Analisis Konsep Dukungan Keluarga di Unit Perawatan Intensif (ICU) Rumah Sakit Berdasarkan Patient and Family-Centered Care

Abstract

Paradigma keperawatan intensif telah bergeser dari model biomedis–teknosentris menuju patient and family-centered care (PFCC) yang menempatkan keluarga sebagai mitra aktif dalam komunikasi, asuhan, dan pengambilan keputusan. Meskipun bukti global terus berkembang, kejelasan konseptual tentang “dukungan keluarga” dalam kerangka PFCC di ICU Indonesia masih terbatas. Penelitian ini bertujuan merumuskan definisi konseptual dan operasional dukungan keluarga sebagai mitra dalam asuhan keperawatan kritis, mengidentifikasi atribut, antecedent, dan konsekuensi, serta menyusun indikator empiris untuk pengukuran dan integrasinya dalam praktik ICU.  Analisis konsep dilakukan dengan pendekatan delapan langkah Walker dan Avant melalui sintesis bukti dari penelitian kuantitatif, kualitatif, dan campuran, uji klinis, serta telaah sistematis dan meta-analisis tentang PFCC dan partisipasi keluarga di ICU dewasa yang terbit tahun 2020–2025. Teridentifikasi lima atribut utama dukungan keluarga: (1) komunikasi terapeutik dan kolaboratif, (2) kehadiran fisik–emosional, (3) partisipasi aktif dalam perawatan dan pengambilan keputusan, (4) keterhubungan berbasis teknologi, serta (5) orientasi pada kebutuhan emosional, informasi, dan rasa aman pasien–keluarga. Atribut-atribut tersebut berhubungan dengan penurunan delirium, durasi ventilasi, dan lama rawat ICU, serta peningkatan kepuasan, kualitas komunikasi, dan kesejahteraan psikologis keluarga. Dukungan keluarga di ICU merupakan kemitraan terstruktur antara keluarga dan tim kesehatan yang meliputi komunikasi, kehadiran, partisipasi, dan pengambilan keputusan bersama. Model ini menjadi dasar teoritis bagi pengembangan kebijakan dan intervensi keperawatan ramah keluarga di Indonesia. The paradigm in intensive care nursing has shifted from a biomedical–technocentric model to patient- and family-centered care (PFCC), emphasizing the family as an active partner in communication, care, and decision-making. Despite growing global evidence, conceptual clarity of “family support” within the PFCC framework in Indonesian ICUs remains limited. This study aimed to formulate a conceptual and operational definition of family support as a partner in critical care nursing, identify its defining attributes, antecedents, and consequences, and develop empirical indicators for its measurement and integration into ICU practice. A concept analysis was conducted using Walker and Avant’s eight-step approach, synthesizing evidence from quantitative, qualitative, and mixed-method studies, clinical trials, and systematic reviews on PFCC and family participation in adult ICUs published between 2020–2025. Five core attributes of family support were identified: (1) therapeutic and collaborative communication, (2) physical–emotional presence, (3) active participation in care and decision-making, (4) technology-mediated connectedness, and (5) orientation to emotional, informational, and safety needs. These attributes were linked with reduced delirium incidence, shorter ventilation duration and ICU stay, improved satisfaction and communication quality, and enhanced family psychological well-being. Family support in the ICU is a structured partnership between families and the healthcare team encompassing communication, presence, participation, and shared decision-making. This conceptual model provides a theoretical foundation for developing evidence-based, family-friendly ICU policies and nursing interventions within the Indonesian critical care context.