Exploring adult patients' perceptions of what enables them to make sense of their intensive care experience

[摘要] ENGLISH SUMMARY : Critical illness requiring admission into an intensive care environment is a significant stressful event in any person's life. Good caregiving in an intensive care environment is supported by appropriate, correct assessment and monitoring, drug and organ support interventions, patient comfort measures, psychological support, and early detection of complications. All these interventions and activities create experiences the critically ill person must make sense of in order to manage long-term consequences of this traumatic encounter (Leach, 2004:13).Critically ill patients' experiences are an important component of a person's perceptions of the quality of care provided in the intensive care unit (Wahlin, Ek & Idvall, 2009:332). During my clinical experiences as a critical care nurse and through listening to patients' and colleagues' accounts of their experiences of intensive care, it appears that in many instances the person's negative experiences outweigh the positive ones.I was keen to explore adult patient's perceptions of what aspects of the intensive care experience had an enabling influence on them making sense of their intensive care encounter and how these aspects enabled the patient to make sense of their experience of intensive care in order to move through the experience and make the experience tolerable.A qualitative descriptive phenomenological research approach was used. This study aimed to explore a participant's own lived intensive care experience through their personal recollections in the intensive care unit. The participant's experience of their time in an intensive care unit was the key event.A purposive sampling strategy using a network sampling method was applied to identify and include participants who had experienced an ICU admission, had recovered and moved from ICU to the ward or home, was able to give informed consent and able to talk with me about their admission and journey through their ICU stay. It was found that participants were enabled to make sense of their ICU experience when they were part of a trusting relationship with their caregiver. A trusting relationship also encompassed the patient knowing that they mattered to their caregiver and allowed the patient to feel at ease and in turn feel safe. Distrust in the caregiver erodes this notion of feeling safe and hindered the patient being able to make sense of their experience of ICU.It is recommended that education and training programmes should include specific content and application of trying to live in a critically ill person's shoes in order to enable a nurse or doctor to have some insight as to what this experience means to a critically ill person.The study will be beneficial to nurses and other healthcare personnel who can offer care that is influenced by insights from this work and optimize a patient's sense of being able to make sense of, tolerate and move through an experience of intensive care.

[发布机构] Stellenbosch University