Anticipatory Grief as a Holistic Experience: A Phenomenological Study of Family Members in an Indonesian Intensive Care Unit

Abstract

Purpose: This study explored how family members of terminally ill patients in an intensive care unit (ICU) experience anticipatory grief as a holistic, multidimensional phenomenon. Design: A qualitative phenomenological approach guided by Jean Watson's Theory of Human Caring was used to capture participants’ lived experiences. Methods: In-depth semi-structured interviews were conducted with seven family members of terminally ill patients in the ICU of a public hospital in West Java, Indonesia. Participants were recruited using purposive sampling. Data were analyzed using Colaizzi's method and reported according to the COREQ checklist. Findings: Five interrelated themes emerged: (a) emotional storm in the face of uncertainty; (b) faith as a spiritual anchor; (c) searching for meaning through reflection; (d) the need for connection and compassion; and (e) preparing the heart through ritual, hope, and letting go. Families experienced grief as a spiritually rooted, emotionally intense, and relationally significant journey, shaped by cultural practices and their interactions with nurses. Conclusions: Anticipatory grief in the ICU is a holistic crisis that calls for intentional, compassionate, and spiritually sensitive nursing presence. Findings support the integration of holistic caring principles and culturally congruent support into ICU practice.