Families’ experiences with a novel nurse-led family support intervention in adult intensive care units: A qualitative thematic analysis

BACKGROUND: Families of critically ill patients face considerable distress during and after their significant others' intensive care unit (ICU) stay. To better address families' needs and to mitigate high burden and post-ICU adverse health outcomes, we implemented a novel family support intervention (FSI) in ICUs as part of a clinical trial. The FSI consists of three core components (engaging & liaising, supporting, communicating), delivered by an ICU family nurse from admission to the post-ICU phase and have shown to improve quality of care in the ICU. OBJECTIVES: The aim of this study was to explore and understand families' experiences with and their perspectives on the benefits of the FSI. DESIGN: A multi-center, qualitative thematic analysis study, embedded within the Family in Intensive Care UnitS (FICUS) cluster-randomized clinical trial. PARTICIPANTS: Family members (n = 17) and ICU survivors (n = 2) of 16 families from eight ICUs, allocated to the FICUS intervention group in the German speaking part of Switzerland. METHODS: 16 semi-structured individual (n = 14), dyadic (n = 1) or group (n = 1) interviews were held from October-December 2023, between three and six months after patients' ICU discharge. Reflexive thematic data analysis with an inductive approach was used. RESULTS: Three themes and nine subthemes were identified. The three themes included having individual family needs met (information and education, coordinative and practical help, and emotional support), skilled care (authentic interest, skilled communication, and knowledge and expertise) and experiencing benefits (feeling assured and oriented, reduced burden and stress, and ability to manage and cope as a family). IMPLICATIONS: Findings highlight the importance of individualized, skilled and strengthening ICU care tailored to families' needs and situations, which follows families into the post-ICU phase. Families experienced the FSI as a beneficial model of care for both individual and family well-being. ICUs should consider building capacity to ensure structured family care.