Mercuri Caterina, Bosco Vincenzo, Guillari Assunta, Rea Teresa, Doldo Patrizia, Nocerino Rita, Giordano Vincenza, Simeone Silvio
Department of Clinical and Experimental Medicine, University of Catanzaro MagnaGraecia, Catanzaro, Italy.
Department of Medical and Surgical Sciences, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy.
Nurs Crit Care. 2025 Sep;30(5):e70134. doi: 10.1111/nicc.70134.
Intensive care unit (ICU) experiences after cardiac surgery significantly influence patient outcomes, including psychological disorders, quality of life and overall comfort. The existing literature emphasises psychological impacts and transitions from ICU to general wards, but there is a paucity of qualitative research focussing specifically on post-cardiac surgery ICU experiences.
This study aimed to explore the lived experiences of patients in the ICU following major cardiac surgery, providing a comprehensive understanding of their emotional and psychological challenges.
Utilising Cohen's phenomenological approach, we conducted in-depth interviews with 20 patients from a cardiothoracic ICU in Southern Italy. Participants were chosen through purposive sampling. Data were analysed using thematic analysis to identify recurring themes.
Five main themes emerged from the data: (1) 'Closing the eyes and not opening them', highlighting pervasive fear and anxiety; (2) 'Confusion upon awakening', marked by disoriented memories and the fear of not being able to breathe; (3) 'Time stood still', describing a distorted perception of time; (4) 'The closeness of my angels: the nurses', underscoring the critical role of nursing support; and (5) 'The other side: exclusion from care', reflecting feelings of marginalisation during the care process.
The study underscores the complex experiences of ICU patients' post-cardiac surgery, emphasising the need for psychological support and inclusive communication strategies to enhance patient outcomes. Further research should focus on developing tailored interventions to support these patients through their recovery process.
There is a clear need for enhanced psychological support for patients before, during and after the ICU stay. Preoperative education programmes that set realistic expectations and provide coping strategies can significantly reduce anxiety and improve patient outcomes. Additionally, enhancing the role of nurses in offering emotional support and involving patients in care decisions can lead to a more positive ICU experience. Psychological interventions can optimise preoperative expectations and reduce hospital stays, offering significant cost-benefit advantages for healthcare systems.
心脏手术后的重症监护病房（ICU）经历对患者的预后有显著影响，包括心理障碍、生活质量和整体舒适度。现有文献强调心理影响以及从ICU过渡到普通病房的情况，但专门聚焦于心脏手术后ICU经历的定性研究较少。
本研究旨在探索心脏大手术后患者在ICU的真实经历，全面了解他们的情感和心理挑战。
采用科恩的现象学方法，我们对意大利南部一家心胸ICU的20名患者进行了深入访谈。参与者通过目的抽样选取。数据采用主题分析法进行分析，以识别反复出现的主题。
数据中出现了五个主要主题：（1）“闭眼不睁眼”，突出普遍存在的恐惧和焦虑；（2）“醒来时的困惑”，其特征是记忆混乱以及对无法呼吸的恐惧；（3）“时间静止”，描述了对时间的扭曲感知；（4）“我的天使很近：护士”，强调了护理支持的关键作用；（5）“另一边：被排除在护理之外”，反映了护理过程中的被边缘化感受。
该研究强调了心脏手术后ICU患者的复杂经历，强调需要心理支持和包容性沟通策略以改善患者预后。进一步的研究应专注于制定针对性的干预措施，以支持这些患者度过康复过程。
显然需要在患者入住ICU之前、期间和之后加强心理支持。设定现实期望并提供应对策略的术前教育计划可显著减轻焦虑并改善患者预后。此外，加强护士在提供情感支持方面的作用并让患者参与护理决策可带来更积极的ICU体验。心理干预可优化术前期望并缩短住院时间，为医疗系统带来显著的成本效益优势。
