Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.
School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, NSW, Australia.
J Clin Nurs. 2019 Mar;28(5-6):781-791. doi: 10.1111/jocn.14673. Epub 2018 Oct 11.
To explore families' experiences of their interactions in an Australian adult intensive care unit (ICU) to develop a grounded theory that can be used by critical care nurses to improve patient- and family-centred care (PFCC).
Families in ICU play an important role in the patient's recovery and outcomes. However, families are at risk of significant psychological morbidity due to their experiences in ICU. Although many ICU patients can make their own decisions, a large proportion are unconscious or chemically sedated and unable to contribute to decisions about their care, leaving the decision-making role to the family. Therefore, the families' psychosocial and emotional well-being must be supported by implementing evidence-based interventions that align with a PFCC approach. This study describes the findings of a grounded theory of family resilience in ICU, of which the core category is Regaining control. The focus of this paper is on the major category: Searching for meaning.
We adopted a constructivist grounded theory method. Twenty-five adult family members (n = 25) of 21 patients admitted unexpectedly to an ICU in metropolitan Australia were recruited. In-depth interviews were used to collect the data, and the analytical processes of constructivist grounded theory underpinned the development of a core category and related subcategories.
When adult family members experience the unexpected admission of a relative to ICU, they move towards a state of being beyond emotional adversity and regaining control when facilitated to search for meaning in their situation. When families were able to make sense of their situation and find a purpose by contributing to their relative's recovery, it encouraged them to cope and be resilient.
Our findings can be used to promote PFCC in ICU, which considers a collaborative approach to meet the patient's needs while providing emotional and psychosocial support to their families.
探索澳大利亚成人重症监护病房（ICU）中家庭互动的经验，以发展一种扎根理论，为重症监护护士提供使用，以改善以患者和家庭为中心的护理（PFCC）。
在 ICU 中的家庭在患者的康复和结局中起着重要作用。然而，由于他们在 ICU 中的经历，家庭面临着严重的心理发病率的风险。尽管许多 ICU 患者可以自己做出决定，但很大一部分是无意识或化学镇静，无法对自己的护理决策做出贡献，将决策角色留给家庭。因此，必须通过实施与 PFCC 方法一致的基于证据的干预措施来支持家庭的社会心理和情感福祉。本研究描述了 ICU 中家庭弹性的扎根理论研究结果，其核心类别是恢复控制。本文的重点是主要类别：寻找意义。
我们采用了建构主义扎根理论方法。从澳大利亚大都市的一家 ICU 中招募了 21 名患者的 25 名成年家属（n=25）。使用深度访谈收集数据，建构主义扎根理论的分析过程为核心类别和相关子类别奠定了基础。
当成年家属经历亲属意外入住 ICU 时，当他们能够在自己的情况下寻找意义并为亲属的康复做出贡献时，他们会从情感逆境中走向恢复控制的状态。这鼓励他们应对并保持弹性。
我们的研究结果可用于促进 ICU 中的 PFCC，这考虑了一种协作方法，以满足患者的需求，同时为其家属提供情感和社会心理支持。
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