HealthDay News — According to a study published in the Journal of Clinical Nursing, no family presence and physical family presence results in predominately negative clinician-family-patient interactions for deteriorating adult patients in the emergency room — while therapeutic family presence results in positive clinician-family-patient interactions.

Megan Youngson, RN, from Deakin University in Burwood, Australia, and colleagues examined the characteristics and interactions of clinicians, patients, and family members during management of deteriorating adult patients in the emergency department. 

The authors observed 5 clinical deterioration episodes within a 50-bed emergency department.

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The researchers found that while family are present during a patient’s episode of deterioration, presence, roles and engagement describe the interactions between clinicians, family members and patients. 

Presence was categorized as no presence, physical presence or therapeutic presence. During a patient’s deterioration episode, clinicians and family members moved through primary, secondary, and tertiary roles.

Engagement was either superficial or deep. A complex interplay was identified between presence, roles, and engagement, with each affecting the form of the other variables.

“This study identified three types of presence that occurred during a patient’s episode of deterioration,” the authors write. “No presence and physical presence resulted in predominantly negative clinician-family-patient interactions, while therapeutic presence resulted in positive clinician-family-patient interactions.”


Youngson MJ, Currey J and Considine J. “Current Practices Related To Family Presence During Acute Deterioration In Adult Emergency Department Patients”. Journal of Clinical Nursing. 2017. doi: 10.1111/jocn.13733. [Epub ahead of print]

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