The meaning of follow‐up in intensive care: patients’ perspective

Abstract

The growing understanding of correlations between experiences and memories from a period of intensive care treatment and complaints of mental character has led to the development of various patient follow-up offers. Little, however, is known about what follow-up may mean to patients. The aim of this study was to explore the meaning of patients' lived experience of being followed-up in a programme consisting of patient diaries, post-intensive care unit (ICU) conversations and visits back to the ICU. Field notes were made from encounters with patients (n = 10) during follow-up. Then they were interviewed twice, at about 6 months (n = 8) and at about 18 months (n = 6) after discharge from hospital. The first interview focused on the patients' experience during intensive care and on their reflections on the experience. The second interview had a particular focus on the meaning for each individual of the sources for understanding that they had been offered. The data was analysed by using a hermeneutic-phenomenological approach. The study corroborated earlier research that found that patients seek to understand experiences they have undergone. They search for meaning in experiences and memories. It is realized that the diary as text and photos, in addition to conveying care and love, is important to induce postexperience reflections. It provided guideposts that follow-up conversations could pursue in the patient's quest for meaning. The conversation also provided an opening for, and could in itself be essential to, the patient's willingness to talk about experiences. It allowed the nurse to accompany the patient in his quest for meaning. The return visit appeared to be significant in the patient's quest for meaning. It was via 'feeling' the room that 'things' fell into place. The study is important in elucidating aspects that are beneficial in the patient's follow-up and which lay the basis for further development of existing and new follow-up offers.

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

“…The purpose is to help the patient to remember their time in the ICU and for the family to get answers to any questions they have. The opportunity to visit the room where the patient was cared for has been shown to help the patients to anchor their dreams in reality (Bäckman et al, 2010;Egerod and Christensen, 2009;Gjengedal et al, 2010;Griffiths et al, 2009;Knowles and Tarrier, 2009;Storli and Lind, 2009;Åkerman et al, 2010).…”

The experiences of ICU patients during follow-up sessions – A qualitative study

“…The findings also highlight the experiences of emotional difficulty by some, for example, nervousness and insecurity involved with returning to the ICU. Storli and Lind (2009) support this, and assert that a return visit to the intensive care room in which they were cared for, can cause feelings of gratitude about having survived this event, and assist with things falling into place. This visit can also make the experience more meaningful through the verbalization of one's feelings and the expression of wanting to face the emotionally difficult aspects at one's own pace.…”

“…It is hoped that this information will clarify and address any questions relating to the patients particular memories, nightmares, and any remaining difficulties from their time spent in the ICU. This can also serve as a valuable knowledge tool for ICU staff (Samuelson and Corrigan, 2009;Storli and Lind, 2009). Therefore, the aim of the study was to describe how ICU patients, experience a follow-up session.…”

Intensive care diaries to promote recovery for patients and families after critical illness: A Cochrane Systematic Review

“…Observational [22,38,[40][41][42][43], prospective cohort with a retrospective reference group [39] , timeseries [1] and qualitative [52,[54][55][56][57] studies have reported the success and importance of patient diaries in the clinical setting. Our review has demonstrated the paucity of randomized controlled trials evaluating patient diaries.…”