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To discuss reflexivity for conducting hermeneutic phenomenology and to present the hermeneutic phenomenological circle.
Discussion paper.
We employed data on the lived experience of loneliness of older adults in residential care homes during the COVID-19 pandemic to demonstrate the reflexivity required for hermeneutic phenomenology. We showcased a reflective process grounded in Heidegger's notions of Being and temporality to uncover the context of meaningfulness and its temporal influence on being.
We proposed a hermeneutic phenomenological circle encompassing four relations passing between Being, the interpreter and being. The circle was successfully applied to demonstrate the reflexivity required to conduct hermeneutic phenomenology.
Engaging in reflexivity requires the researcher to develop knowledge about the philosophy of hermeneutic phenomenology. The hermeneutic phenomenological circle facilitates researchers in anchoring their reflections in Being and temporality.
The hermeneutic phenomenological circle serves as a useful tool for researchers/health professionals to learn hermeneutic phenomenology and to facilitate researchers/health professionals at all career stages to engage in reflexivity.
To investigate the effects of active involvement of family caregivers in adult in-hospital care on patients' readmissions, complications, mortality, length of hospital stay, quality of life, psychological distress and activities of daily living, as well as on the satisfaction of patients, HCPs and family caregivers.
Systematic review.
Ovid Medline, Ovid Embase, EBSCO CINAHL, Cochrane Library (from inception to February 2024).
The PRISMA 2020 statement was followed. Prospective controlled studies focusing on active involvement of family caregivers in adult in-hospital care were included. Two independent teams of authors conducted study selection, quality assessment and data extraction.
Thirteen studies were included, comprising 11 randomised controlled trials. The clinical and methodological heterogeneity precluded a meta-analysis. Six of these studies were performed in stroke patients. Some studies reported statistically significant benefits of active family involvement on readmission rates, hospital LOS, ADL, psychological distress for patients and family members, QoL and satisfaction of family caregivers. However, others did not observe differences in these outcomes. For complication rates, mortality and satisfaction of patients and HCPs, no studies demonstrated significant differences between groups.
Further research is needed to provide a conclusive answer as to whether active family caregiver involvement improves outcomes of adult hospitalised patients.
Despite the inconclusive findings of this review, advocating for active involvement of family caregivers in adult in-hospital care fits the perspective of patient- and family-centred care.
As the care of hospitalised adults is shifting to a more family-centric approach, investigating the effects of an active role of family caregivers in adult in-hospital care is necessary. However, the small number of studies available and heterogeneity between studies included in this review hamper firm conclusions. Further evaluations through well-designed studies are required.
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