Exploring the perspectives of informal caregivers and healthcare professionals on the quality of care provided within an intensive care unit: a Saudi Arabia experience

Abstract

Background:
Intensive care units (ICUs) are complex environments where care quality is critical. Informal caregivers play an essential emotional and supportive role but frequently experience limited involvement in decision-making, inadequate communication, and psychological distress. In Saudi Arabia, caregiving is culturally and religiously significant, yet the perspectives of informal caregivers on ICU care quality are underexplored. Likewise, healthcare professionals' views on how best deliver high-quality care while meeting the needs of informal caregivers require further investigation.

Aim:
This research aims to explore the perspectives of informal caregivers and healthcare professionals on the quality of care provided within an intensive care unit in Saudi Arabia.

Methods:
An explanatory mixed-methods approach was used. Semi-structured interviews with informal caregivers provided insight into their experiences, emotional challenges, and expectations, while an eight-domain care quality survey was administered to ICU healthcare professionals. Follow-on focus groups with healthcare professionals were conducted to explain discrepancies between quantitative and qualitative findings. Qualitative data were thematically analysed, and survey responses were analysed descriptively using SPSS. Integration enabled comprehensive interpretation.

Findings:
Informal caregivers reported challenges related to communication barriers, restricted involvement in care decisions, limited emotional and psychological support, and distress related to visitation policy. Healthcare professionals acknowledged systemic constraints such as workload, infection control policy, and the need for informal caregiver education. Survey results indicated that healthcare professionals were generally satisfied with care quality based on adherence to guidelines. However, hierarchical nature of ICU settings created discrepancies between informal caregivers’ expectations and healthcare professionals’ perceptions. Cultural and religious norms strongly influenced informal caregiver experiences.

Conclusion:
This research provides a nuanced understanding of ICU care quality in Saudi Arabia, shedding light on the experiences of informal caregivers and healthcare professionals. The findings underscore the need informal caregivers’ engagement strategies, enhanced communication protocols, and culturally sensitive approaches to ICU care. Policy reforms, staff training, and family-centred care strategies are essential to align informal caregivers and healthcare professionals’ perspectives and improve ICU outcomes.

Thesis is embargoed until 31 December 2030.

Date of Award	Dec 2025
Original language	English
Awarding Institution	Queen's University Belfast
Supervisor	Peter O'Halloran (Supervisor) & Loreena Hill (Supervisor)