Critically ill patients' experiences of nursing care in the intensive care unit

Abstract

Background: Understanding critically ill patients' experiences of nursing care is an important aspect that can improve quality of care in the intensive care unit. Aim: To elicit critically ill patients' experiences of nursing care in the adult intensive care units. Design: A qualitative descriptive design was utilized. Methods: Sixteen patients who had a predicted mortality risk of above 50% within the first 24 h of admission to the intensive care unit and had been discharged to the ward were purposively selected. The study was conducted at three academic affiliated, tertiary/quaternary specialist hospitals in South Africa. Individual semi-structured interviews were conducted with the selected participants until a point of data saturation was reached. Data were analysed using a conventional content analysis technique (Hsieh and Shannon, 2005). Lincoln and Guba's criteria for ensuring the trustworthiness of qualitative research were applied. Findings: Four major themes emerged: 'being in someone's shoes ', 'communication', 'presence' and 'religion and spirituality'. Conclusions: Even though some participants' responses reflected 'good' nursing care, the majority of the participants had negative experiences in relation to the nursing care they received while admitted in the selected intensive care units. Relevance to clinical practice: This study demonstrates critically ill patients' voices and preferences of intensive nursing care and describes some issues that require not only nurses' but also managerial improvements and interventions in order to ensure quality care and, eventually, patients' satisfaction with intensive nursing care.

Understanding patients’ experiences of being mechanically ventilated in the Intensive Care Unit: Findings from a meta‐synthesis and meta‐summary

“…However, the review included studies published up to 2012 (Baumgarten & Poulsen, 2015) and no other published or ongoing reviews have emerged more recently on this topic to the best of our knowledge, while several primary qualitative studies have been conducted (e.g., Corner, Murray, & Brett, 2019; Kisorio & Langley, 2019). Therefore, recent improvements in the field of mechanical ventilation and sedative medications in ICU (Moreira & Neto, 2016) as experienced by patients that can inform nursing care decisions have not been summarised to date.…”

Anwendung von Zwang in der Intensivmedizin

“…Die Einschränkung der individuellen Freiheit der eigenen Lebensgestaltung als einer der bedeutendsten Werte der westlichen Zivilisation im Rahmen einer intensivmedizinischen Behandlung wird von vielen Patienten als unangenehm beschrieben [20,21]. Das Gefühl der Hilflosigkeit, der Verletzlichkeit und des Ausgeliefertseins bestimmt die eigene Wahrnehmung und wird als Kontrollverlust thematisiert [22].…”

“…Das Erleiden von Schmerzen mit dem Gefühl der Hilflosigkeit und Verletzung der körperlichen Integrität kann in einer unzureichenden Wahrnehmung und Kommunikation durch das Team begründet sein [19,24]. Ebenso kann das Gefühl, nicht ernst genommen zu werden, eine aggressive Kommunikation mit indirekten oder direkten Androhungen oder das Nichtdurchführen von Maßnahmen Patienten in Angst versetzen [21,25].…”

Spiritual needs of patients in an emergency room

“…Die Sensibilisierung von Ärzten, Pflegenden und anderen Gesundheitsberufen für die spirituelle Dimension findet zunehmende Beachtung, z. B. in der Allgemein- [4] und Palliativmedizin [26], in der Onkologie [3], in Psychiatrie und Psychotherapie [30] und in der Intensivmedizin [18,23].…”