Abstract
BACKGROUND: Relatives play an important role for patients cared for in the ICU. Relatives contribute with several positive aspects for the patient receiving care, which also leads to shorter hospital stays and lower mortality rates in cases of serious illnesses. It is therefore important how relatives describe their own engagement and involvement in the care process. AIM: The aim of this study is to explore the meaning of participation in the ICU from the close relatives' perspective. STUDY DESIGN: The study has a qualitative research design using interviews with 12 close relatives (female 9, male 3) of patients treated in the ICU, conducted in one county hospital. The interviews were analysed with thematic analysis. FINDINGS: Our analysis resulted in one main theme and three subthemes. The main theme showed that relatives described participation as conditional during critical illness that requires care in the ICU. Three subthemes emerged: being at the centre of the event, being seen as a unique person and being informed. CONCLUSIONS: Participation in the ICU is contingent upon physical and emotional proximity, relational dynamics, and access to information. Caregivers facilitate this engagement through consistent relationships, adaptive strategies, and transparent communication. To strengthen family involvement, ICUs should implement structured approaches, ensuring participation is inclusive, meaningful, and responsive to individual needs. As research advances, a holistic framework for family engagement will be essential to improving. RELEVANCE TO CLINICAL PRACTICE: Strengthen oral and written communication structures in the ICU. Promote continuity in care relationships. Utilise technology to enhance remote participation.