Family member's perceptions of and experiences with technology in intensive and critical care units: A thematic synthesis

Objectives: To synthesise family members' perceptions of technology in intensive care units. For this study, critical care technology encompasses all electronic, mechanical, and digital equipment used for therapeutic, monitoring, and supportive purposes. Understanding these experiences suggests the importance of maintaining meaningful human connection and emotional support whilst navigating the complexities of critical care technology. Methods: The thematic synthesis was reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. A systematic search was conducted in databases of the APA PsycINFO, CINAHL Plus, EMBASE and PubMed from inception up to June 2024. Qualitative studies that presented family members' quotes regarding technology in intensive care units in peer-reviewed journals were included. Two reviewers independently screened the search results and extracted data from the publications. Although all the included articles were critically appraised using the critical appraisal skills programme checklist and mixed methods appraisal tool, the results of the appraisal did not influence the decision of inclusion. Results: A total of 3,102 articles were identified, 35 articles were included in the full-text assessment and a total of 16 studies were included. As the result of thematic synthesis, three analytical themes and sub-themes were developed as follows: "understanding therapeutic benefits, yet acknowledging the proximity to death" founded on two sub-themes of "therapeutic benefits" and "proximity to death"; "facilitating connectedness and distancing" with sub-themes of "overwhelming strangeness," "information bridge," and "overcoming the physical distance"; and "concerns: comfort and privacy" with sub-themes of "environmental disturbances" and "surveillance ethics". Conclusion: This thematic synthesis illuminates how family members interpret and experience technology in ICUs, offering insights for healthcare providers to enhance family engagement in technological environments. Implications for clinical practice: Understanding these experiences suggests the importance of maintaining meaningful human connection and emotional support whilst navigating the complexities of critical care technology.