The needs and experiences of critically ill patients and family members in intensive care unit of a tertiary hospital in Malaysia: a qualitative study

Abstract

Background Admission to an intensive care unit (ICU) is a stressful experience for patients and their family members. While the focus of management is primarily on medical care, there can be other areas which are overlooked. The purpose of this study was to investigate the needs and experiences of ICU patients and family members. Method This qualitative study involved four trained researchers conducting in-depth interviews (IDI) based on a semi-structured interview guide. The participants were ICU patients and family members. All IDIs were audio-recorded and transcribed verbatim. Four researchers independently analyzed the data via thematic analysis with the aid of QDA Miner Lite®. The themes and subthemes were generated and confirmed by literature and expert opinion. Results Six IDIs were conducted with three patients and three family members, whose ages ranged from 31 to 64 years old. One pair of participants consisted of a patient and his respective family member, while the other four participants did not have a familial relationship with each other. Three main themes emerged from the analysis: (I) critical care services; (II) physical spaces; and (III) monitoring technology. Medical, psychological, physical, and social needs for critical care services were expressed by both patients and family members. Patients’ needs in clinical spaces were highlighted as a conducive ICU environment with ambient temperature and controlled noise levels. In non-clinical spaces, family members expressed a need for more chairs in the waiting area. Participants expressed the need for call bells as well as patients’ negative perceptions of medical equipment alarms in the ICU when it pertained to monitoring technology. Conclusion This study provides an in-depth view at the needs and experiences of ICU patients and family members who have a variety of unmet needs. This understanding is critical for guiding ICU personnel and stakeholders in their efforts to humanize ICU care.

The experiences of the families of patients admitted to the intensive care unit

“…The patient-to-nurse ratio in the ICUs is two to one. Families of patients who had been in the ICU for at least three days were invited to participate in the study [ 12 ]. Visits in the ICU were limited to specific days, namely Monday, Wednesday, and Friday.…”

“…Several studies have highlighted the experiences of families with patients hospitalized in ICUs by focusing on family planning, decision-making for the patient, and improving patient care. For instance, Leong (2023) in Malaysia emphasized the use of family experiences for systematic planning [ 12 ]. Digby (2023) in Australia highlighted the role of family experiences as intermediaries between the patient and the doctor in decision-making [ 13 ].…”