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Navigating Culture and Crisis: Saudi Mothers' Experiences of Family-Centered Care in Pediatric Intensive Care Units-A
Waleed M Alshehri1, Albandari Almutairi2, Thurayya Eid1
1Department of Medical-Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia.
Background: Family-centered care (FCC) is a foundational principle in pediatric healthcare, yet its implementation in culturally specific contexts remains poorly understood. In Saudi Arabia, Islamic values, collective family structures, and gendered caregiving norms shape how mothers engage with pediatric intensive care in ways that existing Western-derived FCC models do not fully capture. The aim of this study was to explore Saudi mothers' experiences of family-centered care during their children's pediatric intensive care unit (PICU) admissions, focusing on perceived barriers, cultural negotiations, and evolving advocacy strategies. Methods: A qualitative descriptive study was conducted with 17 Saudi mothers whose children had been admitted to PICUs across major hospitals in Saudi Arabia within the preceding 12 months. Semi-structured interviews lasting 40-70 min were conducted in Arabic using a pilot-tested, 15-item guide. Data were analyzed through Braun and Clarke's six-phase reflexive thematic analysis. Trustworthiness was strengthened through member checking, reflexive journaling, negative case analysis, and investigator triangulation. Reporting adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Result: Five interconnected themes emerged: (1) confronting crisis and uncertainty, (2) renegotiating maternal identity, (3) brokering culture within biomedicine, (4) forging trust with care teams, and (5) evolving into advocates. These themes trace a developmental arc from initial disorientation through progressive empowerment, shaped at every stage by culturally grounded resources and constraints. Mothers functioned as cultural brokers performing invisible labor that healthcare systems neither recognized nor supported. Conclusions: Saudi mothers in PICUs engage in sophisticated cultural mediation between family systems and biomedical institutions under conditions of acute stress. Findings underscore the need for structurally embedded cultural responsiveness in PICU policy, including continuous cultural assessment, care-team continuity, and family advocacy support.
Background: Family-centered care (FCC) is a foundational principle in pediatric healthcare, yet its implementation in culturally specific contexts remains poorly understood. In Saudi Arabia, Islamic values, collective family structures, and gendered caregiving norms shape how mothers engage with pediatric intensive care in ways that existing Western-derived FCC models do not fully capture. The aim of this study was to explore Saudi mothers' experiences of family-centered care during their children's pediatric intensive care unit (PICU) admissions, focusing on perceived barriers, cultural negotiations, and evolving advocacy strategies. Methods: A qualitative descriptive study was conducted with 17 Saudi mothers whose children had been admitted to PICUs across major hospitals in Saudi Arabia within the preceding 12 months. Semi-structured interviews lasting 40-70 min were conducted in Arabic using a pilot-tested, 15-item guide. Data were analyzed through Braun and Clarke's six-phase reflexive thematic analysis. Trustworthiness was strengthened through member checking, reflexive journaling, negative case analysis, and investigator triangulation. Reporting adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Result: Five interconnected themes emerged: (1) confronting crisis and uncertainty, (2) renegotiating maternal identity, (3) brokering culture within biomedicine, (4) forging trust with care teams, and (5) evolving into advocates. These themes trace a developmental arc from initial disorientation through progressive empowerment, shaped at every stage by culturally grounded resources and constraints. Mothers functioned as cultural brokers performing invisible labor that healthcare systems neither recognized nor supported. Conclusions: Saudi mothers in PICUs engage in sophisticated cultural mediation between family systems and biomedical institutions under conditions of acute stress. Findings underscore the need for structurally embedded cultural responsiveness in PICU policy, including continuous cultural assessment, care-team continuity, and family advocacy support.
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