Intensive Care Nurses’ Experiences of Holistic Delirium and Depression Care: A Phenomenological Study Guided by Neuman's Systems Model

Background: Delirium and depression are common and serious complications among intensive care unit (ICU) patients and are associated with adverse clinical outcomes, prolonged hospitalization, and increased mortality. Although the clinical management of these conditions has been widely studied, less is known about how nurses integrate physical and psychological care to support patients experiencing these complex challenges. Aim: This study explored intensive care nurses’ experiences of providing holistic care for patients with delirium and depression through the lens of Neuman's Systems Model (NSM). Study Design: A qualitative phenomenological approach was used. Semistructured, in-depth interviews were conducted with 23 intensive care nurses working in a tertiary hospital. Data were analyzed using thematic analysis. Results: Six interconnected themes illustrated how nurses balanced physical and psychological care while responding to patient, environmental, and organizational stressors. The findings highlighted the perceived impact of delirium and depression on patient recovery, the central role of non-pharmacological interventions, the emotional and professional burden of care, institutional challenges influencing practice, the effects of stressors on both care quality and nurse well-being, and recommendations for strengthening holistic care. Interpreted through NSM, nurses’ experiences reflected layered preventive practices operating across primary, secondary, and tertiary levels of intervention to maintain patient stability. Conclusions: Holistic care for patients with delirium and depression extends beyond symptom management and requires attention to psychological, environmental, and organizational dimensions of care. Nurses play a pivotal role in promoting patient stability through therapeutic relationships, environmental regulation, psychosocial support, and interdisciplinary collaboration. NSM offers a valuable framework for guiding preventive, holistic nursing interventions in intensive care settings.