Stressors, Needs and Satisfaction of Families of Critically Ill Arabic Patients: A Systematic Review

Family members of critically ill patients encounter major emotional, psychological, and practical challenges, especially during ICU admissions, delays, or transfers. For Arabic families, whether Muslim or Christian, these experiences are strongly influenced by cultural, religious, and social norms.

To conduct a systematic review and synthesis on the stressors, needs, and satisfaction of families of critically ill Arabic patients, with the aim of informing culturally sensitive, family-centered care in the ICU.

A systematic literature review was conducted from 2005 to March 2025. Eligible studies were peer-reviewed English-language articles examining stressors, needs, or satisfaction among families of critically ill Arabic patients in critical care settings. Some studies used validated Arabic versions of standardized instruments (e.g., FS-ICU, CCFNI). Searches were performed in PubMed, CINAHL, Scopus, Web of Science, and the Saudi Digital Library. Study selection followed PRISMA 2020 guidelines, and data were narratively extracted and synthesized.

A total of 52 studies met the inclusion criteria. Thirty (58%) were rated as high quality, 15 (29%) as moderate, and 7 (13%) as low quality. Families reported major stressors including uncertainty, restricted visitation, financial burdens, and cultural or linguistic barriers. Their key needs were emotional reassurance, spiritual guidance, clear communication, and involvement in decision-making. Family satisfaction improved when care was empathetic, culturally sensitive, and supported by spiritual and psychological resources. There is limited evidence on pediatric ICUs and settings affected by violence because most research was conducted in the Middle East and North Africa (MENA) region.

Families of critically ill Arabic patients face complex stressors and have distinct culture-related needs that must be addressed to ensure quality care in the ICU. Empathy, clear communication, and cultural competence from healthcare providers are central to meeting family expectations. However, gaps remain in longitudinal research, studies focusing on pediatric ICUs, and the use of culturally validated measurement tools.

The lack of culturally competent family-centered care remains a significant challenge for practitioners. Enhancing healthcare professionals' cultural sensitivity, implementing spiritually inclusive care, and involving families in shared decision-making are essential steps to improving outcomes for Arabic families in intensive care settings.