Family Intensive Care Unit Syndrome: Investigating the Mediating Role of Healthcare Communication in Psychological Well-Being Among Family Members.

Abstract

Background: Family members of patients in intensive care units (ICUs) often encounter profound emotional and psychological difficulties, a condition known as family intensive care unit syndrome (FICUS). These experiences can severely affect their mental health and psychological well-being. While effective communication within healthcare environments is likely essential for mitigating these challenges, it has not been thoroughly researched as a mediating factor in FICUS.

Aim: This study explores how healthcare communication influences the connection between FICUS and the psychological well-being of family members.

Study design: A cross-sectional descriptive design was adopted across 10 hospitals in Mansoura City, Egypt. Utilising convenience sampling, the study included 244 adult family members (aged 18 and older) of ICU patients who were actively involved in decision-making and maintained regular communication with healthcare staff. Exclusion criteria included family members receiving palliative care or those with pre-existing psychological conditions. Validated tools used in the study included the Family Intensive Care Unit Syndrome Inventory, Ryff's Psychological Well-being Scale and the Healthcare Communication Questionnaire.

Results: Structural equation modelling revealed that healthcare communication fully mediates the relationship between FICUS and psychological well-being. A significant indirect effect was observed (Estimate = -0.063, p < 0.001), while the direct effect was not statistically significant. Model fit indices were excellent (Comparative Fit Index [CFI] = 1.000, Tucker-Lewis Index [TLI] = 1.000, Root Mean Square Error of Approximation (RMSEA) =0.000 and Standardised Root Mean Square Residual [SRMR] ≈0.000), supporting the robustness of the mediation model. Additionally, age negatively influenced both psychological well-being and healthcare communication, identifying older adults as particularly vulnerable.

Conclusions: The findings emphasise the detrimental impact of FICUS on family members' psychological well-being and the pivotal role of healthcare communication in alleviating these effects. Tailored communication strategies and support services are particularly crucial for older family members.

Relevance to clinical practice: The study highlights the critical need to improve healthcare communication practices in ICU settings. Training clinicians in structured and empathetic communication, particularly for families of elderly patients, may help buffer the emotional burden associated with FICUS. Establishing communication protocols and offering psychosocial support services are essential for protecting the well-being of ICU family members.