Near-Death Experiences in Adult ICU Patients: A Scoping Review.

About 15% of intensive care unit survivors report near-death experiences, which involve cognitive, affective, supernatural, and transcendental dimensions. These experiences produce vivid, stable long-term memories and increase spiritual needs, but their effects on psychosocial states and death attitudes vary. The Greyson near-death experience scale is the main assessment tool but has limitations. Understanding near-death experiences requires better assessment tools and integration of neurobiological and psychological frameworks. Identifying and supporting patients with these experiences is important for psychological recovery and long-term prognosis.

Study at a glance

Abstract

Near-death experiences occur in approximately 15% of intensive care unit survivors. Despite their profound impact on post-intensive care syndrome and long-term psychological recovery, near-death experiences remain under-addressed in clinical settings. To systematically map and synthesize evidence regarding the subjective experiences, influencing factors, assessment tools, and prognostic impacts of near-death experiences in adult intensive care unit patients, aiming to provide a comprehensive overview and solid reference for clinical identification and future research. Scoping review. Guided by a scoping review framework, a systematic literature search was conducted across PubMed, Embase, Web of Science, CINAHL, the Cochrane Library, PsycINFO, China National Knowledge Infrastructure, Wanfang Database, and VIP Database, from database inception to April 17, 2026. Data from the included literature were subsequently extracted and synthesized. Seven included studies (five prospective cohorts, one qualitative, one mixed-methods) revealed that adult intensive care unit patients experience multidimensional near-death experiences (cognitive, affective, supernatural, and transcendental). The Greyson near-death experience scale is the primary, albeit limited, assessment tool. Prognostically, near-death experiences produce vivid, stable long-term memories and elevate spiritual needs; however, their impacts on psychosocial states and death attitudes remain heterogeneous. The near-death experiences of adult intensive care unit survivors constitute a unique and multidimensional subjective experience, the understanding of which requires both optimized assessment tools and a deeper integration of neurobiological and psychological frameworks. While increased religious interest and memory stability are evident, the persistent contradictions in psychosocial outcomes suggest that specific disease trajectories and cultural factors play a critical moderating role. Within clinical intensive care unit practice, it is paramount to promptly identify near-death experiences by evaluating patients' multifaceted subjective experiences and providing proactive, effective support, as this plays a critical role in facilitating psychological recovery and improving long-term prognosis.