Bereaved Families' Experiences of Treatment Withdrawal and End-Of-Life Care in the Intensive Care Unit: An...

Bereaved families may experience emotional distress, uncertainty and psychological challenges during treatment withdrawal and end-of-life care in the intensive care unit.

To explore bereaved family members' experiences of treatment withdrawal and end-of-life care in the adult intensive care unit.

The study employed an exploratory descriptive qualitative design. A semi-structured interview guide was used to gather data from seven bereaved family members. Participants were purposively sampled from an 18-bedded adult multi-disciplinary intensive care unit in South Africa. Interviews were transcribed verbatim, imported into qualitative software and analysed using inductive thematic analysis. This qualitative study followed the Consolidated Criteria for Reporting Qualitative Research checklist.

Three major themes emerged from data analysis: emotional reactions and coping, a desire for proximity and participation in care, and communication and information sharing. Families experienced shock, anxiety and emotional distress, relying on social support, faith and personal beliefs to cope with their challenges. They sought physical presence, active participation and spiritual support to cope with treatment withdrawal and end-of-life. Clear, compassionate communication and emotional support was critical to shaping their experience and perception of care.

Bereaved families' experiences during treatment withdrawal in the intensive care unit are complex and multifaceted, often shaped by emotional, spiritual and communication dynamics. Most families experience grief and are inadequately prepared for the impending death of their loved one. Effective communication, family involvement, interdisciplinary collaboration and teamwork are imperative in providing quality end-of-life care. Healthcare providers need to recognise the patient and family as a unit of care and support them throughout the treatment withdrawal process and end-of-life care.

Developing and implementing programs that provide psychological support, educational resources such as informational booklets on grief, and guidance on navigating healthcare services and follow-up care can help bereaved families cope. Similarly, adopting a holistic and family-centred care approach that addresses the emotional, psychological and practical needs of families can improve their overall experience and satisfaction with care.