Sterr Fritz, Hechinger Mareike, Bauernfeind Lydia, Rester Christian, Palm Rebecca, Metzing Sabine
Faculty of Health, School of Nursing Sciences, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany.
Faculty of Applied Healthcare Sciences, Deggendorf Institute of Technology, Land-Au 27, 94469, Deggendorf, Germany.
Crit Care. 2025 Mar 8;29(1):105. doi: 10.1186/s13054-025-05326-6.
The experience of patients under mechanical ventilation in the intensive care unit is described as complex and multifaceted, but an overarching and in-depth understanding of the experience is still missing.
To provide an in-depth analysis and synthesis of patients' experience when being mechanically ventilated in intensive care units.
We conducted a meta-synthesis according to the methodological recommendations of Sandelowski and Barroso. Our systematic literature search in Medline, CINAHL, and Cochrane was complemented by hand and citation searches. We included only qualitative studies with a rich description of conscious patients' experience under mechanical ventilation. Studies on children, step-down units, noninvasive ventilation and non-scientific journal articles were excluded. After the title, abstract and full-text screening by three reviewers, we performed initial, axial and selective coding and in-depth analysis in MAXQDA. The synthesis was supported by multiple discussion rounds.
Of the 2,563 records identified, 20 studies were included in our synthesis. This revealed the central phenomenon of patients being observers of their own lives. They are yearning for a stable picture of reality and developing various situation-specific needs. Finally, patients are finding ways to deal with the situation. These concepts are interwoven in time and are experienced repeatedly in different dimensions.
Patients under mechanical ventilation are highly perceptive. Healthcare professionals are particularly responsible for patients. They should reflect on their role in intensive care and must be sensitized to patients' differentiated experience. Registration, Protocol: https://doi.org/10.17605/OSF.IO/G8Q6X.
重症监护病房中接受机械通气患者的经历被描述为复杂且多面的,但对这种经历仍缺乏全面而深入的理解。
对重症监护病房中接受机械通气患者的经历进行深入分析和综合。
我们根据桑德洛斯基和巴罗斯的方法学建议进行了元综合分析。我们在Medline、CINAHL和Cochrane中进行的系统文献检索辅以手工检索和引文检索。我们仅纳入了对有意识的机械通气患者经历有丰富描述的定性研究。排除了关于儿童、逐步降级病房、无创通气和非科学期刊文章的研究。在三位评审员对标题、摘要和全文进行筛选后,我们在MAXQDA中进行了初始编码、轴心编码和选择性编码以及深入分析。通过多轮讨论对综合分析提供支持。
在识别出的2563条记录中,有20项研究纳入了我们的综合分析。这揭示了患者成为自己生活观察者这一核心现象。他们渴望稳定的现实图景并产生各种特定情境下的需求。最后,患者在寻找应对这种情况的方法。这些概念在时间上相互交织,并在不同维度上反复经历。
接受机械通气的患者具有高度的感知能力。医护人员对患者负有特殊责任。他们应该反思自己在重症监护中的角色,并且必须对患者的不同经历保持敏感。注册,方案:https://doi.org/10.17605/OSF.IO/G8Q6X。