A Theoretical Lens Through Which to View the Facilitators and Disruptors of Nurse-Promoted Engagement With Families in the ICU

The theory of nurse-promoted engagement with families in the intensive care unit (ICU) was developed to describe the dynamic and complex interplay between factors that support or impair nurses' efforts to promote family engagement. Theory construction involved theory derivation and theory synthesis. Concepts and relationships from ecological theory, the Resiliency Model of Family Stress, Adjustment and Adaptation, moral distress theory, and the healthy work environment framework informed the initial formation of the emerging theory. The synthesis of findings from the literature further expanded the scope of the relationships and propositions proposed in the theory. This middle-range theory can set direction for theory-informed focused nursing research that can advance the science of family nursing and guide ICU clinicians in overcoming challenges in family nursing practice. Recommendations are provided for applying this new theoretical lens to guide family nursing curriculum development, practice improvements, and policy changes to support nurses in promoting family engagement.