Family Support Strategies During Intensive Care Unit: A Systematic Review

Family members of critically ill patients in intensive care units (ICUs) often experience significant psychological distress due to uncertainty and fear of adverse outcomes. Structured nursing interventions may help mitigate these challenges by providing emotional support and improving communication. To assess the effectiveness of nursing interventions, compared to standard care, in enhancing communication with healthcare professionals, supporting decision-making, and strengthening emotional attachment among family members of adult ICU patients. This systematic review followed the PRISMA 2020 guidelines. Included studies focused on adult ICU patients and evaluated nursing-led interventions aimed at supporting families in communication, decision-making, or emotional bonding. Studies not involving nursing-led interventions or conducted outside the ICU setting were excluded. A comprehensive search was conducted across PubMed, Scopus, CINAHL, SciELO, and Web of Science for articles published between 2015 and 2025. The quality of included studies was appraised using the Johns Hopkins Nursing Evidence-Based Practice Model and the ROB 2 tool. A narrative synthesis was used to summarize and compare study outcomes. Eighteen studies were included, involving diverse populations, with a predominance of female participants. Interventions ranged from in-person programs-such as structured communication during rounds, open visitation policies, and family involvement in patient care-to technology-assisted approaches that facilitated decision-making and orientation. These interventions were associated with increased family satisfaction and reduced psychological distress. The evidence suggests that family-centered nursing interventions are effective in addressing the emotional and informational needs of families during ICU stays. However, variability in intervention design, small sample sizes, and moderate risk of bias in some studies limit the generalizability of findings. Further high-quality, mixed-methods and controlled studies are recommended to strengthen the evidence base.