1), 103–128. https://doi.org/10.1097/CCM.0000000000002169
Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230–235. https://doi.org/10.1179/2047480615z.000000000329
Franco Fuenmayor, M. E., Fawcett, A., Schwartz, K. E., Horner, S., Balasundaram, M., Burke, B. L., Bean, K. A., Russell, L. N., Simonton, E., MacHut, K. Z., & Fry, J. T. (2024). Understanding family-centered care in the NICU: A scoping review protocol. JBI Evidence Synthesis, 22(7), 1379–1386. https://doi.org/10.11124/JBIES-23-00252
Grandjean, C., Ullmann, P., Marston, M., Maitre, M. C., Perez, M. H., & Ramelet, A. S. (2021). Sources of stress, family functioning, and needs of families with a chronic critically ill child: A qualitative study. Frontiers in Pediatrics, 9(November), 1–15. https://doi.org/10.3389/fped.2021.740598
Hadi, Y. M. W., Munir, Z., Siam, W. N., Studi, P., Keperawatan, I., Kesehatan, F., & Jadid, N. (2020). The effectiveness of applying the family-centered care method to pediatric patients with stress hospitalization. Jurnal Ilmiah STIKES Citra Delima Bangka Belitung, 3(2), 2–4. http://jurnalilmiah.stikescitradelima.ac.id/index.php/JI
Khalili, A., Fateh, Z., Beiranvard, F., & Parvin, A. (2024). Barriers to Implementing Family-Centered Care in Pediatric and Neonatal Intensive Care Units from the Perspectives of Nurses. Pajouhan Scientific Journal, 22(2), 91–97. https://doi.org/10.32592/psj.22.2.91
Latour, J. M., Rennick, J. E., & van den Hoogen, A. (2024). Family-centered care in pediatric and neonatal critical care settings. Frontiers in Pediatrics, 12(March), 1–6. https://doi.org/10.3389/fped.2024.1402948
Meert, K. L., Clark, J., & Eggly, S. (2013). Family-Centered Care in the Pediatric Intensive Care Unit. Pediatric Clinics of North America, 60(3), 761–772. https://doi.org/10.1016/j.pcl.2013.02.011
Miller, L., Richard, M., Krmpotic, K., Kennedy, A., Seabrook, J., Slumkoski, C., Walls, M., & Foster, J. (2022). Parental presence at the bedside of critically ill children in the pediatric intensive care unit: A scoping review. European Journal of Pediatrics, 181(2), 823–831. https://doi.org/10.1007/s00431-021-04279-6
O’Meara, A., Akande, M., Yagiela, L., Hummel, K., Whyte-Nesfield, M., Michelson, K. N., Radman, M., Traube, C., Manning, J. C., & Hartman, M. E. (2022). Family outcomes after the pediatric intensive care unit: A scoping review. Journal of Intensive Care Medicine, 37(9), 1179–1198. https://doi.org/10.1177/08850666211056603
Oude Maatman, S. M., Bohlin, K., Lilliesköld, S., Garberg, H. T., Uitewaal-Poslawky, I., Kars, M. C., & van den Hoogen, A. (2020). Factors influencing implementation of family-centered care in a neonatal intensive care unit. Frontiers in Pediatrics, 8(May), 1–7. https://doi.org/10.3389/fped.2020.00222
Paulsamy, P., Alshahrani, S. H., Venkatesan, K., Prabahar, K., Bhagavathy, M. G., Thangam, M. M. N., Veeramani, V. P., Hegazy, S. M., Ahmed, R., Easwaran, V., A., H. T., A., H. A., Kandasamy, G., & W, W. K. (2024). A Cross-Sectional Study on Nurse-Parent Partnership in the Pediatric Intensive Care Units. International Journal of Clinical Practice, 2024, 1–7. https://doi.org/https://doi.org/10.1155/2024/9934196
Poole, E. I., Ryan, M., Walls, M., Slumkoski, C., Curran, J. A., Seabrook, J. A., & Foster, J. R. (2023). “I want to be there. I have to be there.”: Parents’ perceived barriers and facilitators to bedside presence in the pediatric intensive care unit. Frontiers in Pediatrics, 11(January). https://doi.org/10.3389/fped.2023.1308682
Richards, C. A., Starks, H., O’Connor, M. R., & Doorenbos, A. Z. (2017). Elements of family-centered care in the pediatric intensive care unit. Journal of Hospice and Palliative Nursing, 19(3), 238–246. https://doi.org/10.1097/NJH.0000000000000335
Ryan, M. J., Lee, L. A., Carnevale, F. A., Crump, L., Garros, D., O’Hearn, K., Curran, J. A., Fiest, K. M., Fontela, P., Moghadam, N., Slumkoski, C., Walls, M., & Foster, J. R. (2025). Parental and family presence are essential: A qualitative study of children’s lived experiences with family presence in pediatric intensive care. Journal of Pediatric Nursing, 80, e228–e235. https://doi.org/10.1016/j.pedn.2024.12.017
Seaton, S. E., Manning, J. C., Colville, G., & Mackintosh, N. (2024). Creating a home with a critically ill child: A qualitative study exploring the experiences of parents of children admitted to paediatric critical care following treatment in neonatal care. Australian Critical Care, 38(1), 101101. https://doi.org/10.1016/j.aucc.2024.07.082
Shdaifat, E., Sudqi, A. M., Abusneineh, F. T., & Al-Ansari, N. M. (2022). Assessment of Parent and Nurse Perceptions of Parental Participation in Hospital Paediatric Care. The Open Nursing Journal, 16(1), 1–8. https://doi.org/10.2174/18744346-v16-e2208160
Stalder, S., Händler-Schuster, D., & Benedetti, F. D. (2024). Parents’ experiences of family and daily life after their child’s stay in the pediatric intensive care unit: a qualitative descriptive study. BMC Pediatrics, 24(1), 1–9. https://doi.org/10.1186/s12887-024-04883-z
van Wyk, L., Majiza, A. P., Ely, C. S. E., & Singer, L. T. (2024). Psychological distress in the neonatal intensive care unit: a meta-review. Pediatric Research, September, 0–9. https://doi.org/10.1038/s41390-024-03599-1
Veena, M. (2024). Innovation in Pediatrics: Family-Centered Care and Child-to-Child Approaches. Indian Journal of Nursing Sciences, 09(03), 22–24. https://doi.org/10.31690/ijns.2024.v09i03.005
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