Patients' experiences of humanising care in Scandinavian intensive care units - a systematic review

Using Scandinavian literature reporting patient experiences of intensive care as a case, the aim of this qualitative systematic review was to explore if humanising was addressed in the descriptions of patient experiences and, if so, what words and theoretical perspectives were used to underpin the results. A comprehensive search of qualitative studies published between 1 January 2016 and 12 December 2024 was conducted in Embase, CINAHL, MEDLINE, Scopus, and Web of Science. Twenty-nine studies reporting patient ICU experiences were included and analysed using thematic synthesis following Thomas and Harden. The review adhered to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist. The terms humanisation and de-humanisation were not explicitly used, but the studies engaged with these concepts by corroborating the three themes that defined humanising ICU in this study: (1) feeling recognised as a human being when experiencing connectedness with healthcare professionals, (2) feeling connected with themselves and the situation when experiencing safety and well-being, and (3) feeling connected with significant persons and life outside the ICU. In addition, our analysis identified a further theme: (4) experiencing capacity to influence the situation when able to express themselves. Humanising intensive care involves ethical and caring engagement with the patient, helping them feel connected, experience well-being, and influence their situation. Although Scandinavian literature has not directly studied humanisation, it has focused on understanding patients' experiences and addressing the ontology of critical illness. As such, humanising ICU aligns well with Scandinavian nursing traditions.Implications for clinical practiceICU staff should actively listen to patients and encourage them to express needs and preferences, create a safe and calm environment that supports well-being, and maintain communication with patients and families to promote a humanising approach to intensive care.