Factors contributing to the limited applicability of the caregiver-patient-family triad in critical care

Abstract

Introduction: The caregiver-patient-family triad is a fundamental relational model in critical care, recognised for its positive impact on clinical outcomes and patient satisfaction. However, its effective implementation in Congolese hospitals remains problematic. This study aimed to identify the factors contributing to the limited application of this triad at the Bolenge General Referral Hospital (HGR) and to propose avenues for improvement tailored to the local context.

Methods: A cross-sectional study with descriptive and analytical objectives was conducted from 15 January to 15 April 2026. Exhaustive sampling enabled the inclusion of 92 healthcare professionals working in the critical care units of the Bolenge General Reference Hospital (HGR). The data, collected using a validated self-administered questionnaire exploring organisational, communicational, cognitive and institutional dimensions, were subjected to univariate and bivariate analyses (Pearson’s chi-squared test).

Results: Only 16.3% of respondents were able to systematically involve the family in the care process. The predominant barriers included excessive workload (89.1 per cent), a lack of time dedicated to communicating with families (84.8 per cent), the absence of family involvement protocols (80.4 per cent), a lack of training on the triadic relationship (77.2 per cent) and perceived communication difficulties (72.8 per cent). Inferential analysis revealed that the effective integration of the triad is significantly correlated with specific training for healthcare staff (p < 0.001) and the existence of clear institutional protocols (p = 0.002).

Conclusion: The operationalisation of the caregiver-patient-family triad within the Bolenge Regional General Hospital remains hampered by multidimensional systemic barriers. The introduction of targeted training, the development of appropriate protocols and the provision of dedicated spaces for families are priority areas for action to optimise the quality of critical care.

Keywords: healthcare provider–patient–family triad, critical care, organisational barriers, care relationship, DRC.

Received Date: April 21, 2026

Accepted Date: May 12, 2026

Published Date: June 01, 2026

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/751