To Örebro University

Open-heart surgery is known to affect not only the patient, but also his or her family members. Therefore, family involvement in relation to this surgical procedure ought to be supported. Attention should be paid to the whole family’s well-being. There is a lack of research on how this should be done in current open-heart surgical care settings. The overall aim was to describe, explore, evaluate, and interpret family involvement in relation to patients undergoing open-heart surgery using social support theory. Study I had a mixed-methods convergent parallel design and was conducted through integrating one cross-sectional and two qualitative datasets describing registered nurses’ (n = 267) and licensed physicians’ (n = 20) attitudes toward family involvement in open-heart surgical care. Descriptive qualitative data were analyzed using the critical incident technique to explore patients’ (n =35) (Study II) and family members’ (n = 29) (Study III) experiences and actions regarding family involvement. In Study IV, quantitative data were analyzed in a randomized clinical trial to evaluate the effects of the family health conversations when delivered to patients with their family members via videoconferencing. The primary analysis was based on questionnaire responses from 101 patients (control = 54, intervention = 47) and 99 of their family members (control = 52, intervention = 47). The results of Study I–IV were synthesized by applying a mixed-methods approach. The synthesized findings showed that family involvement in open-heart surgical care entails social and professional supportive aspects. Family involvement is a concept that also has unsupportive aspects. Patients and family members have needs connected to all these aspects that can be met by family-centered care policy and intervention. The family health conversations is one intervention that has potential to meet the needs of families in this context. In addition to the implementation of family-centered policies, the findings support a team approach to supportive conversations in open-heart surgical care and further exploration and evaluation of peer support programs in this context.