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心脏手术后 ICU 患者的生活体验:一项现象学研究。

Lived experience of patients in ICU after cardiac surgery: A phenomenological study.

机构信息

Department of Medicine and Psychology, Sapienza University, Rome, Italy.

Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy.

出版信息

Nurs Crit Care. 2022 Mar;27(2):204-213. doi: 10.1111/nicc.12562. Epub 2020 Oct 15.

Abstract

BACKGROUND

Cardiac surgery (CS) patients spend a significant amount of time in the intensive care unit (ICU). This event can be very overwhelming, with an intense emotional impact, causing vulnerability and a sense of helplessness in patients. Currently, the in-depth description of the ICU stay experience from a patient's own perspective is little studied, especially in the CS setting and using a qualitative approach in Italy.

AIMS

This study aimed to describe CS patients' lived experiences.

METHODS

A qualitative phenomenological study was conducted between October 2018 and December 2019 using the interpretative phenomenological analysis approach.

RESULTS

Eleven patients were interviewed during the months after discharge from the ICU. Four main themes emerged from the analysis of the interviews: (a) will not wake up anymore; (b) endless time in ICU; (c) something keeps me from breathing; and (d) "anchor in the storm." Results confirm the negative experience of patients in the ICU, mainly because of the extubating procedure. Nurses were found to play a key role in decisions, supporting and protecting patients from the psychological stress related to the ICU stay.

CONCLUSION

This is the first study capturing ICU patients' lived experiences after a CS intervention with the use of interpretative phenomenology in Italy. Further investigations are warranted to systematically identify which approaches or strategies are essential to support these patients in the Italian context.

RELEVANCE TO CLINICAL PRACTICE

Our study's results could be useful for tailored care delivery to meet the real needs of Italian patients in the ICU after CS and, consequently, improve the quality of nursing care and patients' outcomes.

摘要

背景

心脏手术(CS)患者在重症监护病房(ICU)中度过大量时间。这一事件可能会带来巨大的心理冲击,使患者感到脆弱和无助。目前,从患者自身角度深入描述 ICU 住院体验的研究很少,尤其是在 CS 环境中,并在意大利采用定性方法进行研究。

目的

本研究旨在描述 CS 患者的生活体验。

方法

采用解释性现象学分析方法,于 2018 年 10 月至 2019 年 12 月进行了一项定性现象学研究。

结果

在 ICU 出院后的几个月内对 11 名患者进行了访谈。从访谈分析中得出了四个主要主题:(a)再也不会醒来;(b)无尽的 ICU 时间;(c)有东西阻止我呼吸;(d)“风暴中的锚”。结果证实了患者在 ICU 中的负面体验,主要是由于拔管过程。研究发现护士在决策中起着关键作用,支持和保护患者免受与 ICU 住院相关的心理压力。

结论

这是意大利首次使用解释性现象学方法对 CS 干预后 ICU 患者生活体验进行的研究。需要进一步研究以系统地确定哪些方法或策略对于在意大利背景下支持这些患者至关重要。

临床意义

我们的研究结果可用于提供定制化护理,以满足意大利 ICU 后 CS 患者的实际需求,从而提高护理质量和患者结局。

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