This article is a meta-synthesis of qualitative studies of patients’ families' experiences following the withdrawal of end-of-life care (EOLC) in intensive care unit, once the decision of withdrawing life-sustaining treatments has been made. This article addresses a topic of great significance given the impact that poor EOLC might have on patients and their families’ lives. Thank you for the opportunity to review this manuscript.
This article is well-written, the review well designed with an appropriate methodology used and it aims at addressing a lack in the current literature. Indeed, the paper engages in the development of a conceptual model of preparedness that reflects families’ needs during EOLC in intensive care units that might help the development of EOLC guidelines and of caring practices. As such, the manuscript provides interesting and relevant information and it has great applicability to put into practice. I have only a few suggestions and questions.

BACKGROUND
1. The author/s uses the term “withdrawal” in the paper, but their search strategy has included also the element “withh”. This suggests that they have taken into consideration cases of EOLC where life-support modalities have been withheld or withdrawn. Could they make this clear in the paper?
2. The author/s should quote the following paper: Chen, C., Michaels, J., & Meeker, M. A. (2019). Family Outcomes and Perceptions of End-of-Life Care in the Intensive Care Unit: A Mixed-Methods Review. Journal of Palliative Care, and comment on it.
3. The author/s highlights the novelty of their work, that is, being the first meta-analysis of qualitative research, however they should better explain why we need this kind of review in terms of what it could reveal when applied to EOLC investigation.