Cultural and Socioeconomic Determinants of Family Satisfaction in ICU Care Across the Globe: A Scoping Review

Margiben Tusharbhai Bhatt¹Sunil Ravindranath^1*Souvik Chaudhuri¹Shreya Nair²Anuja Damani²Bhumika Tumkur Venkatesh³Sujata Shirodkar³

• ¹Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
• ²Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
• ³Campbell South Asia, New Delhi, India

Objective: To map evidence on global cultural and socioeconomic determinants of family satisfaction undergoing treatment in intensive care unit (ICU), including tools used for assessment, influence of cultural beliefs and practices, and impact of socioeconomic status on family satisfaction. Study design: This scoping review followed Joanna Briggs Institute (JBI) guidelines and was reported in accordance with PRISMA-ScR. A comprehensive search of English-language studies was conducted across multiple databases. Studies were included if they examined the impact of cultural and socioeconomic factors on shared or end-of-life decision-making by family members, or if they explored the relationship between these factors and psychological outcomes (e.g., anxiety, depression, insomnia) in caregivers during ICU stays—provided family satisfaction was also assessed. Two independent reviewers screened all studies, and data was extracted using a customized form to ensure consistency and relevance to the research question. Results: A total of 2,121 articles were identified from PubMed (n=68), Scopus (n=475), Embase (n=1,436), Web of Science (n=138), Cochrane (n=4), and other sources (n=10). After removing duplicates, 1,772 articles underwent title and abstract screening, with 101 full texts evaluated. Seventeen studies met the inclusion criteria. Data extraction focused on family characteristics (e.g., religion, race, education, kinship, prior ICU experience), sociocultural and economic factors, end-of-life practices, and ICU-related elements influencing family satisfaction. Findings were narratively synthesized to provide a comprehensive overview of these contextual influences. The review revealed that prioritizing patient symptoms, fostering effective communication to support shared decision-making, and showing compassion toward family needs significantly enhanced family satisfaction. However, a major gap was identified in research from low-and middle-income countries (LMICs). Further studies are needed to understand how diverse cultural and socioeconomic factors affect caregiver satisfaction in these settings and to develop tailored strategies that improve family experiences and outcomes in intensive care units globally. Conclusion: This review comprehensively mapped available evidence and noted that addressing the cultural, socioeconomic, religious, and spiritual requirements of the family, including comfort-based care interventions in ICU may lead to better family perception of ICU care and satisfaction. Further studies are required, especially in LMIC settings, addressing diverse races, religions, and ethnicities in this regard.