title: Memory-making in critical care: a qualitative thematic synthesis
Creators: name: MacEachen, Doreen
Publisher: name: University of Glasgow
Year: 2022

description: Background: Caring for bereaved families is an important aspect of the nursing role in critical care, due to the significant number of deaths and the immediate and long-term effects on family members’ individual grief. Memory-making practices are one way in which dying, death and bereavement can be acknowledged and supported within critical care. Memory-making was introduced into the care of babies who were stillborn and neonates who died to improve parents’ experiences of bereavement, and has since become common practice in adult critical care settings. However, there is limited research to evaluate its impact on bereaved families and their grieving experience. This thesis is a qualitative thematic synthesis which aims to explore families’ experiences of memory-making practices in critical care, with a view to gaining greater understanding of the ways in which memory-making impacts bereaved families and individuals, and the factors which affect their experience of memory-making. Methods: A qualitative thematic synthesis was carried out to systematically identify and synthesise qualitative evidence to explore families’ experiences of memory-making practices in both paediatric and adult critical care settings. A systematic search strategy was developed and five databases were searched (Medline, CINAHL, PsycINFO, Embase and ASSIA). Seven qualitative studies were included, exploring four adult and three paediatric critical care settings in which memory-making was initiated between 2014 and 2020. The memory-making practices included patient diaries, general keepsakes, word clouds and photography. Results: The qualitative thematic synthesis generated four main themes to describe families’ experience of memory-making in critical care: connection, compassion, engagement and creation, and continuation. Connection was made through the shared experience of humanity and emotion, and helped to developed trusting relationships between families and nurses. Compassionate care supported and guided families during the end of a loved one’s life. It welcomed families, and made them more comfortable in a highly technical environment. Engagement with memory-making led to the creation of memories and keepsakes, and was a therapeutic experience that supported the transition of saying goodbye. Families continued their relationship with their loved one and individual grieving process, after the death of their loved one. Conclusions: Memory-making is a meaningful activity for families whose loved one has died in critical care; it brought focus and meaning during a devastating process in a highly technical environment. Families relied heavily on nursing staff for support and guidance, and perceived the offering of memory-making as compassionate care. The creation of keepsakes can foster deeper connections within families and staff, and has a positive impact on the bereavement experience. Families within this synthesis created their memories and keepsakes as a way to stay connected, and therefore continue their relationship with their loved one.