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- Vogel, Gisela, et al.
(author)
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Shifting focus : A grounded theory of how family members to critically ill patients manage their situation
- 2023
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In: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 78
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Journal article (peer-reviewed)abstract
- Objectives: Critical illness is a life-threatening condition for the patient, which affects their family members as a traumatic experience. Well-known long-term consequences include impact on mental health and health-related quality of life. This study aims to develop a grounded theory to explain pattern of behaviours in family members of critically ill patients cared for in an intensive care unit, addressing the period from when the patient becomes critically ill until recovery at home.Research methodology/design: We used a classic grounded theory to explore the main concern for family members of intensive care patients. Fourteen interviews and seven observations with a total of 21 participants were analysed. Data were collected from February 2019 to June 2021.Setting: Three general intensive care units in Sweden, consisting of a university hospital and two county hospitals.Findings: The theory Shifting focus explains how family members' main concern, living on hold, is managed. This theory involves different strategies: decoding, sheltering and emotional processing. The theory has three different outcomes: adjusting focus, emotional resigning or remaining in focus.Conclusion: Family members could stand in the shadow of the patients' critical illness and needs. This emotional adversity is processed through shifting focus from one's own needs and well-being to the patient's survival, needs and well-being. This theory can raise awareness of how family members of critically ill patients manage the process from critical illness until return to everyday life at home. Future research focusing on family members' need for support and information, to reduce stress in everyday life, is needed.Implications for Clinical Practice: Healthcare professionals should support family members in shifting focus by interaction, clear and honest communication, and through mediating hope.
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| 2. |
- Vogel, G., et al.
(author)
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Health-related quality of life after general surgical intensive care
- 2018
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In: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 62:8, s. 1112-1119
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Journal article (peer-reviewed)abstract
- BackgroundImpaired mental and physical health are common complications after intensive care that could influence the patient's health-related quality of life (HRQoL). Earlier research has mainly focused on HRQoL in mixed surgical and medical ICU populations. This study aimed to describe and analyze factors associated with HROoL after discharge from a general surgical ICU. MethodsA prospective cohort study was conducted in a general surgical ICU in Sweden between 2005 and 2012. Adult patients (18years) with an ICU length of stay 96hours were included. HRQoL was measured at 3, 6, and 12months after discharge from the ICU using a questionnaire (SF-36). A linear mixed model was used to analyze changes over time and Wilcoxon Signed Rank Tests were used to compare the 12-months results to an age and gender matched reference population in Sweden. Linear regression analyses were performed to explore the impact on HRQoL from background variables. ResultsOf 447 patients eligible for the study, 276 patients (62%) answered SF-36 at least once at 3, 6 or 12months after ICU care and were included in the study. HRQoL improved over time but was still significantly lower at 12months compared to the reference population. Female gender, age <75years, living single, and ICU-stay of more than 14days were associated with lower HRQoL. ConclusionGeneral surgical ICU patients reports low HRQoL 1year after ICU stay. The impaired HRQoL could be a long-lasting problem with major consequences for the individual, family, and society.
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