Abstract Rationale Engaging family members in care is part of a patient- and family-centered approach in intensive care units (ICUs), but little is known about how ICU clinicians perceive family health literacy and its impact on family engagement. Objective(s) The purpose of this study was to explore clinician perspectives on family health literacy in the ICU. Methods We conducted a secondary analysis of qualitative data, collected on interprofessional teamwork in medical and surgical ICUs across three hospitals in the U.S. Data included 57.6 hours of observations, 17 shadowing experiences, and 41 semi-structured interviews with clinicians and family members. We identified health literacy among family members as an emergent theme and therefore chose to conduct a thematic analysis to characterize perceptions of family literacy in the ICU. We iteratively coded the data until no new themes emerged and consensus was reached among the research team. Results Three main themes were identified: (1) Clinicians assess family members’ health literacy and judge their ability to engage in care, (2) Family members’ participation in the care process is affected by clinicians’ assessments and perceptions of family health literacy, and (3) Clinicians employ strategies to bridge perceived gaps in health literacy. Clinicians evaluated family members’ health literacy, explicitly or implicitly, how family members access, understand, appraise, and apply health information. Their perceptions affected the degree to which they sought or permitted family involvement in care. When clinicians perceived family members as having lower health literacy, they were skeptical of family members’ participation. However, clinicians also saw family members as offering valuable information that can guide care and decision-making. Clinicians described strategies to engage family members in the decision-making process by inviting them to medical rounds, providing updates through consultation, and phone calls. Conclusions The study findings reflected clinicians’ perceptions towards family health literacy and highlighted the importance of their roles in engaging family members. Further studies should explore the factors influencing clinicians’ assessments of family health literacy and develop strategies to enhance equitable family engagement in the ICU.
Kim et al. (Mon,) studied this question.