Palesjö Carina, Nordgren Lena, Asp Margareta
School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
Centre for Clinical Research, Sörmland/Uppsala University, Eskilstuna, Sweden.
J Clin Nurs. 2015 Dec;24(23-24):3494-502. doi: 10.1111/jocn.13002. Epub 2015 Oct 5.
The aim of this study was to describe and interpret the essential meaning of the lived experiences of being in a critical illness-recovery process after a life-threatening condition.
The critical illness-recovery process after a life-threatening condition takes several years and does not only include patients' experiences during intensive care. Previous research has mainly focused on what critically ill patients recall. However, from a phenomenological point of view, experiences are more than memories alone. To plan and perform relevant health care and social support for patients who have survived a life-threatening condition, a more profound understanding about their lived experiences is needed.
In this qualitative study, a phenomenological hermeneutical approach was used. Interviews were conducted with seven patients, two to four years after they had received care in an intensive care unit in Sweden.
The comprehensive understanding of the results shows that the critical illness-recovery process after a life-threatening condition means an existential struggle to reconcile with an unfamiliar body and with ordinary life. This can be understood as an 'unhomelikeness' implying a struggle to create meaning and coherence from scary and fragmented memories. The previous life projects, such as work and social life become unfamiliar when the patient's fragile and weak body is disobedient and brings on altered sensations.
Patients who survive a life-threatening condition have an immense need for care and support during the entire critical illness-recovery process, and also after the initial acute phase. They need a coherent understanding of what happened, and support to be able to perform their changed life projects.
Supporting and caring for patients' recovery from a life- threatening condition involves recognising the patients' struggle and responding to their existential concerns.
本研究的目的是描述和阐释在经历危及生命的状况后处于危重症康复过程中的生活体验的本质意义。
经历危及生命的状况后的危重症康复过程需要数年时间，且不仅包括患者在重症监护期间的体验。以往研究主要聚焦于危重症患者能回忆起什么。然而，从现象学角度来看，体验不仅仅是记忆。为了为从危及生命的状况中幸存下来的患者规划和提供相关的医疗保健及社会支持，需要对他们的生活体验有更深刻的理解。
在这项定性研究中，采用了现象学诠释学方法。在瑞典一家重症监护病房接受护理两到四年后，对七名患者进行了访谈。
对结果的全面理解表明，经历危及生命的状况后的危重症康复过程意味着与陌生的身体以及平凡生活达成和解的生存挣扎。这可以被理解为一种“无家可归感”，意味着努力从可怕且零散的记忆中创造意义和连贯性。当患者脆弱无力的身体不听使唤并带来感觉改变时，诸如工作和社交生活等以前的生活规划就变得陌生了。
从危及生命的状况中幸存下来的患者在整个危重症康复过程中以及初始急性期过后都极其需要护理和支持。他们需要对所发生的事情有连贯的理解，以及能够执行改变后的生活规划的支持。
支持和护理患者从危及生命的状况中康复，需要认识到患者的挣扎并回应他们的生存关切。
