Experiences of Thai Family Members of Patients with COVID-19 who Died in Intensive Care Units: A Phenomenological Study.

The COVID-19 pandemic exacerbated family distress during end-of-life care, especially in the intensive care unit. Resource constraints, limited hospital capacity, and increased economic strain hindered timely access to care while amplifying public fear and social isolation. While some studies have i...

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Published in:Pacific Rim International Journal of Nursing Research Vol. 30; no. 3; pp. 738 - 760
Main Authors: Keawsuttha, Watcharee, Chaiviboontham, Suchira, Pokpalagon, Piyawan
Format: research tables/charts Journal Article
Published: Thailand Nursing & Midwifery Council Jul-Sep2026
Online Access:View this record in EBSCOhost
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      dt: Jul-Sep2026
      vid: 30
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      pub: Thailand Nursing & Midwifery Council
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        10.60099/prijnr.2026.280445
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        atl: Experiences of Thai Family Members of Patients with COVID-19 who Died in Intensive Care Units: A Phenomenological Study.
      aug:
        au:
          Keawsuttha, Watcharee
          Chaiviboontham, Suchira
          Pokpalagon, Piyawan
        affil: RN, MSN, Master's student, Master of Nursing Science Program (Adult and Gerontological Nursing), Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
      sug:
        subj:
          COVID-19
          Death Psychosocial Factors
          Intensive Care Units
          Extended Family Psychosocial Factors
          Family Attitudes Evaluation
          Stress, Psychological
          Anxiety
          Patient-Family Relations
          Grief
          Human
          Male
          Female
          Adult
          Middle Age
          Funding Source
          Phenomenological Research
          Thailand
          Qualitative Studies
          Bereavement
          Thematic Analysis
          Communication
          Powerlessness
          Uncertainty
          Burial Practices
          Culture
          Coping
          Digital Technology
          Mental Health
          Family Centered Care
          Nursing Role
          Compassion
          Support, Psychosocial
          Spirituality
          Psychological Distress
          Referral and Consultation
          Semi-Structured Interview
          Decision Making, Family
          Time Factors
          Aged
          Interviews
          Purposive Sample
          Quality of Health Care
          Descriptive Research
          Snowball Sample
          Questionnaires
          Data Analysis Software
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: The COVID-19 pandemic exacerbated family distress during end-of-life care, especially in the intensive care unit. Resource constraints, limited hospital capacity, and increased economic strain hindered timely access to care while amplifying public fear and social isolation. While some studies have investigated family experiences across regions worldwide, little is known about these experiences within Asian cultural contexts, particularly in Southeast Asia. This qualitative study, grounded in Husserl's descriptive phenomenology, explored the experiences of Thai family members of patients with COVID-19 who died in intensive care units. Ten bereaved family members were recruited via snowball sampling on online platforms through a digital poster. Participants who met the eligibility criteria were video recorded during semi-structured online interviews. Data were analyzed using Colaizzi's seven-step phenomenological method, which provides a systematic process for moving from signif icant statements to formulated meanings, theme clusters, and an essential structure of the phenomenon. This approach enabled an in-depth understanding of Thai family members' lived experiences of the death and dying of a loved one to COVID-19 in the ICU, with rigor ensured in accordance with Guba and Lincoln's criteria. The analysis revealed six themes: 1) broken and disrupted communication; 2) living with uncertainty; 3) striving for involvement in patient care amid powerlessness; 4) eternal separation without a f inal goodbye; 5) disrupted funeral rituals and cultural practices; and 6) the journey toward healing after loss. The f indings underscore the need for clear communication, flexible family involvement supported by technology, and early mental health monitoring to strengthen family-centered and bereavement care in epidemic ICU contexts. Nurses play a key role in providing timely and consistent information, coordinating family engagement through digital contact, and offering compassionate support during restricted visitation. The f indings also highlight the importance of culturally and spiritually responsive nursing care aligned with Thai beliefs and practices. In addition, nurses should screen for psychological distress, provide bereavement support, and facilitate timely referrals to prevent complicated grief. Collectively, these implications support the development of flexible, family-centered nursing protocols that can be effectively implemented during pandemics and other infectious disease crises.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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