In-hospital interventions to promote relational practice with families in acute care settings: A scoping review

Relational practice is characterised by genuine interaction between families and healthcare professionals that promotes trust and empowerment. Positive clinical outcomes have been associated with relational practice. To assess and examine in-hospital interventions designed to promote relational practice with families in acute care settings of emergency departments, intensive care units and high care units. The preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the design of this scoping review. To identify relevant studies, databases (Academic Search Complete; CINAHL; PubMed; PsyInfo) and the search engine Google Scholar were searched using terms for core elements of relational practice and family engagement. Of the 117 articles retrieved, eight interventional studies met the search criteria. The interventions focused on relational practice elements of collaborating with and creating safe environments for families, whilst only one addressed healthcare professionals being respectful of families' needs and differences. In relation to the nature of engagement of families in interventions, the focus was mainly on improving family functioning. Family engagement in the interventions was focused on involving families in decision-making. The scoping review revealed a limited number of in-hospital interventions designed to promote relational practice with families in acute care settings. Further research is encouraged to develop such interventions. Contribution: The scoping review has highlighted specific elements of relational practice that have been overlooked in the mapped interventions. This provides guidance on where future interventional research may be focused.

The Family Therapy Engagement Model (FTEM)

@#Among pediatric Occupational Therapists’ goals is to provide a holistic approach towards intervention planning which includes preparing the child’s social environment, especially in facilitating the carry-over of tasks in the child’s daily contexts. This model explores the factors contributing to the limited opportunities for family/caregiver participation during actual therapy sessions. It also discusses and integrates some of the best practice principles for family engagement that are based on the Phoenix Theory of Parent Attendance, Adlerian Play Therapy, and Discrimination model. This model was conceptualized in response to the growing need to increase family engagement during therapy in the Philippine setting, which could help them overcome barriers and strengthen their therapeutic skills and relationship with the child. Techniques and intervention processes that aim to engage the family during occupational therapy need to be further developed and studied. To fulfill this, this paper introduces a conceptual framework that maps out (1) five core elements, (2) five phases of family therapy engagement, and (3) a process checklist during the intervention process. The five core elements that affect family engagement are client, therapist, family, therapy-related, and environmental factors. This model explains how good collaboration between the family and therapists can be achieved if they undergo the preparation, consultation, planning, experiential activities, and re-education phase. The researchers suggest using this conceptual framework as a guide to understand and provide a systematic family engagement process during therapy sessions.