Villa Marta, Ausili Davide, Pegoraro Flavia, Nava Giancarla, Bassi Martina Giulia, Bramati Sabrina, Manuela Cavaliere, Simone Giannella, Rona Roberto, Giani Marco, Lucchini Alberto
Department of Emergency and Intensive Care - Adult and Paediatric General ICU, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Nurs Crit Care. 2025 Jul;30(4):e70105. doi: 10.1111/nicc.70105.
Patients with severe hypoxaemia due to Adult Respiratory Distress Syndrome may require extracorporeal membrane oxygenation (ECMO). ECMO centres, known as 'hub hospitals', provide mobile teams that can initiate ECMO treatment at local 'spoke' hospitals before transferring patients to hub facilities. This hub-and-spoke system is operational throughout northern Italy.
To explore the experiences and perceptions of family members when their loved ones received ECMO treatment and were subsequently relocated from a spoke hospital to a hub hospital.
Semi-structured phone interviews with thematic analysis. Family members of patients transferred with ECMO from a spoke to a hub hospital were recruited for this study. Data analysis followed the principles of thematic synthesis.
Six phone interviews were conducted with family members eligible for the study. Three main themes and nine subthemes were generated from interview data: (1) The 'Wait' (subthemes: Fear, despair and anguish; Disbelief; Confusion and disorientation; Daily clinical news), (2) The 'Trust' (Trust in healthcare professionals; Hope and optimism; Technology), and (3) The 'Gratitude' (Fortune and awareness; Commitment, humanity and to take care of). Each relative's experience was unique; however, several common behaviours and emotional patterns emerged during the interviews. The ECMO process was perceived as a collaborative experience involving the interplay between patients, their family members and healthcare providers.
Family members' experience with ECMO patients indicates that ECMO is perceived as a crisis-focused intervention that provides last-minute hope. Despite the dire circumstances, the narratives shared by the interviewees provided the ability to reflect on their ICU experiences.
The findings of this small, single-location study indicate that including the viewpoints of patients' families in future qualitative research and follow-up initiatives for former ICU patients could provide further understanding of how family members perceive the experience of a patient undergoing ECMO. The involvement of family members is crucial when providing care to critically ill patients. This is particularly relevant for critical care nurses who play a key role in supporting families during ECMO.
因成人呼吸窘迫综合征导致严重低氧血症的患者可能需要体外膜肺氧合（ECMO）治疗。被称为“枢纽医院”的ECMO中心提供移动团队，这些团队可以在当地的“辐条医院”启动ECMO治疗，然后再将患者转至枢纽医院。这种枢纽-辐条系统在意大利北部各地都在运行。
探讨家庭成员在其亲人接受ECMO治疗并随后从辐条医院转至枢纽医院时的经历和看法。
采用主题分析的半结构化电话访谈。招募了通过ECMO从辐条医院转至枢纽医院的患者的家庭成员参与本研究。数据分析遵循主题综合原则。
对符合研究条件的家庭成员进行了6次电话访谈。访谈数据产生了3个主要主题和9个子主题：（1）“等待”（子主题：恐惧、绝望和痛苦；怀疑；困惑和迷失方向；每日临床消息），（2）“信任”（对医护人员的信任；希望和乐观；技术），以及（3）“感激”（幸运和意识；承诺、人性和照顾）。每位亲属的经历都是独特的；然而，访谈中出现了一些共同的行为和情感模式。ECMO过程被视为一种涉及患者、其家庭成员和医护人员之间相互作用的协作经历。
家庭成员对ECMO患者的经历表明，ECMO被视为一种以危机为重点的干预措施，提供了最后的希望。尽管情况严峻，但受访者分享的叙述让人有能力反思他们在重症监护病房的经历。
这项小型单地点研究的结果表明，在未来针对 former ICU患者的定性研究和后续举措中纳入患者家属的观点，可能会进一步了解家庭成员如何看待患者接受ECMO的经历。在为重症患者提供护理时，家庭成员的参与至关重要。这对于在ECMO期间为家庭提供支持方面发挥关键作用的重症护理护士尤为重要。
