Challenges of the patient transition process from the intensive care unit: a qualitative study

Abstract

Background:The transition of patients from the intensive care unit (ICU) to the general ward is challenging. Patients and caregivers experience high levels of anxiety during the transition period.This study aimed to explain the challenges that patients face during the transition process. Methods:In this qualitative research of conventional content analysis, data collection was conducted between February 2018 and July 2019 in educational hospitals affiliated with the Iran University of Medical Sciences. After obtaining informed consent, purposive sampling was performed with 22 nurses, intensive care physicians, anesthesiologists, and patients and their families using in-depth semi-structured interviews until data saturation. Results:The data obtained from the interviews indicated their perceptions and experiences, which are expressed scientifically through qualitative research. A total of 504 initial codes were extracted from continuous data analysis. The content analysis yielded three main themes in the challenges patients face during the transition process from the ICU: mixed feelings regarding transition (happiness/hope, worry/uncertainty, abandonment); care break (different atmosphere, the difference between the program and the quality of care, assigning care to the patient and family, and care culture and beliefs); and search for support and information (ineffective communication, self-care capacity of patient and family, ineffective and disrupted training, and weak follow-up programs), which inflicts care shock in the patients. Conclusions:The results showed that patients and their families were in a state of care shock during the ICU transition process and were sometimes disconcerted. It is necessary to design and implement care models according to the needs and challenges patients face during the transition period from ICU (patient-centered), based on the evidence available, and after considering the field of medicine and the accessibility of care in the country. The transition process can be improved and enhanced by obtaining knowledge about ICU transition care and related challenges as well as organizing a learning environment.

Family caregivers' experiences and needs of transitional care during the transfer from intensive care unit to a general ward: A qualitative study

“…Similar to the caregivers situating with other types of ICU, participants reported that their care efficiency of family members during the process of ICU transition was more affected by the internal and external environment, such as varied degrees of mental burdens and mixed emotional response, which led to their inactive, and even negative care activities (de Grood et al, 2018; Herling et al, 2020). These findings are consistent with reported experiences of participants who were in a state of care shock and sometimes disturbed during ICU transition (Ghorbanzadeh et al, 2021). During the transition period of ICU, professionals should provide psychological support, pay close attention to the real feelings of nurses, and dynamically assess their psychological status when evaluating their mental, emotional and cognitive status.…”

Dietetic-Led Nutrition Interventions in Patients with COVID-19 during Intensive Care and Ward-Based Rehabilitation: A Single-Center Observational Study

“…Of the patients transferred to the ward, 90% received ward-based dietitian-prescribed individualized nutrition interventions. Continuity of nutritional interventions can be problematic during the transition from ICU to the ward [ 18 ]. Structured dietetic handover between ICU and ward dietitians to improve the transfer of nutritional history and meet nutritional needs for recovery were used [ 1 ].…”

Validation of manual to complement the transition of care at discharge from intensive care

“…The transition process can be improved by obtaining knowledge about the challenges related to hospitalization and care in the ICU, as well as the organization of an environment and learning conditions (23) , as the preparation of the patient and his/her family needs to be expanded considering their individual needs (19)(20)(21)(22)(23) .…”