Leaving the intensive care unit: a phenomenological study of the patients’ experience

McKinney, Aidin; Deeny, Pat

doi:10.1016/s0964-3397(02)00069-1

Cited by 83 publications

(100 citation statements)

References 37 publications

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“…In common with other research, findings highlight the enormous emotional and physical impact of critical illness, [32][33][34][35][36][37] which affects information delivery at this time.…”

Section: Discussionsupporting

confidence: 80%

Involving Users in the Development of Effective Critical Care Discharge Information: A Focus Group Study

Bench

Day

Griffiths

2011

American Journal of Critical Care

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Background Discharge from critical care to a general care unit is a difficult period, and more effective information is needed to support patients and their families at this time. Objectives This study sought the views of patients, relatives and health care staff on (1) the most effective methods of delivering critical care discharge information, (2) the required information content of any proposed strategies, (3) the benefits and limitations of any existing strategies, and (4) potential resource implications. Methods In this qualitative focus group study, 11 adult patients, 8 family members, and 23 health care staff in England took part in 8 focus group interviews at 2 hospitals. The computer software program NVIVO7 was used for thematic analysis of the data. Results Three key themes were identified from the data: (1) considerations related to effective discharge information, (2) goals of critical care discharge information, and (3) resource implications. Conclusions This focus group study provides unique user insight into what influences successful and unsuccessful information giving. Based on real experiences, it adds to the limited international body of current evidence. Findings will be of value in designing future critical care discharge information and identifying the related resource implications.

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“…In common with other research, findings highlight the enormous emotional and physical impact of critical illness, [32][33][34][35][36][37] which affects information delivery at this time.…”

Section: Discussionsupporting

confidence: 80%

Involving Users in the Development of Effective Critical Care Discharge Information: A Focus Group Study

Bench

Day

Griffiths

2011

American Journal of Critical Care

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“…48 Information needs most commonly identifi ed were about the health condition and effects of treatment, 30,31,42,52,62 prognosis, 32,47 what to expect in a new environment or on discharge, 41,49,53 selfmanagement and treatment, 40 and contingency plans for complications or unexpected events.…”

Section: Information From Clinicians Enables Patient Agencymentioning

confidence: 99%

“…These links referred to communication between the patients and their specifi c health care clinicians as well as to the communication between health care professionals. 38 Patients, especially those who see themselves as agents of their own care, want to be part of the information loop around their care, both giving and receiving information.48 Information needs most commonly identifi ed were about the health condition and effects of treatment, 30,31,42,52,62 prognosis, 32,47 what to expect in a new environment or on discharge, 41,49,53 selfmanagement and treatment, 40 and contingency plans for complications or unexpected events.53 Information empowers patients, giving them a sense of partnership and control, 3,37,43 particularly for informal caregivers. 44,60 Just as most information transfer between clinicians depends upon documentation, written information for patients is important for achieving continuity and a sense of security.…”

mentioning

confidence: 99%

“…Learning from hospital discharge planning, transition care provides information to help patients anticipate and understand the new environment and know where to get help, and it outlines a contingency plan for returning to a safe care environment in the case of unmanageable distress. 35,40,41,43,51 Informational Continuity Information Among Clinicians Experienced Through Gaps Patients assume clinicians are communicating until proven otherwise. Communication failures defi ned patients' experience of discontinuity in almost twothirds of the studies.…”

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confidence: 99%

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Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

Haggerty

Roberge

Freeman

et al. 2013

The Annals of Family Medicine

205

261

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PURPOSE Continuity of care among different clinicians refers to consistent and coherent care management and good measures are needed. We conducted a metasummary of qualitative studies of patients' experience with care to identify measurable elements that recur over a variety of contexts and health conditions as the basis for a generic measure of management continuity.METHODS From an initial list of 514 potential studies (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007), 33 met our criteria of using qualitative methods and exploring patients' experiences of health care from various clinicians over time. They were coded independently. Consensus meetings minimized conceptual overlap between codes.RESULTS For patients, continuity of care is experienced as security and confidence rather than seamlessness. Coordination and information transfer between professionals are assumed until proven otherwise. Care plans help clinician coordination but are rarely discerned as such by patients. Knowing what to expect and having contingency plans provides security. Information transfer includes information given to the patient, especially to support an active role in giving and receiving information, monitoring, and self-management. Having a single trusted clinician who helps navigate the system and sees the patient as a partner undergirds the experience of continuity between clinicians.CONCLUSION Some dimensions of continuity, such as coordination and communication among clinicians, are perceived and best assessed indirectly by patients through failures and gaps (discontinuity). Patients experience continuity directly through receiving information, having confi dence and security on the care pathway, and having a relationship with a trusted clinician who anchors continuity. Ann Fam Med 2013;11:262-271. doi:10.1370/afm.1499. INTRODUCTIONC ontinuity of care is the extent to which a series of health care services is experienced as connected and coherent and is consistent with a patient's health needs and personal circumstances.1 As patients increasingly receive care from multiple professionals and organizations, improving continuity of care has become a research priority. Although continuity of care is understood differently across health disciplines, an interdisciplinary review of concepts and measures of continuity of care found all disciplines would recognize 3 types of continuity. 1,2 Relational continuity is the therapeutic relationship between a patient and 1 or more clinicians that bridges episodes of care and provides coherence through clinicians' growing comprehensive knowledge of the patient. It is most valued in primary care and family medicine. Informational continuity ensures connectedness and coherence by the uptake of information on past events and is most emphasized in the nursing sciences.3-6 Management continuity refers to consistent and coherent management by different clinicians 263 CONT INUIT Y O F C A R E WIT H MULT IPL E CLINICIANSthrough coordinated and timely delivery of complemen...

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“…Incluso en el mejor de los casos, cuando el paciente ya no se encuentra en estado crítico y es posible su traslado de UCI a planta algunos pacientes suelen angustiarse y sentirse inseguros por no saber lo que les espera en este nuevo contexto (McKinney & Deeny, 2002). A todo esto hay que añadir la frecuente ausencia de control así como la falta de significado que percibe el paciente sobre la situación que vive (Frediksen & Ringsberg, 2007;McKinley et al, 2002;Moser et al, 2003;Scott, 2004;Stein-Parbury & McKinley, 2000).…”

Section: Ingresados En Una Uciunclassified

Afectación emocional asociada al ingreso en una Unidad de Cuidados Intensivos

Juliá¹

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Leaving the intensive care unit: a phenomenological study of the patients’ experience

Cited by 83 publications

References 37 publications

Involving Users in the Development of Effective Critical Care Discharge Information: A Focus Group Study

Involving Users in the Development of Effective Critical Care Discharge Information: A Focus Group Study

Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

Afectación emocional asociada al ingreso en una Unidad de Cuidados Intensivos

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