Relocation stress in critical care: a review of the literature

Abstract

1. Transfer to the ward following a period in intensive care may cause stress for patients. 2. A review of the literature reveals that this phenomenon has been described in a number of different ways, such as transfer stress, transfer anxiety, translocation syndrome and, more recently, relocation stress. 3. This paper reviews the various concepts before arriving at a more operational definition of the phenomenon. 4. It attempts to reveal what causes this phenomenon and to what extent it exists. 5. Patients' responses to transfer are identified and the physical and psychological problems that have been associated with discharge from intensive care are discussed. 6. Lists of interventions that the literature suggests may reduce or prevent this phenomenon from occurring are reviewed. 7. Recommendations for practice development and further research are made.

An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective

“…Reference lists from relevant articles were also checked as a method of finding similar articles or to source a primary reference. Internet searches using 'Google Scholar' and highly recognised transferring from ICU, especially that of transfer anxiety/relocation stress (Coyle, 2001; Leith, 1998;McKinney & Melby, 2002;Odell, 2000;Saarmann, 1993;Strahan & Brown, 2005). It is recognised within the literature that patients' can experience both adverse physical and psychological effects after being transferred from ICU.…”

“…Transfer from intensive care to the ward is a positive indication of progress towards better health, yet it creates negative feelings such as fear, anxiety and may cause stress (McKinney & Melby, 2002Saarmann, 1993). This concept of transfer anxiety transpires when patients are moved from a familiar environment, where they feel safe and secure, to that of an unfamiliar environment (Coyle, 2001;Leith, 1998;McKinney & Melby, 2002;Saarmann, 1993) .…”

“…This concept of transfer anxiety transpires when patients are moved from a familiar environment, where they feel safe and secure, to that of an unfamiliar environment (Coyle, 2001;Leith, 1998;McKinney & Melby, 2002;Saarmann, 1993) . Other terminology used includes transfer stress, translocation syndrome and relocation stress.…”

“…Fright can also occur, firstly when coming to terms with their illness and secondly on transfer to the ward, as patients and families do not know what to expect in a different environment where routines, treatment and monitoring can be different (Coyle, 2001;Leith, 1998;McKinney & Melby, 2002;Saarmann, 1993). Fright and anxiety can also be exacerbated by the sudden decrease in monitoring of the patient prior to transfer and a lack of control over the environment.…”

“…Leith (1998) conducted informal interviews and found that patients and families benefited from visits from ward staff prior to transfer and visits by ICU staff post transfer as a means of decreasing transfer anxiety. Saarmann (1993) and McKinney and Melby (2002) also acknowledge the significance of pre-transfer visits from the nurse who will be caring for the patient on the ward. However, this may not always be practical due to time and resource constraints within the ward environment.…”