Background Mental illness is increasing in the society and it affects the person in the daily life. Relatives are helpful in the recovering of the person with mental illness. In order to provide a good nursing it is important that the nurse knows how relatives experience how it is to live with a person with mental illness. Aim The aim of this study was to illuminate relatives experiences of living with a person with mental illness. Method This study was literature- based and 11 qualitative articles were analyzed for the results. The articles were analyzed by the method of contributing to evidence-based nursing based on analysis of qualitative research. Results The results of this study showed that relatives living with a person that suffers from mental illness experienced a heavy burden. Feelings of guilt and shame was described, which had an impact on the daily life because of constant worry for the person with the mental illness. Relatives also experienced anxiety for the future. The relatives felt excluded from the healthcare and they felt that the healthcare did not take responsibility for the person with the mental illness. The rights to be provided with adequate care, both for the patient and for their relative was described as a constant fight. Conclusion The relatives experienced social isolation, feelings of guilt and loneliness. A need for greater support from the hospital staff desired due the relatives had a need for care and experiences of being excluded from the healthcare was described.

Background: At the emergency department parents arrives with their children in need of urgent medical care in various degrees. For a parent it can be hard to handle when their child has to go through treatments or medical examinations that can be unpleasant. A well-functioning cooperation between parents and caregivers is important to give the child a good health care. To implement familyfocused care can facilitate the care of the child and to increase the sense of participation. Purpose: The aim of this literature review is to describe parents experiences of care of their children at the emergency department. Methods: The study was conducted as a literature review. The articels were found in the databases Cinahl, PubMed, Web Of Science and by manual research. Results: Six factors were selected that had significance for parents’ experiences of the care of their child at the emergency department. These were: communication, information, participants, waiting times and pain management. The results showed that communication between parents, children and caregivers and also between the caregivers mutually influenced the experience. The parents wanted to feel involved in the care of their children. Depending on how long the family had to wait to meet the doctor they were satisfied in different degrees. Conclusion: Parents’ needs a good communication to feel satisfied with the visit at the emergency department. Parents’ felt that the waiting times could be improved. Whether the parents wanted to be present during some medical examinations or treatments of the child it was important to them that they were offered to attent. / Bakgrund: På en akutmottagning inkommer föräldrar med sina barn som är i behov av akut vård i olika grader. För föräldrar kan det vara svårt att hantera när deras barn behöver genomgå behandlingar och undersökningar som kan upplevas som obehagliga. Ett väl fungerande samarbete mellan föräldrar och vårdpersonal är viktigt för att barnet ska få en god vård. Att tillämpa familjefokuserad omvårdnad kan underlätta vårdandet av barnet samt öka föräldrarnas känsla av delaktighet. Syfte: Syftet med studien var att beskriva föräldrars upplevelser vid vård av deras barn på akutmottagning. Metod: Studien genomfördes som en litteraturöversikt. Artikelsökning genomfördes i databaserna Cinahl, PubMed, Web of science samt manuell sökning. Resultat: Sex faktorer valdes ut som hade betydelse för föräldrars upplevelse vid vården av deras barn på akutmottagning, dessa var följande: kommunikation, information, delaktighet, väntetider samt smärtbehandling. Resultatet visade att kommunikation mellan föräldrar, barn och vårdpersonal samt vårdpersonalen sinsemellan påverkade upplevelsen. Föräldrarna önskade att få känna sig delaktiga i vården av deras barn. Beroende på hur länge familjen fick vänta på ett möte med läkare blev de nöjda i olika grader. Slutsats: För att föräldrar ska känna sig nöjda med vården av deras barn på akutmottagning behövs en god kommunikation. Något som föräldrar ansåg kunde förbättras var väntetiderna. Oavsett om föräldrarna ville vara närvarande vid vissa undersökningar och behandlingar av barnet var det viktigt att de blev erbjudna att närvara.

Background: Each year approximately 700 children are affected by type 1 diabetes in Sweden. This chronic disease has an impact on the whole family but especially the parents who have the responsibility as a caregiver. Parents are therefore in need of support from friends and family as well as help from the nurse to deal with the situation. The nurse can provide support with a family focused care and will therefore include the whole family and use their strengths and resources. Aim: The aim of this study was to describe parents' experience of living with a child with type 1 diabetes. Method: The method used was a literature study with the aim to contribute to evidence based care with an analysis based on qualitative research. Ten scientific articles were analyzed. Three themes and seven subthemes emerged. Results: Three main themes and seven subthemes emerged during the analysis that responded to parents' experience living with a child with type 1 diabetes. The main themes were the stress that parents are exposed to, need of help and the unique community. Conclusion: Parents experienced a change in everyday life for the whole family. Therefore, the nurse needs to be responsive and adapt the nursing care to the parents, so they can support the child in a better way. / Studien beskriver föräldrars upplevelser av att leva med ett barn med typ 1 diabetes. Typ 1 diabetes är den mest förekommande autoimmuna sjukdomen hos barn i hela världen. Sjukdomen innebär att kroppen har slutat producera hormonet insulin, vilket medför en förhöjd blodsockernivå som kan leda till komplikationer. Studiens resultat baseras på tio vetenskapliga artiklar. Dessa söktes fram via två databaser. Genom analys och sammanställning av artiklarna framkom en beskrivning av föräldrarnas upplevelser. Detta redovisas som teman och subteman i resultatet. I resultatet beskrivs föräldrarnas omställning från att leva med ett friskt barn till att leva med ett barn med kronisk sjukdom och vilka känslor som uppstår vid bearbetningen samt det förändrade föräldraansvaret. Resultatet beskriver också de förhållanden som underlättar föräldrarnas bearbetning. Resultatet lyfter även fram de krav och förväntningar som föräldrarna har på vårdpersonal och personer i omgivningen samt den saknade förståelsen från människor runt föräldrarna.  Typ 1 diabetes påverkar barnens rätt att vara som andra och relationen med andra barn. Även relationen mellan barnet och föräldrarna påverkas. Sjukdomen drabbar inte bara barnet utan hela familjen. Sjuksköterskan är ansvarig för att ge familjen en god familjefokuserad vård och för att ge individanpassat stöd till föräldrarna i den förändrade livssituationen. Denna studie kan ge sjuksköterskor mer kännedom om vilka omvårdnadsbehov som föräldrarna har.

Årligen beräknas upp till 30.000 personer primärinsjukna i stroke.  I samband med en allt äldre population samt ökad förekomst av ohälsa drabbas landets befolkning i allt större omfattning av sjukdom. Riskfaktorer för stroke ses både hos den yngre och äldre generationen vilket tenderar till att fler drabbas av stroke. Detta i sin tur påverkar familjekonstellationer och närståendekretsar i större omfattning än tidigare. Strokeinsjuknandet ger funktionsnedsättningar som även påverkar närståendes vardag och livsvärld. Syftet med studien var att belysa närståendes upplevelser av vardagen när en familjemedlem drabbats av stroke. Studien genomfördes som en litteraturstudie där tolv artiklar bildade resultatet. I resultatet framkom det att stroke sågs som ett trauma och upplevdes som ett existentiellt kaos. Insjuknandet sågs ha många negativa effekter på familjens funktion på grund av bland annat oönskade roller och orättvisa förväntningar. Stora påfrestningar inom relationerna framkallade känslor av främlingskap. Familjefokuserad omvårdnad kan tänkas vara ett vetenskapligt redskap att fånga upp hela familjens och närståendes hälsa och lindra onödigt lidande. Vidare forskning kring informering samt långsiktig psykologisk uppföljning skulle kunna hjälpa familjen bearbeta traumat. / Up to 30,000 people annually suffers primary stroke. Due to an older population and enlarged incidence of illness, sickness are increasingly tending to affect family and close relatives. Stroke incidence generally results in impairments which also may affect relatives’ everyday life and lived world. The purpose of this study was to illuminate the experiences of close relatives of everyday life by the time a family member suffered stroke. The study was conducted as a literature review in which twelve articles formed the result. The result showed that stroke incidence was seen as a trauma and chaos of existential meaning. The incidence was seen to have many negative effects on family functioning such as unwanted roles and unfair expectations. High stress in relationships evoked feelings of alienation. Family focused nursing might be a tool of scientific support to capture the whole family and kindred health and alleviate unnecessary suffering. Further research on information sharing and long-term psychological follow-up could help family to process the trauma.

Sammanfattning Bakgrund: Prostatacancer är den mest förekommande cancerformen hos män i Sverige, vilket innebär att det finns många närstående till män med prostatacancer i sjukvården. Sjuksköterskor behöver därför kunna bistå med hjälp och stöd under sjukdomstiden.   Syfte: Att beskriva närståendes erfarenheter av att leva med en partner som drabbats av prostatacancer.   Metod: En litteraturöversikt baserad på kvalitativ data med induktiv ansats valdes. Resultatet baserades på elva originalartiklar som har kvalitetsgranskats samt analyserats utifrån Fribergs femstegsmodell.   Resultat: Dataanalysen genererade fyra huvudkategorier. I En gemensam resa framkom det att beslut var ett delat ansvar och att få och ge stöd var av stor vikt. I Att försöka kontrollera vardagen beskrivs de känslomässiga reaktioner som fanns hos närstående samt deras förmåga att hantera vardagen. Behov av kunskap visade att majoriteten av de närstående uttryckte ett kommunikations- och informationsbehov. I Förändringar i relationer framkom de relationella förändringar paren tvingades möta i samband med sjukdomen.   Slutsats: Närstående har individuella behov som mer kommunikation, information samt stöd som behöver tillfredsställas av sjuksköterskeprofessionen eller vårdpersonal, vilket innebär att sjukvården har en stor roll att spela i de närståendes liv. / Summary Background: Prostate cancer is the most common form of cancer to afflict men in Sweden, many of whom have a partner. For this reason, the nurses need to provide council, help and support during the course of the disease.   Purpose: To describe next of kin’s experiences living with men suffering from prostate cancer.   Method: A review based on qualitative data with an inductive approach. The result was based on eleven peer reviewed original articles that had also been analyzed in accordance with Fribergs five step model.   Result: The data analysis generated four main categories. In A common journey, it appeared that choices were a shared responsibility and to receive and give support were of great importance. In Attempting to control every-day life the emotional reactions of those next of kin and their capability to manage their every-day lives are described. The need for knowledge showed how the majority of those next of kin expressed a need for communication and information. Changes in relations showed the relational changes couples had to undergo in connection to the disease.   Conclusion: From the result it can be concluded that the needs described by next of kin to men with prostate cancer ought to be appeased by the nursing profession. The result shows that men suffering from the disease are in need of increased communication with nursing professionals as well as support and information. This means that the health care system have a big role to play in the lives of those next of kin to the individual requiring medical care.

Var tredje person får beskedet cancer. Det här innebär att en hel familj kan komma att påverkas, vilket kan skapa ett lidande i förhållande till vården, sjukdomen, livet och vardagen, samt det existentiella. Syftet med studien är att belysa lidandet hos närstående till en cancersjuk person. Material samlades in genom att läsa nio utvalda bloggar där närstående skrev om sitt lidande i relation till den cancersjuka personen. I studien användes en deduktiv analys utifrån Erikssons (1994) teori om lidande. Resultatet beskrivs utifrån begreppen vårdlidande, sjukdomslidande, existentiellt lidande och livslidande. Det framkom att närstående upplevde hopplöshet och frustration i förhållande till nonchalant personal med bristande stöd och bemötande. Ekonomisk påfrestning och ett ansträngt förhållande mellan partnerna var något som framkom tydligt i både resultatet och tidigare forskning. För att minska lidandet hos närstående krävs mer kunskap om familjefokuserad omvårdnad hos vårdpersonal. Det behövs mer kunskap hos sjuksköterskor om hur fokus ska läggas på familjen. Detta för att närstående ska kunna hantera sin sorg, sitt lidande och för att inte själva drabbas av sjukdom på grund av att de mår dåligt, vilket även belyses i tidigare studier (Wallskär, 2010a). / Every third person will be diagnosed with cancer. This means that the whole family around the sick person will get involved and affected by the situation. It will create a suffering, not only in the relatives’ lives but also in relation to the care, the cancer disease and the existential part. The purpose of this study is to highlight the suffering of relatives living with a person diagnosed with cancer. Material was collected by reading nine selected blogs which was written by relatives about their suffering when living with a person sick with cancer.  The study used a deductive analysis based on Erikson's (1994) theory of suffering. The results are described based on the concepts of suffering to the care, sickness suffering, existential suffering and suffering in life. It was revealed that relatives experienced hopelessness and frustration in relation to casually staff with lack of support and treatment. Economic strain and a strained relationship between the partners who deteriorated was something that emerged clearly in both results and previous research. More knowledge is needed by health professionals on family focused care to reduce the suffering of relatives. More knowledge is needed among nurses on how to focus effort on the family. The related parties should be able to cope with their grief and their suffering without getting ill because they feel bad, which is shown happening in previous studies (Wallskär, 2010a).

Bakgrund: Med ökande medelålder i befolkningen ökar också förekomsten av hjärtsvikt. Internationella studier har visat att gruppen patienter med hjärtsvikt ökar globalt och beskrivs mer eller mindre som en “epidemi”, som tycks fortsätta öka. Hjärtsvikt är ett kliniskt syndrom som visat sig vara både progressiv och fysiskt diskvalificerande för patienten. Att kunna erbjuda god vård i hemmet som ökar och optimerar hälsan för patienten ter sig vara en stor utmaning för sjukvårdspersonal då hjärtsvikt är en oförutsägbar sjukdom.  Motiv:  Hjärtsvikt är komplext, problematiskt och det kräver stor kompetens av sjukvårdspersonal. Genom att tillvarata sjuksköterskors erfarenheter av att vårda denna patientgrupp i hemmet kan ökad kunskap erhållas som förhoppningsvis kan bidra till ökad livskvalitet för patienter med hjärtsvikt som vårdas i hemmet.   Syfte: Syfte med studien var att belysa sjuksköterskors erfarenheter av att vårda och behandla patienter med hjärtsvikt i hemmet. Metod: Åtta semistrukturerade intervjuer genomfördes med sjuksköterskor som arbetade med hemsjukvård. En kvalitativ innehållsanalys valdes för att analysera intervjutexten.  Resultat: Fyra  huvudteman med 12 understödjande subteman framkom i resultatet. Tema 1: Att ha ett ansvarsfullt och meningsfullt arbete. Tema 2: Att sträva efter att möjliggöra att leva sitt liv hemma trots hjärtsvikt. Tema 3: Att ha bristande förutsättningar för sitt arbete. Tema 4: Att arbeta i team  Konklusion: Att arbeta med hjärtsviktspatienten i hemmet visar vara både utmanande och svårt då sjukdomen är komplex och snabbt kan förändras och försämras. Dock finns en mängd omvårdnadsåtgärder som kan förbättra patientens livskvalitet och upplevelse av hälsa trots sjukdom. Att inkludera familjen som en enhet visade sig vara av stor vikt för patientens livskvalitet. Sjuksköterskor känner stor tillfredsställelse i sitt arbete genom att göra gott för patienten. / Background: With increasing average age in the population, the incidence of heart failure also increases. International studies have shown that the group of patients with heart failure is increasing globally and describes more or less as an "epidemic", which seems to continue increasing. Living with heart failure is a clinical syndrome that has been shown to be both progressive and physically disqualifying for the patient. Being able to offer good care that increases the health of the patient seems to be a challenge for healthcare professionals, as heart failure is an unpredictable disease. Motive: Heart failure is complex, problematic and requires a great deal of expertise from healthcare professionals. By utilizing nurses' experiences of caring for this group of patients, increased knowledge can be available and can hopefully contribute to an increased quality of life for patients with heart failure in homecare. Aim: The aim of the study was to illustrate the nurse's experiences of caring for and treating patients with heart failure at home. Methods: Eight semi-structured interviews were conducted with nurses who worked with home health care. A qualitative content analysis was chosen to analyze the interview texts.  Result: Four main themes with 12 supporting sub-themes appeared in the results. Theme 1: Having a responsible and meaningful job. Theme 2: To strive to make it possible to live one's life at home despite heart failure. Theme 3: Having lack of conditions for their work. Theme 4: Working in teams Conclusion: Working with heart failure patient at home proves to be both challenging and difficult as the disease is complex and can quickly change and deteriorate. However, there are a number of nursing measures that can improve the patient's quality of life and experience of health despite illness. Working to include the family as a unit proved to be of great importance for the patient's quality of life. Nurses feel great satisfaction in their work by doing good for the patient.

Bakgrund En fjärdedel av världens befolkning har i något sammanhang varit i kontakt med psykisk ohälsa. När en individ drabbas av ohälsa påverkas även de närstående. Familjefokuserad omvårdnad kan vara ett adekvat redskap för sjuksköterskan att även inkludera närstående i vården. I Hälso- och sjukvårdslagen framgår hur sjuksköterskan ska bidra med information och kunskap för att den närstående ska kunna delta i vården. Psykisk ohälsa förekommer inom alla patientgrupper och en av sjuksköterskans huvuduppgifter blir att stödja den vårdsökande samt dess närstående till fortsatt hjälp och förbättrad hälsa.   Syfte Att beskriva upplevelser av att vara närstående till en person med psykisk ohälsa.   Metod Litteraturöversikt med induktiv ansats baserad på artiklar med kvalitativ design. Datainsamling genom sökning i databasen CINAHL samt sekundärsökning. Analys av 12 artiklar utifrån Fribergs femstegsmodell.   Resultat Resultatet visar att närstående till personer med psykisk ohälsa upplever familjesituationen förändrad, en negligerad egenhälsa, att information och stöd efterfrågas samt sökande efter meningsfullhet.   Slutsats Sjuksköterskan har en viktig roll i att tillfredsställa behovet av information för närstående till personer med psykisk ohälsa, då bristande kunskap och felaktiga uppfattningar försvårar livssituationen. / Background A quarter of the world population has in some context been in contact with mental illness. When an individual is affected by ill-health this also affects the individual’s relatives. Family focused care can be an adequate implement for the nurse to also include relatives in health care. The Health Care Act shows how the nurse's role is to provide information and knowledge so the relatives will be able to participate in the care. Mental ill-health occurs within all patient groups and one of the nurse's main tasks is to support the care applicant and its relatives to continued help and improved health.   Aim To describe experiences of being a relative to a person with mental illness.   Method Literature review with inductive approach based on articles with a qualitative design. Data was collected through CINAHL and a secondary search. Analysis of 12 articles made with Fribergs five-step model.   Results The result shows that relatives to individuals with mental ill-health experience a changed family situation, neglected own-health, more information and support is needed and a search for meaning.   Conclusion The nurse receives an important role to satisfy the need of information to relatives of individuals with mental ill-health, as a lack of knowledge and wrong comprehensions obstructs the life situation.

Bakgrund: Inom neonatalvården idag är det ovanligt att barn dör, men när det sker innebär det en i många fall livslång kris för de föräldrar som drabbas. Neonatal palliativ vård omfattar en helhetssyn och fokus på hela familjen, vilket bidrar till att relationer mellan familjen och vårdpersonalen byggs upp. Det innebär också etiska dilemman och att ställas inför svåra beslut. Syfte: Syftet var att beskriva föräldrars erfarenhet av neonatal palliativ vård. Metod: En litteraturöversikt baserad på 12 kvalitativa artiklar som söktes fram i databaserna AMED, Cinahl, Medline och PsycINFO. Fribergs trestegsmodell användes för analys. Resultat: Åtta kategorier framkom: Att få möjlighet att vara nära; Att vara delaktig i att fatta beslut; Betydelsen av information; Att bli behandlad med respekt; Att lindra barnets lidande; Betydelsen av samtal och stöd; Att skapa minnen samt Sjukhusmiljöns betydelse. Slutsats: Föräldrarna har behov av att få vara delaktiga i barnets vård för att skapa minnen. De behöver information för att förstå och efterfrågar fortsatt kontakt med vårdpersonal och uppföljning efter dödsfallet. / Background: In today’s neonatal care, it is uncommon that babies die. When it happens, it is associated with a life-long crisis for the affected parents. In neonatal end-of-life care, the focus is on the entire family and on the relationships that occur between the family and the health care professionals. It is also related to the ethical questions and difficult decisions that take place in this situation. Aim: The aim was to describe parents´ experiences in neonatal end-of-life care. Method: A literature review consisting of 12 articles with a qualitative approach were made. Searches were made in the databases AMED, Cinahl, Medline and PsycINFO. Fribergs three step method for analysis was used. Results: Eight categories were found: To be able to be near; To be involved in making decisions; The importance of information; To be respected; To alleviate child suffering; The meaning of conversation and support; To create memories and The significance of the hospital environment. Conclusions: The parents have the need to be involved in the care of their dying child to create lasting memories. They need information to understand and they ask for further contact and follow-up meetings after the death of their child.

Introduction: The purpose of this study was to facilitate an improved understanding by intensive care nurses about their care of family members of critically ill patients. The study aimed to challenge intensive care nurses to reconceptulaise family nursing within the context of the intensive care unit (ICU). Background to the study: Critical illness is not an event that occurs in isolation for the patient and staff. It affects the patient's family in a unique way. A plethora of literature exists identifying the needs of family members in the ICU. However, there are considerably fewer studies which have examined interventions to meet family members' needs and no identified research that discreetly examined the concept of family-focused nursing in the intensive care environment. Design of the study: This study utilised a collaborative action research methodology. It was developed in four phases through the cyclical, dynamic steps of action research. Setting: This study was undertaken in the general intensive care facility of a metropolitan tertiary referral hospital. Phase One: Phase One of the study was the establishment of a collaborative action research group (CARG) with interested registered nurses working in a general intensive care unit. The CARG explored the first two research questions of this study: 1) What are intensive care nurses' perceptions of family-focused nursing? and 2) Is familyfocused nursing appropriate in the intensive care environment? Data were collected through audio taping meetings, flip chart notes and the researcher's reflective diary. Data analysis was undertaken utilising open coding. For the first research question, open coding of the data revealed two categories relating to perceptions of family focused intensive care nursing: partnership in care and maintaining a balance. For the second research question, CARG members agreed unanimously that family focused nursing was appropriate in the intensive care environment. The CARG determined future direction of the action research phases, commencing with a family needs analysis in Phase Two. Phase Two: Phase Two of the study was the utilization of a descriptive survey to determine family member needs in the ICU to determine focuses for interventions during Phase Three. Both family members and staff in the ICU were surveyed utilising the Critical Care Family Needs Index (CCFNI) (Molter & Leske, 1983). Data were analysed by the CCFNI subcategories of assurance, proximity, information, comfort and support, comparing means, rank ordering of means and t-test for statistically significant differences in means between the family members and staff participants. Results indicated that statistically significant differences in means scores between family members and staff participants were in the CCFNI categories of assurance, proximity, information and support. On the basis of these results, a platform for Phase Three of this study arose. The areas for intervention for Phase Three were identified by the CARG as: the provision of staff education seminars to raise staff awareness of family needs and the development of a structured family assessment tool to identify family needs in the ICU. Phase Three: Phase Three of the study addressed research question three: &quotHow can intensive care nurses provide care that is focused toward the family of the critically ill patient?" Phase Three examined practice interventions in two areas. Phase Three Part A was the implementation of nursing staff education seminars. Forty-two nursing staff participated in the family needs education seminars. Data were collected by detailed researcher field notes and completion of a descriptive survey, the CCFNI, post seminar attendance. Thirty-five participants completed the CCFNI. This CCFNI data from nursing participants in the education seminars was compared to family members CCFNI data from Phase Two. Open coding of data from the education seminars revealed codes of family needs, visiting, family presence, encouragement, simple things and boundaries under the theme of &quotestablishing the context" and attitudes, confidence, empathy and culture under the theme of &quotbuilding a partnership". CCFNI results highlighted statistically significant differences in means scores between family members and staff participants were in the subcategories of proximity and support. Results demonstrated that through understanding family members needs that intensive care nurses can provide care that is focused toward the family of the critically ill patient. This is a building process to be achieved over time. Phase Three Part B was the content validity development of a family assessment tool for the Computer Information System (CIS) in the ICU. A family assessment tool (See Figure 6.1) was developed through the literature and in consultation with the CARG. A series of focus groups were organised. All nursing staff in the general ICU were invited to participate. Twenty-nine registered nurses (43.9%, n=66) participated in the family assessment tool focus groups. The five domains of the family assessment tool, family roles, family spokesperson, family perception and coping, family issues and family health needs, were each discussed to determine readability, clarity and applicability. The focus groups agreed on content validity of the family assessment tool. (See Figure 6.2). Phase Four: Finally, Phase Four of the study has addressed research question four: &quotIs action research an appropriate methodology to transform intensive care nursing practice?" Somekh's (1995) framework was utilised to guide this critical evaluation. It is suggested that action research is an appropriate methodology to transform intensive care nursing practice as it enables the development of professional, it is sensitive to the specific nature of intensive care nursing, it acknowledges of attributes of the researcher in the process. It is also an appropriate methodological choice as it provides opportunity for a critical evaluation and a platform for the ongoing nature of the action research journey. Conclusions: Overall the findings achieved the objectives of the study in that organisational, cultural and clinical practice changes were identified to facilitate family-focused intensive care nursing. Collaboration occurred with intensive care nurses to effect change. The action research process involved in the change process was articulated throughout the four phases of the study. An improved understanding by intensive care nurses about their family nursing practice was demonstrated in Phase Three and the efficacy of action research methodology for clinical practice change was demonstrated in Phase Four.