Abstract:
BACKGROUND:Sedation practices in the intensive care unit have evolved from deep sedation and paralysis toward lighter sedation and better pain management. The new paradigm of sedation has enabled early mobilization and optimized mechanical ventilator weaning. Intensive care units in the Nordic countries have been particularly close to goals of lighter or no sedation and a more humane approach to intensive care. OBJECTIVES:The aim of our study was to systematically review and reinterpret newer Nordic studies of the patient experience of intensive care to obtain a contemporary description of human suffering during life-threatening illness. DESIGN:We conducted a meta-synthesis in which we collected, assessed, and analyzed published qualitative studies with the goal of synthesizing these findings into a new whole. Analysis was based on the scientific approach of Gadamerian hermeneutics. SETTINGS:Nordic intensive care units. PARTICIPANTS:Patients in Nordic intensive care units. METHODS:We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and PsycINFO. Each original paper was assessed by all authors using the Critical Appraisal Skills Program instrument for qualitative research. We included 22 studies, all of which provided direct patient quotes. RESULTS:The overarching theme was identified as: The patient experience when existence itself is at stake. We constructed an organizing framework for analysis using the main perspectives represented in the included studies: body, mind, relationships, and ICU-environment. Final analysis and interpretation resulted in the unfolding of four themes: existing in liminality, existing in unboundedness, existing in mystery, and existing on the threshold. CONCLUSIONS:Our main finding was that human suffering during intensive care is still evident although sedation is lighter and the environment is more humane. Our interpretation suggested that patients with life-threatening illness descend into a liminal state, where they face the choice of life or death. Caring nurses and family members play an important role in assisting the patient to transition back to life.
journal_name
Int J Nurs Studjournal_title
International journal of nursing studiesauthors
Egerod I,Bergbom I,Lindahl B,Henricson M,Granberg-Axell A,Storli SLdoi
10.1016/j.ijnurstu.2015.04.017subject
Has Abstractpub_date
2015-08-01 00:00:00pages
1354-61issue
8eissn
0020-7489issn
1873-491Xpii
S0020-7489(15)00137-6journal_volume
52pub_type
杂志文章,meta分析abstract:BACKGROUND:Nurses' clinical judgement plays a vital role in pressure ulcer risk assessment, but evidence is lacking which patient characteristics are important for nurses' perception of patients' risk exposure. OBJECTIVES:To explore which patient characteristics nurses employ when assessing pressure ulcer risk without...
journal_title:International journal of nursing studies
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abstract:BACKGROUND AND OBJECTIVES:Occupational stress in nursing has frequently been considered in nursing literature. The operationalization of job demands in different work settings and its relation to distress have been discussed to identify significant interactions with job resources. In this study, job demands were define...
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pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND:Variations in rural nurses' sense of community and engagement in rural communities are poorly understood, although there is evidence that these are linked to community cohesion and perceived community resilience. OBJECTIVE:The aim of our research was to develop descriptive profiles of rural nurses who exhib...
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journal_title:International journal of nursing studies
pub_type: 杂志文章,评审
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abstract::This study queried 508 persons diagnosed with multiple sclerosis (MS) regarding what conditions made performing their work or tasks 'difficult' and 'easier'. The subjects represented four groups: employed outside the home, homemakers, unemployed, and retired. Their written responses were content analysed. Conditions r...
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更新日期:2015-06-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2008-07-01 00:00:00