Patient- and Family-Centered Care, Communication, and Relationship Development Along a Technological Continuum in the ICU: A Scoping Review

OBJECTIVES: Effective multidirectional and longitudinal communication is essential to patient- and family-centered care (PFCC) in the ICU. While communication technologies have the potential to facilitate effective communication, their utilization, especially during the COVID-19 pandemic, has been variable. This scoping review answers the following research questions: What communication tools, strategies, and programs have been used in ICUs? What are their reported effects on PFCC and multidirectional communication? To what extent do these studies consider equity, diversity, and inclusion principles? DATA SOURCES: The scoping review followed Arksey and O'Malley's (2005) framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We conducted a search covering the period from 2007 to 2024, focusing on the concepts of communication, ICU, and PFCC in OVID Medline, EBSCO CINAHL, and OVID Embase. Relevant studies were screened and reported in this review. STUDY SELECTION: Searches identified 3280 unique sources, which were screened at a three-stage asynchronous review. A total of 131 articles were included in this review. DATA EXTRACTION: Communication tools, strategies, and programs were categorized into technology-based and non-technology-based interventions. Technology-based interventions included eight subcategories such as data-enabled devices, electrolarynx, and eye trackers. Non-technology-based strategies included 13 subcategories such as family meetings, diaries, and dedicated personnel. DATA SYNTHESIS: Positive outcomes were reported in 82% of studies for both technology-based and non-technology-based communication tools, strategies, and programs on PFCC. CONCLUSION: Most technology and non-technology communication tools, strategies, and programs positively impact communication and PFCC in the ICU. However, only 4% of studies focused on equity, diversity, and inclusion in the evaluation, design, or development of their intervention, indicating a need for further research in this area.