Familial Roles in Surrogate Decision‐Making for Mechanically Ventilated Patients in the Respiratory Intensive Care Unit: A Qualitative Study

BACKGROUND: In China, when patients need mechanical ventilation treatment, alternative decision-makers are influenced by many factors before making a decision. AIM: This study aimed to explore the experiences of family members in making decisions about mechanical ventilation proxies in respiratory intensive care units. STUDY DESIGN: We employed a phenomenological study design and collected data through semi-structured interviews with purposively selected 12 family members of mechanically ventilated patients who were admitted to the RICU of a tertiary grade A hospital in Chongqing in June and July 2024. The Colaizzi seven-step analysis method was utilised, and the NVIVO 12.0 software was used for data processing. RESULTS: This study identified three main themes: (1). Complex emotions related to decision-making (intersecting expectations and hopes, coexisting fears and worries); (2). Social and cultural influences (benevolence and filial piety, peace and a good death, family consultation and patient autonomy); and (3). Personal background factors (economic burden, knowledge levels, perceptions of emotional patients and limited doctor-patient communication). CONCLUSIONS: When patients in the RICU undergo mechanical ventilation, family members encounter a decision-making dilemma influenced by various factors. RELEVANCE TO CLINICAL PRACTICE: Our research aims to explore the decision-making experience of family members with mechanical ventilation in the RICU. Intensive care nurses can refer to our research results or verify them, thereby helping patients and their families make better decisions.