A qualitative study of long‐term ICU patients' inner strength and willpower: Family and health professionals as a health‐promoting resource

Abstract

Aims and objectives To explore how the presence of family and health professionals influences long‐term critically ill patients' inner strength and willpower as an incitement to keep fighting for recovery. Background This study reports long‐term critically ill patients' experiences of family and health professionals as health‐promoting resources in terms of significance for their inner strength and willpower. Earlier research on this topic is scarce. Design A qualitative, hermeneutic‐phenomenological approach, within the context of Antonovsky's salutogenic theory. Methods Seventeen long‐term critically ill patients were interviewed once, at 6–18 months after ICU discharge. The consolidated criteria for reporting qualitative research (COREQ) were used (Supplementary File 1). Results Four main themes identified how family and staff promoted and challenged the patient's inner strength and willpower: (a) the importance of family and friends; my family was surrounding me, (b) staff contributions, (c) challenges to inner strength and willpower in relation to family and (d) loneliness and indifferent care. Conclusion This study brings new knowledge from the long‐term critically ill patient's view about the impact of family, friends and nurses on the patient's inner strength and willpower. All impact is experienced positively and negatively. Relevance to clinical practice Knowledge from the long‐term critically ill patient's view is vital in nurse–patient interactions to facilitate liberation of inner strength and willpower.

‘I want to get back!’ A qualitative study of long‐term critically ill patients’ inner strength and willpower: Back home after long‐term intensive care

“…Our findings correspond with previous research on what promotes inner strength during an ICU stay showing family support and inner strength to be vital for returning to ones' ordinary life (Alexandersen et al, 2020;Alpers et al, 2012;Wåhlin et al, ). Dinglas et al (2018) recommend a core-set of five outcomes for studies reporting post-discharge outcomes for critical ill survivors: survival, physical functioning, cognition, mental health, QoL and pain.…”

“…Consequently, ICU care mainly focuses on treatment supporting the bodily functions. The long-term ICU patient's pathway is extremely hard, involving several traumatic experiences and a heavy symptom burden (Alexandersen et al, 2019(Alexandersen et al, , 2020. In this context, long-term ICU patients' existential will is a salutogenic resource (Alexandersen et al, 2019;Haugdahl et al, 2018).…”

“…This study is part of a large qualitative study among long-term critically ill patients, family members and nurses exploring patients' inner strength and survival (Alexandersen et al, 2019(Alexandersen et al, , 2020Haugdahl et al, 2018).…”

Intensivsykepleieres opplevelser med langtids-intensivpasienters indre styrke og vilje til overlevelse

“…En nylig studie av Alexandersen og kolleger viser at intensivsykepleierne kan vaere en ressurs for å fremme pasienters indre styrke og vilje til overlevelse i møte med alvorlig sykdom, lidelse og belastning (18). Følgelig kan intensivsykepleie forstås som et avgjørende aspekt ved pasientens GMR ved at intensivsykepleierne aktivt bidrar til Figur 1: Sammenhengen mellom begrepene salutogenese, OAS, GMR, livsmot, indre styrke og viljestyrke/vilje til overlevelse.…”

“…Wåhlin og kolleger avdekket et gap mellom hva langtidsintensivpasientene ønsket, og den hjelpen de fikk under intensivoppholdet i forhold til indre styrke og viljen til å kjempe (11). Alexandersen og kolleger har nylig vist at langtidsintensivpasienter opplever forhold som både fremmer og hemmer deres indre styrke og vilje til overlevelse (18). Forskning innen dette tema er ikke konkluderende, og fremdeles har vi lite kunnskap om hvordan intensivsykepleierne opplever pasienters indre styrke og vilje til overlevelse, samt hvordan de eventuelt arbeider for å fremme denne ressursen.…”