An Exploration of Parents' and Healthcare Professionals' Experiences and Perceptions of Family-Centred Care (FCC) for Children in the PICU in Saudi Arabia: A Sequential Explanatory Mixed-Methods Study

Abstract

This thesis investigates the experiences and perceptions of parents and healthcare professionals regarding family centred care (FCC) for children admitted to paediatric intensive care units (PICUs) in Saudi Arabia, employing a sequential explanatory mixed-methods approach. Quantitative data from healthcare staff surveys assessed current FCC practices and identified key gaps, while qualitative interviews with parents and focus groups with professionals explored lived experiences and institutional barriers. The findings reveal systemic challenges such as hierarchical communication, restricted parental involvement, and environmental factors, language barriers and heavy workloads that inhibit effective FCC implementation. Although healthcare professionals conceptually support FCC, its practical application is often undermined by institutional policies and perceived parental knowledge limitations. Parents expressed trust in professionals yet reported exclusion from decision-making and care routines, resulting in feelings of helplessness and disenfranchisement. Structural and cultural factors, including restrictive visiting policies and inadequate family facilities, further hinder meaningful family participation. The study’s integrative analysis demonstrates the critical need for culturally adapted, policy supported FCC models in Saudi PICUs, highlighting the importance of infrastructure improvements, educational interventions for both staff and families, and the development of collaborative care frameworks. These recommendations are informed by both local context and international best practices, aiming to foster family engagement, improve communication, and enhance patient outcomes. This work provides new insights into FCC within the Saudi context and offers actionable strategies for reforming paediatric critical care environments to better support families and children. The thesis contributes to the growing body of evidence advocating for holistic, culturally sensitive approaches to FCC in diverse healthcare settings.