Lived experience of patients inICUafter cardiac surgery: A phenomenological study

Abstract

Background: Cardiac surgery (CS) patients spend a significant amount of time in the intensive care unit (ICU). This event can be very overwhelming, with an intense emotional impact, causing vulnerability and a sense of helplessness in patients. Currently, the in-depth description of the ICU stay experience from a patient's own perspective is little studied, especially in the CS setting and using a qualitative approach in Italy.Aim: This study aimed to describe CS patients' lived experiences.Methods: A qualitative phenomenological study was conducted between October 2018 and December 2019 using the interpretative phenomenological analysis approach.Results: Eleven patients were interviewed during the months after discharge from the ICU. Four main themes emerged from the analysis of the interviews: (a) will not wake up anymore; (b) endless time in ICU; (c) something keeps me from breathing; and (d) "anchor in the storm." Results confirm the negative experience of patients in the ICU, mainly because of the extubating procedure. Nurses were found to play a key role in decisions, supporting and protecting patients from the psychological stress related to the ICU stay. Conclusion: This is the first study capturing ICU patients' lived experiences after a CS intervention with the use of interpretative phenomenology in Italy. Further investigations are warranted to systematically identify which approaches or strategies are essential to support these patients in the Italian context.Relevance to clinical practice: Our study's results could be useful for tailored care delivery to meet the real needs of Italian patients in the ICU after CS and, consequently, improve the quality of nursing care and patients' outcomes.

What is the lived experience of patients with left ventricular assist devices during the COVID-19 pandemic? A qualitative analysis

“…This qualitative research was conducted following the interpretative phenomenological analysis (IPA) approach. 9 A qualitative analysis was employed to explore LVAD patients’ peculiar experiences during the COVID-19 pandemic, and it could provide a unique contribution to research in this field, 10 , 11 as it reflects an in-depth inquiry into the lived experiences of patients with LVADs in the COVID-19 era. Considering that the presence of LVAD determines personalized and specific health and life needs, 6 an in-depth analysis was necessary to understand these specific experiences also during a critical situation such as the COVID-19 pandemic.…”

Diaries in intensive care units: An Italian qualitative study

“…Family members constantly report the need to improve communication with the interdisciplinary team during hospitalization in ICU 17 . During a patient's stay in ICU, family members need to understand and remember a new medical language at a time when they are already under stress and experiencing new events and activities for the first time 18,19 . Furthermore, keeping a diary would seem to lead to more personalized and holistic nursing care and nurses also perceive the time spent writing diaries as part of nursing care 18,20 …”

The ABCDE bundle implementation in an intensive care unit: Facilitators and barriers perceived by nurses and doctors

“…Since 2014, Society of Critical Care Medicine, through the ICU Liberation Collaborative, have promoted a further evolution of the ABCDE bundle, including the ‘F’ that stands for ‘Family engagement and empowerment’ (Marra, Ely, et al, 2017; Stollings et al, 2020). The involvement of family members in the whole ICU planning of care allows the team to take charge of the needs of the family, involving them in the planning of care as surrogate decision makers who know in depth the desires and wishes of the patient (Albanesi et al, 2020). Moreover, it may result in a lowering of their stress and anxiety related to the criticality of the situation (Marra, Ely, et al, 2017).…”

“…The involvement of family members in the whole ICU planning of care allows the team to take charge of the needs of the family, involving them in the planning of care as surrogate decision makers who know in depth the desires and wishes of the patient (Albanesi et al, 2020).…”