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ICU communication experiences and needs among patients, family members, and healthcare professionals: a qualitative meta-synthesis
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DOI：10.1186/s12912-026-05153-2.png)
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Abstract
En 中文
In the ICU, communication is fundamental to high-quality critical care and depends on the involvement of patients, family members, and healthcare professionals. While existing research has mainly examined the perspectives of individual groups or focused on dyadic interactions, the ways in which the experiences and needs of these three groups intersect within ICU communication have received comparatively little attention. This review aimed to synthesise qualitative evidence on the communication experiences and needs of patients, family members, and healthcare professionals in ICU settings, and to develop an interpretive framework explaining how these experiences and needs shape ICU communication. A systematic search was performed in eight electronic databases from their inception to 1 February 2026. Reference lists of included studies were also screened manually. Eligible studies were identified according to predefined inclusion and exclusion criteria. The quality of the included studies was evaluated with the Critical Appraisal Skills Programme checklist and the Mixed Methods Appraisal Tool. Findings were synthesized using thematico synthesis, and an interpretive framework was developed based on the integrated findings. The synthesis included 35 studies and developed four analytical themes: (1) information imbalance as a structural driver of instability in ICU communication; (2) multi-level structural barriers constraining communication; (3) emotional experiences as both outcomes of communication and regulatory mechanisms; and (4) adaptive strategies sustaining communication under constrained conditions. Information imbalance arose from mismatches between information complexity and recipients’ interpretive capacity, selective information disclosure, and fragmented communication delivery. Communication was further constrained by physiological and environmental conditions, interactional limitations, individual differences, and institutional factors. Communication experiences could generate both positive and negative emotions, which may subsequently influence how patients, family members, and healthcare professionals communicate. Cognitive adjustment, emotional support, and behavioral compensation partially maintained communication under constrained conditions. ICU communication is a dynamic process shaped by information imbalance, structural barriers, and emotional feedback mechanisms. Although constrained by multiple factors, communication can be maintained through adaptive strategies, highlighting its resilience even under challenging ICU conditions. Improving ICU communication therefore requires coordinated interventions targeting information delivery, structural support, emotional responsiveness, and multi-party collaboration.
Keywords:
Intensive care unit
Communication
Healthcare professionals
Family members
Thematic synthesis
Qualitative evidence synthesis
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