The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: A phenomenological-hermeneutic study

Karlsson, Veronika; Bergbom, Ingegerd; Forsberg, Anna

doi:10.1016/j.iccn.2011.11.002

Cited by 147 publications

(180 citation statements)

References 34 publications

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“…Another common them of being underwater or strangled is potentially associated with patient reports of moderate dyspnea and breathlessness related to mechanical ventilation. 5,30 Investigation of ICU events associated with disturbing delusional memories of ICU would allow development of interventions targeting ICU experiences most likely to trigger these disturbing memories.…”

Section: Discussionmentioning

confidence: 99%

“Releasing a lot of poisons from my mind”: Patients' delusional memories of intensive care

Guttormson

2014

Heart & Lung

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Objectives To describe intensive care unit (ICU) patients’ delusional memories and interpretations of those memories Background Delusional memories of the ICU are distressing for patients and may impact psychological recovery. Methods This is secondary analysis from a study of mechanically ventilated patients’ recall in relation to sedation. Subjects, recruited from one medical-surgical ICU, participated in structured interviews after extubation. Results Subjects (n=35) with a mean age of 66 (SD 12.9) and on the ventilator a median of 4.5 days provided detailed descriptions of delusional memories of being shackled, caged, strangled, or being in a foreign country. Delusions were very real and frightening in the moment. Subjects had difficulty connecting to reality to allow processing of the delusions. Conclusions Patients’ delusional memories of ICU share common distressing themes. Assisting patients’ to connect to real ICU events and process delusional memories may help with psychological recovery after critical illness.

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Section: Discussionmentioning

confidence: 99%

“Releasing a lot of poisons from my mind”: Patients' delusional memories of intensive care

Guttormson

2014

Heart & Lung

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“…Endotrakeal tüp (ET) birçok hastada anksiyete nedenidir. ET ile iletişim kurulamaması, hastanın kendisini ifade edememesi hastaların endişelerini arttırırken; özellikle de yatkınlı-ğı olan hastalarda panik atakları da arttırmaktadır (3,4).…”

Section: Discussionunclassified

Role of Anxiety During Unsuccessful Weaning

Savran¹,

Başoğlu²

2015

Yoğun Bakim Derg

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One of the potential negative effects of anxiety in intensive care units is unsuccessful weaning trials. In patients who are clinically suitable for weaning, although there are no underlying respiratory pathology symptoms, like dyspnea, tachypnea, tachycardia, and sweating can be observed due to anxiety. Therefore, unsuccessful weaning trials and prolonged intubation can form a vicious cycle. We want to share our experience of unsuccessful weaning trials in a patient who had been extubated successfully under sedation afterwards. We admitted a 44-year-old male patient with the diagnosis of community-acquired pneumonia and related type 1 respiratory insufficiency. In his personal history, he had a renal transplantation from a living donor in April 2010 and was using immunosuppressive treatment. The patient had been intubated, and mechanical ventilatory support began on admission. In the following days, upon observing regression of infiltrations in x-ray and laboratory parameters, increase in compliance, hemodynamic stability, and increase in consciousness and muscle strength, sedation was ceased, and he was extubated. After 1 hour of successful spontaneous respiration, we observed dyspnea, tachypnea, excess sweating, agitation, and a decline in oxygen saturation, and we reintubated the patient. On being unsuccessful in our second extubation attempt, after 10 hours of spontaneous breathing, we reconsidered the patient's clinical status. We agreed on giving psychological support to the patient, besides medical care. We explained all of the steps of his treatment and medical procedures. With the help of reading cards, we communicated with him and calmed him down and made him feel safe. This time, we continued midazolam infusion at a rate of 2 mg/hour and successfully extubated him. After extubation, we did not interrupt the midazolam infusion for 24 hours. After completing his treatment, we discharged the patient. The most important potential negative effect of anxiety in intensive care units is increased oxygen consumption and decreased benefit of mechanical ventilation. This leads to prolonged intubation and unsuccessful weaning trials. We also experienced unsuccessful weaning trials in our patient due to anxiety, although clinically, he was ready for extubation. As anxiety was clinically present, just like respiratory insufficiency, we could not be aware of it at the very beginning. We observed that giving psychological support, besides medical care, increases weaning success.

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“…Berdasarkan wawancara dengan beberapa pasien kritis yang terpasang ventilator, mereka memiliki masalah fisik, psikososial dan spiritual. Hal ini didukung oleh Samuelsson, 2006;Karlsson, Bergbom & Forsberg 2012; bahwa pasien akan merasa nyeri, dan ketidaknyamanan yang disebabkan oleh tube endotrachea dan beberapa alat yang terpasang dalam tubuh pasien dan merasakan tidak berdaya.…”

Section: Pendahuluanunclassified

“…Di Indonesia sendiri, khususnya di Rumah Sakit yang berada di wilayah Jawa Barat, belum ada penelitian yang mengungkap pengalaman pasien selama terpasang ventilator. Di luar negri telah banyak dilakukan penelitian serupa yang dilakukan oleh Samuelsson (2006 ), Karlsson, Bergbom & Forsberg (2012), dan Varga, Dioszeghy & Frituz (2007). Atas pertimbangan bahwa adanya perbedaan latar belakang budaya, status sosial, perbedaan paham agama dalam hal melakukan ibadah dan proses perawatan yang dilakukan.…”

Section: Pendahuluanunclassified

“…Karena pada dasarnya perasaan panik saat prosedur suction dapat menimbulkan spasme pada saluran napas sehingga mengakibatkan sesak napas (Hudak & Galo 2013). Keluhan ketidaknyamanan ini didukung oleh (Samuelsson, 2006, Karlsson et al, 2012, Varga, Dioszeghy & Frituz, 2007 bahwa pasien yang terpasang ventilator merasakan ketidaknyamanan yang disebabkan suction dan beberapa alat yang terpasang dalam tubuh pasien.…”

Section: Prosedur Suction Yang Dilematis -Antaraunclassified

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Pengalaman Pasien yang Pernah Terpasang Ventilator

Bastian¹,

Suryani²,

Emaliyawati³

2016

JKP

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AbstrakJumlah pasien kritis yang terpasang ventilator menempati dua per tiga dari seluruh pasien ICU di Indonesia. Kondisi kritis dengan terpasang ventilator akan menimbulkan masalah fisik, psikososial dan spiritual. Tenaga kesehatan terutama perawat perlu memberikan asuhan keperawatan terhadap pasien ICU yang terpasang ventilator secara menyeluruh. Penelitian kualitatif terhadap pasien yang terpasang ventilator sangat diperlukan sebagai upaya untuk menggali secara mendalam pengalaman hidup pasien selama terpasang ventilator dan menemukan new insight (pemahaman baru) tentang pengalaman mereka. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Data didapatkan dengan wawancara mendalam terhadap 6 partisipan yang terdiri dari 2 laki-laki dan 4 perempuan, usia antara 27-54 tahun, yang terpasang ventilator antara 4 sampai 27 hari dan mendapatkan sedasi yang minimal. Analisis data menggunakan metode Colaizzi. Ada 8 tema yang didapatkan dari pengalaman hidup pasien selama terpasang ventilator yaitu (1) hilangnya harapan dalam menjalani hidup, (2) merasa telah diambang kematian, (3) prosedur suction yang dilematisantara nyaman dan tidaknyaman, (4) kehadiran orang terkasih sebagai spirit dalam melanjutkan hidup, (5) memandang penyakit sebagai rencana dari Tuhan, (6) memandang rendah citra diri, (7) pentingnya fasilitator dalam menjalani ritual keagamaan dan (8) keinginan untuk dirawat oleh tenaga kesehatan yang terampil. Individu yang hidup selama terpasang ventilator mengalami dilemma dengan prosedur suction, memiliki citra diri yang rendah, membutuhkan fasilitator dalam pemenuhan kebutuhan spiritual serta keinginan untuk dirawat oleh tenaga kesehatan yang terampil. Berkaitan dengan hal tersebut, pasien yang terpasang ventilator membutuhkan dukungan, pendampingan dan kemampuan yang terampil dari petugas kesehatan terutama dari perawat.Kata kunci: Pasien kritis, pengalaman hidup, ventilator. The Experience of Patients after using Ventilator AbstractThe number of critically ill patients with mechanical ventilation occupies almost two-thirds of all ICU patients in Indonesia. The critical condition with mechanical ventilation will be followed by many human responses such as physical, psychosocial and spiritual problems. Health care providers, especially nurses are demanded to provide holistic care to the patients with mechanical ventilation. Qualitative study can be used to explore the life experience of the patients with mechanical ventilation to gain new insights of their experience. This study is a qualitative study using phenomenological approach. The data was obtained by in-depth interviews to six participants consisting of two men and four women with age range from 27 to 54 years. The length of time with mechanical ventilation was between 4 to 27 days and they received a minimal sedation. The data was analyzed by Colaizzi method of analysis. There were eight themes found from this study: hopelessness in life, feel closer to dying, the suction procedure dilemma between comfortable and uncomfo...

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The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: A phenomenological-hermeneutic study

Cited by 147 publications

References 34 publications

“Releasing a lot of poisons from my mind”: Patients' delusional memories of intensive care

“Releasing a lot of poisons from my mind”: Patients' delusional memories of intensive care

Role of Anxiety During Unsuccessful Weaning

Pengalaman Pasien yang Pernah Terpasang Ventilator

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