Exploring the association between family needs and clinical status in intensive care unit patients: a cross-sectional study.

Background: Admission to the intensive care unit (ICU) significantly impacts patients and their families, and unmet family needs can lead to post-intensive care syndrome-family (PICS-F), highlighting the importance of nursing support and family-centred care. Aims: To examine the association between the clinical status of critically ill patients (CIPs) and the perceived needs of their next of kin (NOK) in an ICU. Methods: A cross-sectional study was conducted with 140 dyads of CIPs and their NOK in a Portuguese ICU. Clinical status was assessed using the Coma Recovery Assessment Instrument of the University of Aveiro, the Glasgow Coma Scale, the Richmond Agitation-Sedation Scale, the Numeric Pain Scale and the Behavioural Pain Scale. NOK needs were assessed using the Family Needs Inventory in the ICU. Results: NOK needs were highly prioritised, particularly regarding participation in care and information. Significant negative associations were found between patients' clinical status scores and the perceived importance of NOK needs, indicating that poorer clinical status was associated with greater perceived needs. Sex, ventilatory support and relationship to the patient were identified as independent predictors of the perceived importance of NOK needs. NOK of patients under sedation, analgesia and invasive mechanical ventilation reported higher scores. Conclusions: Clinical severity is significantly associated with NOK needs. This study contributes to nursing theory by reinforcing a family-centred perspective and highlighting how patient clinical instability may increase family vulnerability during ICU hospitalisation. Nursing practice and policy recommendations include structured communication protocols and formalised family involvement in care to mitigate PICS-F.