Table 2.

Summary of Articles Included in the Literature Review.

No.	Author/Year published/ Country	Title/Aim/Objectives	Methodology	Themes	Conclusion
1	Hoffman et al., 2012 Malawi	Utilization of family members to provide hospital care in Malawi: the role of hospital guardians To characterise guardian population and explore their role in the healthcare system of KCH	Mixed methods Quantitative survey, 60 guardians, simple random and convenience sample In-depth interviews with guardians, HCWs and managers Descriptive analysis, emergent coding	PG demographics Impact of caring role	Poor FCC implementation as characterised by poor communication between HCWs and nurses. PG needs were not considered when involving them in the care.
2	Khosravan et al., 2014 Iran	Family participation in the nursing care of the hospitalized patients	Comparative descriptive 253 family members quota sampling 83 nurses, census sampling Questionnaire Descriptive stats and chi-square	PG demographics Impact of caring role	PGs voluntarily participate in the care of inpatients. Poor partnership and collaboration between PGs and HCWs leads to increased burden to the PGs
3	Ewart et al., 2014, England	PFCC on an acute adult cardiac ward To explore the effects of advancing PFCC within acute adult inpatient services	Pre-post-intervention Survey, questionnaire Convenience sample 28PG, 24pts	FCC principles	Collaboration and partnership between PG, patient and HCW in care provision has positive impact on patient and PG hospital experience
4	Alipoor et al., 2016, Iran	Care experiences and challenges of inpatients companions in Iran's healthcare context: A qualitative study To investigate the care experiences of inpatients companions at hospital	Qualitative In-depth, unstructured interview 13PGs, purposive sample Thematic analysis	PG roles Impact of caring role	PGs spend a substantial amount of time to voluntarily offer physical and psychological care to inpatients under strenuous conditions. HCW to provide support to meet their needs to help them cope with the caring role
5	Mackie et al., 2018, Australia	Acute care nurses views on family participation and collaboration in fundamental care To understand how family participation and collaboration in care is enacted for hospitalised adult patients and their relatives	Mixed methods, Exploratory sequential design Observer-as-participant observation Semi structured interviews 16 nurses observed 14 nurses purposeful sample interviewed Descriptive stats Qualitative thematic analysis	Ethical implications of involving PGs Communication and collaboration in FCC	Nurses behaviour and attitudes influence implementation of FCC in their practice
6	Alshahrani et al., 2018, Saudi Arabia & Australia	The involvement of relatives in the care of patients in medical settings in Australia and Saudi Arabia: an ethnographic study To understand the role of relatives in patient care and nurses’ roles in relation to involvement of relatives in medical settings in two different countries Impact of relatives on quality patient care in both medical settings	Interpretivist, ethnographic Observation, interviews and review of public documents Spradley method of analysis of ethnographic enquiry Australia: 22pts, 22 relatives, 11 nurses (observed and interviewed) Saudi: 48 patients, 52 relatives & 18 nurses	PG demographics PG roles Impact of caring role	Need for policy to articulate roles and responsibilities for nurses and PGs in acute hospital settings
7	Rostami et al., 2015 Iran	The effect of education intervention on nurses attitudes toward the importance of FCC in paediatric wards in Iran. To determine nurses’ attitudes towards parents’ participation in the care of their hospitalised children in Iran	RCT Experiment; pre-post-follow-up Questionnaire Random sample, 200 paediatric nurses Descriptive and analytical analysis	FCC principles Benefits of FCC	Implementation of FCC problematic Educational intervention improves nurses attitudes towards FCC
8	Segaric & Hall, 2015 Canada	Progressively engaging: Constructing nurse, patient and family relationships in acute care settings To develop a substantive theory incorporating complex interactional processes and explanations for nurse, patient and family efforts to construct relationships during acute care hospitalisation	Grounded theory Purposive sample of 17 nurses, 13 patients and 10 family members Interviews Constant comparison analysis	FCC principles Barriers to FCC	Nurses to initiate relationship with family Workplace conditions and personal factors influence nurse-family relationships
9	Tehrani et al., 2012 Iran	Effects of stress on mothers of hospitalised children in a hospital in Iran To investigate the impact of different stressors in mothers of hospitalised children	Cross sectional study Simple random sample 225 mothers Descriptive and inferential analysis	PG demographics	Need for professional and in depth training of for HCP and nurses on dealing with mothers of hospitalised children
10	Lee et al., 2012 Malaysia	Impact on parents during hospitalisation for acute diarrhoea in young children To determine the emotional impact on parents of young children who require hospitalisation for AD	Prospective Convenience sample 85 parents/caregivers Descriptive stats	PG demographics Physical, psychosocial and economic impact of the caring role	Hospitalisation of children causes considerable distress and financial burden to parents and disruption of daily routines and missed workdays
11	Sener & Karaca, 2017 Turkey	Mutual expectations of mothers of hospitalised children and paediatric nurses who provided care: Qualitative study To identify the mutual expectations of mothers whose children were hospitalized in the paediatric department of a university hospital and nurses who provided care	Descriptive phenomenological study In depth qualitative interview Purposive sample 5 nurses and 24 mothers	Psychosocial impact of child's hospitalisation Mothers expectations from nurses The hospital environment Nurses’ expectations from mothers	Children's hospitalization is stressful for mothers. Open and therapeutic communication between parents and nurses contribute to improving quality of care provided to children and their families
12	Söderbäck & Christensson, 2008 Mozambique	Family involvement in the care of a hospitalized child: A questionnaire survey of Mozambican family caregivers To articulate Mozambican caregivers expressed needs, expectations and experiences of hospital care and hospital staff	Cross sectional 100 PG, random sample Questionnaire	PG demographics Impact of caring role Barriers to FCC	Parents have desire to involve in the care of their hospitalized children. The PGs’ expectations are rooted in their poverty, households situation and healthcare system and hierarchical construct of their culture. Theses influence their communication and relationships hence they view hospital staff as superior. Need to empower the caregivers in the caring process in a cultural sensitive way
13	Tsironi & Koulierakis, 2018 Greece	Factors associated with parents’ levels of stress in paediatric wards To assess the level of stress that parents of hospitalized children experienced and evaluate the association of parents stress and satisfaction and identify its predictors	Cross sectional study Convenience sample 350 parents Qiuestionnaire	FCC principles	During paediatric hospitalization, parental needs (Communication, interpersonal healthcare, continuous information and involvement in child care) should be considered to reduce parents’ stress and to improve their satisfaction in the quality of care provided
14	Coyne et al., 2011 Ireland	What does FCC mean to nurses and how do they think it could be enhanced in practice. To report nurses’ perceptions and practice of FCC	Survey design 750 nurses, convenience sample Questionnaires, open-ended questions	FCC principles Barriers to FCC	To provide good quality FCC nurses need adequate resources, appropriate education, support from managers and support from all members of the multidisciplinary team
15	Phiri et al., 2017 Malawi	Registered Nurses’ experiences pertaining to family involvement in the card of hospitalised children at a tertiary government hospital in Malawi To describe RNs experience of family involvement in the care of hospitalised children at a tertiary hospital	Descriptive qualitative study Semi-structured interview 14 FT RNs purposive sample, data saturation Qualitative content analysis	FCC principles Barriers to FCC Implications of the caring role	Family involvement in the care of hospitalised children desirable. Its implementation is inconsistent and problematic Need to regulate family involvement
16	Wray, Lee et al., 2011 UK	Parental anxiety and stress during children's hospitalisation: The stay close study To assess anxiety and stress in parents of children admitted to hospital, identify influencing factors and assess feasibility and acceptability of the methodology to parents and hospital staff	Longitudinal study using mixed methods approach Pre-post hospitalization 28 convenience sample Descriptive stats and inferential analysis	Implications of the caring role	Parents experience substantial stress and anxiety when their child is admitted to hospital. Screening for those at high risk for anxiety and implementing interventions to reduce uncertainty and maladaptive coping strategies maybe beneficial
17	Auslander, 2011 Israel	Family caregivers of hospitalised adults in Israel: A point prevalence survey and exploration of tasks and motives. To estimate the extent of inpatient caregiving by family members of patients hospitalized in acute care hospitals in Israel, and its caregiver and patient correlates.	Survey 513 convenience family caregivers Descriptive and inferential analysis	FCC principles	Staff should identify caregivers, assess their motivations, and help determine appropriate tasks
18	Caporaso et al., 2016 Italy	Characteristics of caregivers attending adult and paediatric patients in Milan Hospital To investigate in depth characteristics and needs of caregivers involved in adult and paediatric patients who are receiving treatment for acute pathologies in hospital	Questionnaire 364 caregivers	PG demographics FCC principles PG roles	Poor implementation of FCC when involving PG in caring for acute inpatients
19	Ambrosi et al., 2017 Italy	Factors affecting in-hospital informal caregiving as decided by families: findings from a longitudinal study conducted in acute medical units To describe the proportion of patients admitted to acute medical units receiving care from informal caregivers as decided by the family To identify the factors affecting the numbers of care shifts performed by informal caregivers	Longitudinal study 1464 patients convenience sample	PG roles FCC principles	Families contribute substantially to the care of inpatients especially during the morning and afternoon shifts Patients are more likely to receive IC when they are risk of prolonged hospitalization and high occurrence of adverse clinical events such as falls, agitation/confusion, pressure sores and use of physical restraints Higher amount of missed nursing care is associated with higher amount of care shifts by IC
20	Lavdaniti, Raftopoulos et al., 2011 Greece	In-hospital informal caregivers’ needs as perceived by themselves and by the nursing staff in Northern Greece: A descriptive study To compare the perceptions of the nurses and in-hospital informal caregivers about in-hospital informal caregivers’ knowledge and informational needs, and factors that influence these perceptions	Descriptive, non-experimental study 320 nurses and 370 IC in three general hospitals in Greece Questionnaires Descriptive stats	PG coping strategies Impact of caring role	In-hospital IC perceived that they have more educational and informational needs than nurses did. Nurses to identify these needs to be able to meet them
21	Ito et al., 2010 Japan	Perceptions of Japanese patients and their families about medical treatment decision making To investigate Japanese patients and their families’ perceptions regarding their actual and desired involvement in ethical decision making during a period of hospitalisation	Survey Questionnaire, convenience sample 128 patients and 41 family members	PG demographics Information sharing Decision making preferences for competent patients	Family play crucial role in healthcare decision making even for competent patients Medical decision making to be done in collaboration with the HCW
22	Lin et al., 2016 Taiwan	Reasons for family involvement in elective surgical decision making in Taiwan: a qualitative study To inquire into reasons for family involvement in adult patients’ surgical decision making processes from the view point of patients’ family	Qualitative Purposive sample of 12 family members and 12 patients	PG roles	Family obliged to participate in decision making using their personal resources and connections. Family offers emotional support to patient by helping achieve a good relationship with medical team and protects patient's rights
23	Coyne, 2015 Ireland	Families and health care professionals’ perspectives and expectations of FCC: hidden expectations and unclear roles To investigate how FCC was enacted from families and nurses’ perspectives	Qualitative, grounded theory approach 18 children, parents and nurses	FCC model of care Roles of PG Communication, negotiation of roles Implications of the caring role	Families willing to get involved in caring for their sick children in hospital Hidden expectations and unclear roles stressful for families Nurses to identify family needs and collaborate with them to provide optimal FCC
24	Stuart & Melling, 2014 England	Understanding nurses’ and parents’ perception of FCC To explore and compare the differences between parents and nurses perceptions of FCC for children's acute short stay admissions	Mixed method Questionnaires	FCC principles PG roles	Nurses to facilitate partnership with PGs to effectively implement FCC.
25	Siffleet et al., 2010 Australia	Costs of meals and parking for parents of hospitalised children in an Australian paediatric hospital To explore potential impact on family budget of costs of parking and meals incurred during a child's hospitalization	Survey	Economic implications of caring role	Hospital stay significantly depletes family disposable income Policy to consider offering three free meals to PGs Provide facilities with a broad choice of healthy, cheap and easily accessible meals on hospital site
26	Ibilola Okunola et al., 2017 Nigeria	Paediatric parents and nurses perception of FCNC in South West Nigeria To explore FCC behaviours perceived by paediatric nurses and parents as most and least important Effect of demographic characteristics on perception of FCNC	Descriptive quantitative design Purposive sample 323 PG Simple random sample 176 nurses Questionnaire	Information sharing and negotiation in FCC PG demographic characteristics	PGs and nurses value open communication and negotiation of patient care as the most important FCC behaviours. Years of nurses’ experience significantly influences perception of FCC behaviours by nurses. Length of hospital stay by PGs does not influence perception of FCC behaviours.