The patient experience of intensive care: A meta-synthesis of Nordic studies

Egerod, Ingrid; Bergbom, Ingegerd; Lindahl, Berit; Henricson, Maria; Granberg-Axéll, Anetth; Storli, Sissel Lisa

doi:10.1016/j.ijnurstu.2015.04.017

Cited by 94 publications

(130 citation statements)

References 47 publications

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“…These meetings seemed to represent a turning point, at which the patients were pushed to make a choice about life and death. In line with the present findings, previous studies have shown experiences on the border of consciousness to be filled with personal meaning as well as healing potential (Storli, Lindseth, Asplund, , ; Egerod et al, ). This salutogenic perspective of dreams and delusions providing a healing potential represents a complementary view to the pathogenic perspective interpreting delusional experiences as a symptom of ICU delirium (Barr et al, ).…”

Section: Discussionsupporting

confidence: 93%

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

Alexandersen

Stjern

Eide

et al. 2019

Journal of Clinical Nursing

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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.

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Section: Discussionsupporting

confidence: 93%

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

Alexandersen

Stjern

Eide

et al. 2019

Journal of Clinical Nursing

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“…At the same time, communication [21] and muscular activity [7] remain possible by means of limiting sedation, in line with current recommendations. Nevertheless, there is a lack of data available reporting patients’ perceptions in such settings.…”

Section: Introductionsupporting

confidence: 56%

Teamwork enables high level of early mobilization in critically ill patients

Hickmann

Castanares-Zapatero

Bialais

et al. 2016

Ann. Intensive Care

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BackgroundEarly mobilization in critically ill patients has been shown to prevent bed-rest-associated morbidity. Reported reasons for not mobilizing patients, thereby excluding or delaying such intervention, are diverse and comprise safety considerations for high-risk critically ill patients with multiple organ support systems. This study sought to demonstrate that early mobilization performed within the first 24 h of ICU admission proves to be feasible and well tolerated in the vast majority of critically ill patients.ResultsGeneral practice data were collected for 171 consecutive admissions to our ICU over a 2-month period according to a local, standardized, early mobilization protocol. The total period covered 731 patient-days, 22 (3 %) of which met our local exclusion criteria for mobilization. Of the remaining 709 patient-days, early mobilization was achieved on 86 % of them, bed-to-chair transfer on 74 %, and at least one physical therapy session on 59 %. Median time interval from ICU admission to the first early mobilization activity was 19 h (IQR = 15–23). In patients on mechanical ventilation (51 %), accounting for 46 % of patient-days, 35 % were administered vasopressors and 11 % continuous renal replacement therapy. Within this group, bed-to-chair transfer was achieved on 68 % of patient-days and at least one early mobilization activity on 80 %. Limiting factors to start early mobilization included restricted staffing capacities, diagnostic or surgical procedures, patients’ refusal, as well as severe hemodynamic instability. Hemodynamic parameters were rarely affected during mobilization, causing interruption in only 0.8 % of all activities, primarily due to reversible hypotension or arrhythmia. In general, all activities were well tolerated, while patients were able to self-regulate their active early mobilization. Patients’ subjective perception of physical therapy was reported to be enjoyable.ConclusionsMobilization within the first 24 h of ICU admission is achievable in the majority of critical ill patients, in spite of mechanical ventilation, vasopressor administration, or renal replacement therapy.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0184-y) contains supplementary material, which is available to authorized users.

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“…A further finding was the many descriptions of discomforts other than pain, possibly dominating because descriptions of actual pain were rare. The majority of these discomforts have been reported on and presented in reviews of the qualitative literature (Cutler et al., ; Egerod et al., ; Tsay, Mu, Lin, Wang, & Chen, ). We found that well‐known discomforts relating to MV, communication difficulties, comprehension and experiencing delusions were often triggered or aggravated by how the patients fluctuated between states of wakefulness.…”

Section: Discussionmentioning

confidence: 99%