Abstract

Research question: Development of a Theoretical Framework for Family Resilience Among Critically Ill Patients' Families in Intensive Care Settings. Background: Families of ICU patients face significant crises during their relatives’ critical illness. Family resilience plays a vital role in overcoming these challenges, yet theoretical frameworks for ICU family resilience remain understudied, limiting clinical interventions. Purpose: To explore the development of family resilience in ICU settings from the perspective of ICU medical staff and construct a theoretical framework.

Methodology: A constructivist grounded theory study using Glaser and Strauss’s traditional approach. Ten ICUs across nine provinces/municipalities in China, including Beijing, Liaoning, Shandong, Zhejiang, Sichuan, Chongqing, Xizang, Hainan and Guangdong, representing diverse geographical and cultural regions. Twenty-one ICU medical staffs (7 physicians, 14 nurses) with 3–25 years of ICU experience. Data were collected via 8 face-to-face interviews and 13 telephone interviews. Theoretical sampling and constant comparative analysis were employed until saturation.

Results: The core issue, development of ICU family resilience, emerged with 162 conceptual codes, 15 core categories, and 9 substantive concepts. The theoretical model integrates five coding families: conditions (patient illness severity, family characteristics), processes (adaptive behavior, interactive behavior, cultural factors), covariance (disease duration, economic burden), and consequences(adaptation vs. breakdown). Key adaptive behaviors included environmental, psychological, and functional adjustments. Interaction with professionals, patients, and social resources facilitated resilience. Cultural values and regional norms significantly influenced decision-making.

Conclusion: This study constructs a theoretical model of ICU family resilience from the perspective of clinicians, emphasizing the roles of adaptive processes, professional-family interaction, and cultural context. The framework offers global applicability for guiding family-centered interventions in critical care.