Psychological needs and their determinants among family members of ICU patients: a mixed-methods study

Family members of patients in intensive care units (ICU) experience substantial psychological stress, primarily driven by uncertainty about prognosis, restricted visitation policies, and insufficient communication with healthcare professionals; however, their needs remain inadequately recognized and addressed in routine clinical practice. To examine the levels, associated factors, and lived experiences of psychological needs among ICU patients’ family members using a mixed-methods approach. A convergent parallel mixed-methods design was conducted in a tertiary hospital in China. Quantitative data were collected from 200 family members of ICU patients using the Critical Care Family Needs Inventory and analyzed with descriptive statistics and multiple linear regression. Limited de-identified patient clinical data were extracted in accordance with the ethics-approved protocol. Qualitative data were obtained from semi-structured interviews with 16 family members and analyzed using Colaizzi’s phenomenological method. Findings were integrated using a joint display approach. A total of 200 family members completed the quantitative survey, and 16 participated in individual interviews. The overall psychological-needs score was 145.39 ± 19.59. Assurance had the highest mean item score (3.75 ± 0.35), followed by Information (3.51 ± 0.49), Proximity (3.45 ± 0.50), Support (2.89 ± 0.61), and Comfort (2.78 ± 0.87). Factors associated with psychological needs varied across dimensions, including ICU experience and occupation for Assurance; residence and illness understanding for Support; cohabitation, ethnicity, illness understanding, and age for Information; occupation for Proximity; and religious belief for Comfort. Qualitative analysis identified five major domains: personal distress, assurance needs, information and communication needs, proximity needs, and guidance needs. The qualitative findings converged with the quantitative findings for Assurance, Information, and Proximity, partially converged for Support, and expanded the quantitative assessment by identifying personal distress and guidance needs. Psychological needs of ICU patients’ family members extend beyond those captured by quantitative measures, with emotional support and guidance often underrecognized. Discrepancies between measured and lived experiences highlight the value of mixed-methods approaches and the need for more responsive family-centered care.