Building family resilience: Qualitative perspectives from a multisite experimental study in intensive care units

Objective: We sought to explore how the family resilience framework may help us understand the relationship between patient- and family-centered care interdisciplinary rounds and the stressors, resources, organizational, and systems context during critical illness of patients, their families, and the health care professionals providing the care in the intensive care unit. Background: Family inclusion and engagement in patientand family-centered interdisciplinary rounds in the intensive care unit is a challenging and an under-researched issue in critical care. Despite evidence that family presence can provide benefits to patients and family members, current literature still shows that family members are excluded. Method: We examined qualitative data from patients, families, and health care professionals involved in a multisite experimental study using the family resilience framework, and Braun and Clarke's (2006) constructionist, contextualist approach to thematic analysis. Results: We learned that the participants' experiences and perception of family engagement during patient- and-familyccntered care interdisciplinary rounds is centered around the family as the "synchronizer," achieved with family acting as "moderator," as an advocate, and as "therapeutic" that assisted the patients, family members, and health care professionals to be "feeling happy," which also aided in providing "forewarning and mindfulness of the impermanence of life and imminence of death." Implications: We present and discuss our findings in the light of theoretical foundations and empirical support for the use of the Family Resilience Framework in critical care and propose how the framework can help implement policies and programs that will address the needs of patients and their families in this aspect of critical care.