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To explore how the restricted visitation policy impacts family members' visitation experiences and perceptions in an adult intensive care unit (ICU).
Focused ethnography.
Data collection included 39 observation sessions (totalling 65.3 h), 19 semi-structured interviews with family members, and document analysis of policies relevant to ICU visitation. Fieldwork was conducted in a general adult ICU at a tertiary hospital in China from April 2021 to December 2021. Data were analysed using reflexive thematic analysis.
Family visitation was represented by ‘being an outsider’ and ‘being an insider.’ ‘Being an outsider’ illustrates that the restricted visitation policy operated as a structural mechanism constructing the ICU as the staff's territory, positioning families as outsiders by limiting their access, information, and involvement in patient care. ‘Being an insider’ captures how family members constructed the waiting area as a socially meaningful family space where they reclaimed presence and formed a supportive community.
Family visitation was shaped by the intersection of structural constraints, culturally embedded family roles, and relational dynamics among families. Restricted visitation policies reinforced family members’ powerlessness and limited their involvement.
The findings highlight the need to critically reconsider restricted visitation policies. Flexible, context-sensitive visitation approaches that take into account cultural norms and family roles may better support family involvement in ICUs.
The study contributes theoretically informed and culturally grounded insights into how the restricted visitation policies function as active structural constraints on family members' visitation experiences. It supports global efforts to develop inclusive, family-centred ICU visitation practices that recognise the structural and relational needs of family members.
The Standards for Reporting Qualitative Research guidelines were followed.
No patient or public contribution.
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