ICU sedation, delirium & recovery
Barriers to critical care utilization in low-resource settings: A multicenter study of family perspectives
Authors' conclusion
Family perceptions of ICU care in Pakistan are defined by fear, financial constraints, spiritual values, and a strong desire for active participation.
Study context
- Population
- Family members of intensive care unit (ICU) patients at 10 public hospitals in three provinces of Pakistan6 focus groups
- Participants
- 38 members
- Outcome
- Families' perceptions of intensive care and barriers affecting ICU utilization
Methodological detailsfocus group discussions, multicentre, inductive thematic analysis
- Focus group discussions
- Multicentre
- Inductive thematic analysis
Main finding
As reported in the abstract
- Three themes and 16 subthemes emerged
- ICU admission viewed as a sign of impending death, causing significant psychological distress
- Ventilators understood as lifesaving, though some associated them with harm
- Major barriers: public bed shortages and prohibitive private costs; insurance has improved access
- Families prioritized active involvement in care but faced poor communication, mistrust in private hospitals and discomfort with trainees
- 24-h senior physician coverage provided reassurance
- Spiritual beliefs heavily influenced end-of-life decisions, often prompting care withdrawal to prevent suffering
Original publication
Barriers to critical care utilization in low-resource settings: A multicenter study of family perspectives. J Crit Care. Published 10 April 2026. doi:10.
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