Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
J Clin Nurs. 2018 Oct;27(19-20):3630-3640. doi: 10.1111/jocn.14523. Epub 2018 Jun 21.
To explore family members' experiences of long-term intensive care unit (ICU) patients' pathways towards survival and to highlight family members' efforts to promote the patient's health during the ICU stay.
Although considerable research has been devoted to the substantial burden of long-term ICU patients, less attention has been paid to health-promoting factors that facilitate patients' health and survival during ICU stays. Support from family members can improve patient outcome. However, there is little knowledge of the specific contributions provided by family members.
A hermeneutic phenomenological approach, within the context of Antonovsky's salutogenic theory and Merleau-Ponty's phenomenology of the body, involving the body as the fundament of experience and understanding.
In-depth qualitative interviews. Thirteen family members of long-term ICU patients were interviewed once, at six to 18 months after ICU discharge. The consolidated criteria for reporting qualitative research were used.
Three themes were identified: (i) A body at a breaking point; (ii) family members' presence; and (iii) breaking through. In the perspective of the family members, their beloved ones were at a breaking point between life and death. The family's presence was significantly health promoting, demonstrating and communicating love and sensitivity. Moreover, family members' understanding of the patient's unique characteristics and personality was crucial to the patient's experience of being understood, recognised and acknowledged. Inner strength represented a life force capable of moving the patient from the breaking point towards a breakthrough towards life. Family members purposely used their knowledge about the patient to trigger, nurture and release the patient's inner strength.
Family presence helps to trigger, arouse and release a patient's inner strength, representing important health-promoting factors facilitating patients' health and survival during an ICU stay.
Insights into the unique and vital health-promoting influence of family participation indicate the responsibility of the ICU team to provide support for families.
探索长期重症监护病房（ICU）患者生存路径中家庭成员的体验，并强调家庭成员在 ICU 住院期间为促进患者健康所做的努力。
尽管大量研究致力于研究长期 ICU 患者的巨大负担，但对促进 ICU 住院期间患者健康和生存的健康促进因素关注较少。家庭成员的支持可以改善患者的预后。然而，对于家庭成员提供的具体贡献知之甚少。
在 Antonovsky 的健康促进理论和 Merleau-Ponty 的身体现象学背景下，采用解释学现象学方法，将身体作为经验和理解的基础。
深入的定性访谈。对 13 名长期 ICU 患者的家属进行了一次访谈，时间在 ICU 出院后 6 至 18 个月。使用了定性研究的综合报告标准。
确定了三个主题：（i）身体处于崩溃的边缘；（ii）家庭成员的存在；（iii）突破。从家庭成员的角度来看，他们所爱的人处于生死关头。家庭的存在对健康有明显的促进作用，表现出爱和敏感性，并进行沟通。此外，家庭成员对患者独特特征和个性的理解对患者被理解、认可和承认的体验至关重要。内在力量代表着一种生命力，能够将患者从崩溃的边缘推向突破，走向生命。家庭成员有意利用他们对患者的了解来触发、培养和释放患者的内在力量。
家庭的存在有助于触发、唤起和释放患者的内在力量，这是促进 ICU 住院期间患者健康和生存的重要健康促进因素。
深入了解家庭参与的独特而重要的健康促进影响表明 ICU 团队有责任为家庭提供支持。
