3. Family-Centred Care Interventions in Adult Intensive Care Units: A Scoping Review of Experiences, Barriers and Facilitators

Item Type: Journal Article

Authors: Chang, Pei-Yu;Nakajima, Shohei;Kuo, Shu-Yu and Tsai, Shao-Yu

Publication Date: 2026

Journal: Nursing in Critical Care 31(5), pp. e70614

Abstract: 

Background Family-centred care (FCC) is recognized as a holistic approach to improve patient outcomes, reduce psychological symptoms in family caregivers, and enhance communication between families and healthcare professionals. However, existing research has primarily focused on clinical outcomes or isolated FCC components, with limited attention given to the experiences of those involved in its implementation. 

Aims This study aimed to synthesize the experiences of family caregivers and healthcare professionals with FCC interventions and to identify the barriers and facilitators to the implementation of FCC interventions in adult intensive care units (ICUs). 

Study Design This review followed the Arksey and O'Malley framework and PRISMA-ScR guidelines, covering studies up to August 2025. The databases searched included CINAHL, Embase, PsycINFO, PubMed, Scopus and the Cochrane Library. Data were synthesized narratively to summarize the main findings across studies. 

Results A total of 32 studies were included. Both family caregivers and healthcare professionals generally expressed willingness to engage in FCC interventions. However, several barriers to implementation were identified, including interpersonal factors, relational challenges and workforce limitations. Strong relationships among families and healthcare teams, a positive unit culture and supportive institutional policies were noted as facilitators. 

Conclusions This scoping review highlights the complex interplay of interpersonal, organizational and environmental factors that influence the successful implementation of FCC interventions in adult ICUs. Addressing identified barriers and leveraging facilitators are essential for developing effective, context-sensitive strategies to enhance the delivery of FCC. Future research should focus on knowledge and tools from implementation science to guide the integration and sustainment of FCC interventions in adult ICUs. 

Relevance to Clinical Practice FCC implementation in ICUs requires addressing barriers and facilitators at multiple levels. Supportive policies, clear communication, leadership support and family needs are essential for facilitating the integration of FCC into ICU practice and strengthening collaboration between families and healthcare professionals. 


URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC13444658/

 2. Ethical and Emotional Dilemmas in the Medical Decision-Making Process Among Family Members of Intensive Care Patients: A Qualitative Study

Item Type: Journal Article

Authors: Bahcecioglu Turan, Gülcan;Demir, Mizgin and Gür, Fatma

Publication Date: 2026

Journal: Nursing in Critical Care 31(5), pp. e70630

Abstract: 

Background Intensive care units (ICUs) constitute a highly challenging environment for patients' relatives due to critical illnesses and uncertain prognoses, creating significant ethical and emotional strain. Family members often face profound ethical dilemmas and a substantial emotional burden when making medical decisions on behalf of the patient. 

Aim This study aimed to explore the ethical and emotional dilemmas experienced by family members of intensive care patients during the medical decision-making process and the strategies they used to cope with these experiences. 

Study Design This qualitative descriptive study was conducted between January and March 2026 in the adult ICUs of a public hospital located in eastern Türkiye. Data were collected through semi-structured, in-depth interviews with 20 family members selected via purposive sampling. Interviews were discontinued upon reaching data saturation. The study was reported in accordance with the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines to ensure transparency and methodological rigour. 

Findings Four main themes reflecting participants' experiences were identified: 'Ethical Dilemma and Responsibility', 'Intense Emotional Reactions and Internal Reflection', 'Information and Communication Process' and 'Coping and Support Mechanisms'. Participants reported being caught between critical decisions such as prolonging life and alleviating suffering. The weight, uncertainty and irreversibility of these decisions led to significant stress, anxiety and feelings of guilt. Social support, along with spiritual and individual coping strategies, played a crucial role in managing this process. Conclusions Family members of patients in intensive care experience a multilayered burden encompassing ethical, emotional and cognitive dimensions during medical decision-making. Effective communication, guidance and social-spiritual support mechanisms are critical in alleviating this burden. 

Relevance to Clinical Practice This study highlights the ethical and emotional burden experienced by family members during decision-making in intensive care settings and underscores the importance of clear and empathetic communication by healthcare professionals. Additionally, the provision of psychosocial and spiritual support may facilitate decision-making and reduce the burden on family members.


URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC13467664/

 1. Harnessing Artificial Intelligence to Strengthen Acute and Critical Care Nursing Practice: A Systematic Review

Item Type: Journal Article

Authors: Almagharbeh, Wesam Taher;Alkubati, Sameer A.;Alasmari, Amal Ali;Alharbi, Amal Ali;Alfanash, Hazem AbdulKareem;Abuadas, Fuad H.;El Arab, Rabie Adel;Alkhawaldeh, Abdullah;Alamri, Ayman Ateq;Albalawi, Haia Mahdi and Alatawi, Abeer

Publication Date: 2026

Journal: Nursing in Critical Care 31(5), pp. e70606

Abstract: 

Background Artificial intelligence (AI) is reshaping clinical decision support systems (CDSSs). In acute and critical care, nurses provide continuous surveillance, recognise deterioration, coordinate escalation and translate protocols into bedside action. AI-CDSS may be particularly relevant when they support rather than replace clinical judgement. Aim To examine whether nurse-used AI-CDSS improve patient-important outcomes in acute and critical care contexts and summarise effects on care processes and nurse-reported outcomes. 

Study Design Following PRISMA 2020 and a preregistered protocol, we searched eight databases and major trial registries for English-language studies from 1 January 2010 to 1 January 2026. Searches were conducted on 1 January 2026. We included randomised, quasi-experimental and adjusted cohort studies in which registered nurses or nursing teams were primary users of AI-CDSS generating patient-specific predictions or recommendations. Mortality was pooled using a random effects model; other outcomes were synthesised narratively. 

Results Seven studies involving about 75 000 patients were included. Most evidence came from acute wards, intensive care units, sepsis, deterioration and delirium-prevention contexts, with additional home and palliative care evidence. Three mortality studies were pooled. Nurse-facing AI-CDSS were associated with lower hospital mortality (RR 0.68, 95% CI 0.53-0.87; I² = 24%), although the prediction interval included possible no effect. Length of stay and protocol adherence generally improved when tools were embedded in nursing workflows. Nurse-reported outcomes were sparse. 

Conclusion Nurse-facing AI-CDSS may strengthen acute and critical care nursing by improving surveillance, escalation and protocol delivery for patients at risk of deterioration. Evidence is promising but limited by small study numbers, heterogeneous interventions and sparse nurse-reported outcomes. Critical care implementation should prioritise nurse-centred design, alert burden, equity, safety monitoring and rigorous evaluation before scale-up. Relevance to Clinical Practice Nurse-used AI-CDSS show potential to improve patient outcomes and care processes, but evidence remains limited and context dependent.



URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC13448097/