Thirteen studies were included in the review. Seven studies were quantitative in design and included six descriptive studies and one pre-post intervention survey (with 1,000 nurses, patients and families in 35 hospitals). Six studies were qualitative by design and included two grounded theory and four descriptive studies (interviews with 11 patients, 27 family members and 46 nurses).
Twenty-eight findings were identified from the qualitative studies and grouped into 11 categories based on commonality of meaning and relevance to visiting hours in intensive care units within the context of patient- and family-centred care. Nine of these findings were unequivocal (32%), 18 were credible (65%) and one was unsupported (2%).
All of the qualitative studies reported the main synthesised finding that visiting hours were seen as guidelines rather than rules or policy, influenced by the nurse for the benefit of self and patient. Other themes also emerged. Family involvement could include participation in the physical and emotional care of the patient. Nurses cared not only for the patient but also for the family by preparing them for what took place in the unit and giving them permission to leave should the family need to rest. Families wanted explanations of what was happening in terms they could understand and the patient wanted the family to be informed. The family developed personal cues from information provided by nurses. Dignity and respect were seen as issues; other issues were supporting all patient and family decisions and privacy and confidentiality. Visiting had different meanings for the nurse, patient and family but flexibility in time and duration emerged as an important aspect. Nurses believed that flexible visiting was beneficial to patient and families but they wanted to retain control of the policy.
Results from the quantitative studies reported that visiting hour guidelines that are flexible during certain situations were most beneficial to meet the needs of the patient, family and nurse (four studies). Flexible visiting policies also enabled the transfer of valuable information between patients, family members and nurses (four studies). Other results were reported in individual studies.