“Never in my mind to give up!” A qualitative study of long‐term intensive care patients’ inner strength and willpower—Promoting and challenging aspects

Abstract

Aims and objectives To explore aspects that promote and challenge long‐term ICU patients’ inner strength and willpower. Background Considerable research has been devoted to ICU patients’ experiences; however, research on long‐term ICU patients is limited. Studies in a health‐promoting perspective focusing on long‐term ICU patients’ inner strength and willpower are scarce. Design A qualitative, hermeneutic‐phenomenological approach, using in‐depth interviews. Methods Seventeen long‐term Norwegian ICU patients were interviewed once, at 6–18 months after ICU discharge. The consolidated criteria for reporting qualitative research was used (Data S1). Results The lived experience of the phenomenon “inner strength and willpower” and what promotes and challenges this phenomenon in long‐term ICU patients were represented by four main themes and nine subthemes. Promoting aspects comprised of two main themes and five subthemes: (a) “No doubt about coming back to life” with subthemes; “Strong connectedness to life; feeling alive and present,” “Meaning and purpose; feeling valuable to somebody.” (b) “How to ignite and maintain the spark of life,” with the subthemes: “Practical solutions, coping skills from previous life experiences,” “Provocative and inspiring experiences” and “Vivid dream experiences that ignite the willpower.” Two main categories and four subcategories represented challenging aspects: (a) Exhaustion, weakness and discomfort; subthemes; “Physical challenges” and “Mental discomfort” and (b) “Tiring delusions,” subthemes; “Living in the worst horror movie” and “Feeling trapped.” Conclusion This study expands on previous studies by providing insights about what promotes and challenges long‐term ICU patients’ inner strength and willpower during their recovery trajectory. Relevance to clinical practice Insights into the variety of long‐term ICU patients’ experiences during the recovery trajectory are important for ICU nurses to support and facilitate ICU patients’ inner strength and willpower.

General practitioners’ views and experiences in caring for patients after sepsis: a qualitative interview study

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“…33 34 As part of this trial, in-depth interviews were held with GPs to explore their experiences with patients discharged from ICU and the intervention. Qualitative research has been conducted with post-ICU patients in detail [37][38][39][40][41][42][43] but, to date, no one had explored in depth the views and experiences of GPs caring for these patients. The aim of this study is to describe GPs' views and experiences of caring for postsepsis patients and of participating a specific outreach training, in order to inform and contribute to applicable future aftercare structures in primary care.…”

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“…Neglecting of the situational context by individuals is problematic, even though defense mechanisms are a conceptual aspect of adaptation (Beutel, 1985). Assessing the physiological adaptation of individuals is associated with the exploration of the dysfunctional metacognitive beliefs, which is related to anxiety, depression, and perceived quality of life (Alexandersen et al, 2019;Lenzo et al, 2019).…”

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“…This requires that information from and about the family is transferred between health professionals. Close family members know the patient well and should be acknowledged as essential resources in the care of the patient as they commonly are supportive and represent hope and safety (Alexandersen et al, 2019;Haugdahl et al, 2018). In addition, family members have their own needs.…”