Thoracic and cardiovascular surgery patients: Intensive care unit experiences

Abstract

BackgroundIntensive care units are stressful places where patients experience physical and psychological discomfort. Understanding the experience of these patients regarding nursing care is very important.Aims and objectivesTo determine the intensive care experiences of thoracic and cardiovascular surgery patients and the factors that affect them.DesignThe research consists of two phases: quantitative and qualitative.MethodsThis was a descriptive and cross‐sectional study. Its research sample comprised 100 patients who spent at least one night in an intensive care unit after thoracic or cardiovascular surgery. The Intensive Care Experiences Scale (ICES) and the Numeric Rating Scale were used. Two open‐ended questions were asked to the patients to understand what they felt when they were attached to mechanical ventilation and to describe their intensive care experiences.ResultsThe ICES mean score was 66.35 ± 6.88. Significant negative relationships were found between length of stay and severity of pain and ICES total scores. A significant difference was found between scale scores and being understood by health care professionals when attached to mechanical ventilation. The patients stated that, when they were attached to mechanical ventilation and during their stay in the intensive care unit, they experienced feelings of helplessness, uncertainty, and fear. They also experienced physical discomfort and reported no longer fearing death.ConclusionIt was determined that patients partially positively perceived their experiences. It was found that they focused on coming out of surgery alive. The physical discomfort and negative emotions reported can be reduced or relieved by competent care.Relevance to clinical practiceThe intensive care experiences and emotions of intensive care patients are important. Physical discomfort and negative emotions can be mitigated or alleviated by competent nursing care.

Perceived Severity of Stressors in the Intensive Care Unit: A Systematic Review and Semi-Quantitative Analysis of the Literature on the Perspectives of Patients, Health Care Providers and Relatives

“…Study characteristics showed that the investigations were performed in diverse international regions, with a median patient sample size of 76.5. Gender distribution and age were similar to those of other ICU studies that had applied questionnaires or interviews to investigate the experience of ICU patients (e.g., [9,10,28,[65][66][67][68][69][70][71][72][73][74][75]): With an average rate of 64%, most of the patients were men and had a median age of 55.7 years. There were 13 studies that had also included stressor ratings of HCPs who were mostly women (68.4%) and were between 30 and 40 years of age.…”

“…However, findings showed that patients sometimes have memory problems concerning their ICU treatment. Several studies found indeed that between 15% and 38% of ICU patients did not remember their experiences on ICU, and approximately 50% had difficulties to distinguish dreams and reality [1,5,9,12,27,28,59,60,81]. This means that stress perception of this considerably large group of ICU patients has either been distorted or has not been included in the reviewed questionnaire investigations.…”

“…Furthermore, the literature review is restricted to quantitative studies. Yet, several recent qualitative and mixed methods studies have been conducted that contribute substantially to a deeper understanding of how patients, their relatives, and HCPs experience treatment in an ICU, including ICU stressors (e.g., [9,[27][28][29][84][85][86][87][88][89][90][91][92][93]). These studies address to a greater extent patient preferences, the stressful experiences of relatives, as well as innovative concepts to reduce ICU stress.…”

“…Their results suggest that both HCPs and relatives rate the severity of patients' stressors higher than patients do. The majority of studies follows a quantitative approach, but also qualitative and mixed methods have been applied (e.g., [9,[27][28][29]).…”

Intensive Care Experiences of Postoperative Patients

“…Some supportive approaches are recommended for patients in the intensive care unit to feel safe and have positive experiences ( 15 ). The physical discomfort and negative emotions experienced by patients in the intensive care setting can be reduced with effective healthcare professionals ( 9 ). Therefore, it is important that healthcare professionals are aware of patients’ experiences to meet the needs of patients and prevent physiological and psychological morbidities ( 11 , 15 ).…”