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

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MARC

Egerod, I.Köpenhamns universitet (author)

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

Article/chapterEnglish2015

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Elsevier BV,2015

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LIBRIS-ID:oai:gup.ub.gu.se/220185
https://gup.ub.gu.se/publication/220185URI
https://doi.org/10.1016/j.ijnurstu.2015.04.017DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-3285URI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Background: Sedation practices in the intensive care unit have evolved from deep sedation and paralysis toward lighter sedation and better pain management. The new paradigm of sedation has enabled early mobilization and optimized mechanical ventilator weaning. Intensive care units in the Nordic countries have been particularly close to goals of lighter or no sedation and a more humane approach to intensive care. Objectives: The aim of our study was to systematically review and reinterpret newer Nordic studies of the patient experience of intensive care to obtain a contemporary description of human suffering during life-threatening illness. Design: We conducted a meta-synthesis in which we collected, assessed, and analyzed published qualitative studies with the goal of synthesizing these findings into a new whole. Analysis was based on the scientific approach of Gadamerian hermeneutics. Methods: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and PsycINFO. Each original paper was assessed by all authors using the Critical Appraisal Skills Program instrument for qualitative research. We included 22 studies, all of which provided direct patient quotes. Results: The overarching theme was identified as: The patient experience when existence itself is at stake. We constructed an organizing framework for analysis using the main perspectives represented in the included studies: body, mind, relationships, and ICU-environment. Final analysis and interpretation resulted in the unfolding of four themes: existing in liminality, existing in unboundedness, existing in mystery, and existing on the threshold. Conclusions: Our main finding was that human suffering during intensive care is still evident although sedation is lighter and the environment is more humane. Our interpretation suggested that patients with life-threatening illness descend into a liminal state, where they face the choice of life or death. Caring nurses and family members play an important role in assisting the patient to transition back to life. (C) 2015 Elsevier Ltd. All rights reserved.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences hsv//eng
Hermeneutics
Intensive care
Liminality
Meta-synthesis
Nursing
Patient experience
MECHANICAL VENTILATION
QUALITATIVE RESEARCH
SEDATION PRACTICE
CRITICALLY-ILL
UNIT
ICU
METASYNTHESIS
PARADIGM
ILLNESS
TEXTS
Nursing
Intensive care
Människan i vården

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Bergbom, Ingegerd,1947Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences,Göteborgs Universitet(Swepub:gu)xbergi (author)
Lindahl, Berit,1955Högskolan i Borås,Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences,Akademin för vård, arbetsliv och välfärd(Swepub:gu)xlberi (author)
Henricson, M.Högskolan i Jönköping (author)
Granberg-Axell, A.Sjukhuset i Halmstad (author)
Storli, S. L.Universitetet i Trömsö (author)
Köpenhamns universitetInstitutionen för vårdvetenskap och hälsa (creator_code:org_t)

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In:International Journal of Nursing Studies: Elsevier BV52:8, s. 1354-13610020-74891873-491X

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