Department of Rehabilitation, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Deventer Hospital, Department of Rehabilitation, Deventer, The Netherlands.
J Adv Nurs. 2022 Oct;78(10):3358-3370. doi: 10.1111/jan.15338. Epub 2022 Jun 28.
To explore lived experiences of patients recovering from COVID-19-associated intensive care unit acquired weakness and to provide phenomenological descriptions of their recovery.
A qualitative study following hermeneutic phenomenology.
Through purposeful sampling, 13 participants with COVID-19-associated intensive care unit acquired weakness were recruited with diversity in age, sex, duration of hospitalization and severity of muscle weakness. Semi-structured in-depth interviews were conducted from 4 to 8 months after hospital discharge, between July 2020 and January 2021. Interviews were transcribed verbatim and analysed using hermeneutic phenomenological analysis.
The analysis yielded five themes: 'waking up in alienation', 'valuing human contact in isolation', 'making progress by being challenged', 'coming home but still recovering' and 'finding a new balance'. The phenomenological descriptions reflect a recovery process that does not follow a linear build-up, but comes with moments of success, setbacks, trying new steps and breakthrough moments of achieving mobilizing milestones.
Recovery from COVID-19-associated intensive care unit acquired weakness starts from a situation of alienation. Patients long for familiarity, for security and for recognition. Patients want to return to the familiar situation, back to the old, balanced, bodily self. It seems possible for patients to feel homelike again, not only by changing their outer circumstances but also by changing the understanding of themselves and finding a new balance in the altered situation.
Muscle weakness impacts many different aspects of ICU recovery in critically ill patients with COVID-19-associated intensive care unit acquired weakness. Their narratives can help nurses and other healthcare professionals, both inside and outside of the intensive care unit, to empathize with patient experiences. When healthcare professionals connect to the lifeworld of patients, they will start to act and communicate differently. These insights could lead to optimized care delivery and meeting patients' needs in this pandemic or a possible next.
探索 COVID-19 相关重症监护病房获得性肌无力患者的生活体验，并对其康复过程进行现象学描述。
遵循解释学现象学的定性研究。
通过目的性抽样，招募了 13 名 COVID-19 相关重症监护病房获得性肌无力患者，他们在年龄、性别、住院时间和肌肉无力严重程度方面存在多样性。2020 年 7 月至 2021 年 1 月，在出院后 4 至 8 个月间，进行了半结构式深入访谈。访谈逐字记录并使用解释学现象学分析进行分析。
分析产生了五个主题：“在异化中醒来”、“在隔离中重视人际接触”、“通过挑战取得进展”、“回家但仍在康复中”和“找到新的平衡”。这些现象学描述反映了一个康复过程，它不是线性的，而是伴随着成功、挫折、尝试新步骤和实现动员里程碑的突破时刻。
COVID-19 相关重症监护病房获得性肌无力的康复始于异化的情况。患者渴望熟悉、安全和认可。患者希望回到熟悉的环境，回到旧的、平衡的、有身体自我的状态。患者似乎可以再次感到舒适，不仅可以通过改变外在环境，还可以通过改变对自己的理解，在改变的情况下找到新的平衡。
COVID-19 相关重症监护病房获得性肌无力会对重症患者的 ICU 康复产生许多不同方面的影响。他们的叙述可以帮助护士和其他医疗保健专业人员，无论是在重症监护病房内还是外，感同身受地理解患者的经历。当医疗保健专业人员与患者的生活世界联系起来时，他们将开始以不同的方式行动和交流。这些见解可能会导致护理提供的优化，并满足患者在这一大流行期间或下一次可能的需求。
