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新冠肺炎疫情期间重症监护病房患者的隔离体验。

Experiences of isolation in patients in the intensive care unit during the COVID-19 pandemic.

机构信息

The Danish National Center for Grief, Copenhagen, Denmark.

Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2023 Sep;67(8):1061-1068. doi: 10.1111/aas.14284. Epub 2023 May 28.

Abstract

BACKGROUND

During the COVID-19 pandemic, patients in the intensive care unit have been subjected to strict isolation precautions, and potentially long and complicated patient courses. The aim of the study is to provide an investigation of the experiences of isolation in COVID-19-positive patients in the ICU during the first phase of the COVID-19 pandemic in Denmark.

METHODS

The study was performed in a 20-bed ICU at a university hospital in Copenhagen, Denmark. The study is based on a phenomenological framework, Phenomenologically Grounded Qualitative Research. This approach provides insights into the tacit, pre-reflective and embodied dimensions of the specific experience under investigation. Methods included a combination of in-depth structured interviews with ICU patients 6-12 months after ICU discharge, and observations from inside the isolated patient rooms. The descriptions of experiences gathered through the interviews were subjected to systematic thematic analysis.

RESULTS

Twenty-nine patients were admitted to the ICU in the period 10 March and 19 May 2020. A total of six patients was included in the study. Themes consistently reported across all patients included (1) being objectified to degrees that implied self-alienation; (2) feeling a sense of being in captivity; (3) being in an experiential state of surrealism, and finally (4) experiencing extreme loneliness and intercorporeal deprivation.

CONCLUSION

This study provided further insights into the liminal patient experiences of being isolated in the ICU due to COVID-19. Robust themes of experience were achieved through an in-depth phenomenological approach. Although, similarities in experiences compared to other patient groups exist, the precarious situation constituted by COVID-19 lead to significant intensifications across multiple parameters.

摘要

背景

在 COVID-19 大流行期间,重症监护病房的患者受到严格的隔离预防措施,且可能经历漫长而复杂的病程。本研究旨在调查 COVID-19 阳性患者在丹麦 COVID-19 大流行第一阶段在重症监护病房(ICU)隔离期间的体验。

方法

该研究在哥本哈根的一家大学医院的 20 张床位的 ICU 中进行。该研究基于现象学框架,即现象学基础的定性研究。这种方法提供了对所研究的特定体验的隐性、前反思和体现维度的深入了解。方法包括对 ICU 出院后 6-12 个月的 ICU 患者进行深入的结构化访谈,并对隔离病房内的情况进行观察。通过访谈收集的体验描述经过系统的主题分析。

结果

2020 年 3 月 10 日至 5 月 19 日期间,共有 29 名患者被收入 ICU。共有 6 名患者纳入研究。所有患者一致报告的主题包括(1)被客体化到自我异化的程度;(2)感到被囚禁;(3)处于超现实主义的体验状态;最后(4)经历极度孤独和身体缺失。

结论

本研究进一步深入了解了 COVID-19 导致 ICU 隔离的患者的边缘体验。通过深入的现象学方法,得出了强有力的体验主题。虽然与其他患者群体的体验相似,但 COVID-19 带来的不稳定局势在多个参数上导致了显著的加剧。

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