Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study

Abstract

Aims and objectives To reveal meanings of family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer. Background Interhospital intensive care unit‐to‐unit transfers take place between different hospitals and their respective intensive care units (ICUs). These types of transfers are an increasing phenomenon but are sparsely studied from the family members' perspective. Indeed, the patient's critical illness and care can have a major impact on family members. During the transfer process, there is a demand for the involved intensive care health personnel to make family members feel safe and cared for. Design A qualitative design based on phenomenological hermeneutics. Methods The study was conducted at two Swedish general ICUs. Data were generated through individual in‐depth interviews with seven family members and analysed using a phenomenological hermeneutical approach. The Criteria for Reporting Qualitative Research principles were applied in the conduct and reporting of this study. Results Four themes that reveal meanings of family members' lived experiences were developed: losing your safe haven, dealing with uncertainty, carrying your own and others' burdens and a wish to be close. Conclusions The study reveals that an interhospital intensive care unit‐to‐unit transfer affects the whole family and is characterised by family members experiencing many negative feelings. The findings also illustrate that being a family member when a loved one is transferred means being exposed to the core existential elements of being human, such as loneliness and searching for meaning. Relevance to clinical practice The study highlights the importance of maintaining a family‐centred approach during the transfer process. Our findings can provide deeper knowledge for intensive care health personnel, better preparing them for the delicate task of providing family‐centred care during the interhospital intensive care unit‐to‐unit transfer process.

Critically Ill Patients: Family Experiences of Interfacility Transfers From Rural to Urban Centers and Impact on Family Relationships

“…Through consideration of the participants’ experiences of a family member’s IFT for advanced critical care services, both challenging and beneficial aspects of experience were identified. As with previous studies, family members in the present study experienced concerns about managing responsibilities at home while away at the urban center, fear and uncertainty related to traveling to an unfamiliar city and hospital, worry that something would happen to their relative while enroute to the urban center, and, for some, concern related to how they would manage financially ( Johnson, 1999 ; Karlsson et al, 2020 ; Mackie et al, 2014 ). These findings also overlap with transfer experiences for other health-related indications, such as pregnancy-related conditions ( Woodhart et al, 2018 ) or cancer-related care ( Chua et al., 2022 ).…”

“… Karlsson et al (2020) and Mackie et al (2014) indicated that receiving information from health care providers that is honest and complete is beneficial for family members and the absence of this is distressing, which was an experience echoed by participants in the present study. However, despite this need for information, participants in the present study often described an aversion or reticence to communicating with health care providers or even being present in the critical care area for fear of “bothering” health care providers.…”

“…In addition to this, one participant of the present study noted she was less comfortable speaking with nurses in the urban center compared with nurses in the rural center; with nurses in the rural hospital being from and living in the same geographical location as her, it felt easier to talk to these individuals. It has been noted in previous work that family members generally are reluctant to communicate concerns with intensive care unit (ICU) health care providers, thereby suffering in silence ( Bell et al, 2018 ; Burns et al, 2018 ; Karlsson et al, 2020 ). However, the discomfort of family members from rural areas, specifically when communicating with nurses in urban centers, has not previously been noted.…”

“…Critical care nurses are well positioned to support family members during this experience ( Frivold et al, 2015 ; International Family Nurses Association (IFNA), 2015 ; Mackie et al, 2014 ). However, the experiences of family members in rural areas whose critically ill relative undergoes an IFT for advanced critical care services are poorly understood ( Burns & Petrucka, 2020 ; Karlsson et al, 2020 ). In addition to this limited understanding, Burns and Petrucka (2020) found that healthcare professionals do not view the experiences of family members from rural areas as unique, thereby potentially neglecting their distinct care needs.…”

“…However, critical care nurses must first gain an understanding of the unique experiences of family members from rural areas to ensure appropriate and meaningful care. While there has been increasing interest in the needs of family members of critically ill patients who undergo an IFT to a distant urban center in Australia ( Johnson, 1999 ; Mackie et al, 2014 ) and Sweden ( Karlsson et al, 2020 ), no studies were located that explore this phenomenon in North America.…”