Original Article

The lived experiences of intensive care patients on transfer to a general ward

Abstract

Background & Aim: This study aimed to discover the lived experiences of patients transferred from the intensive care unit (ICU) to a general ward, to reach a deeper understanding of this phenomenon.
Methods & Materials: This is a qualitative study with an interpretative phenomenological approach, which is conducted at hospitals affiliated to universities, and private hospitals of Tehran in 2013. Eighteen participants were purposefully selected for face-to-face and semi-structured interviews.
Results: The findings revealed that the ICU patients experienced various feelings during the process of transition to a general ward. In this regard, three main themes were identified: “happiness of return” (consisted of three subthemes: “return to living,” “return to family,” and “return to a general ward”); “separation anxiety” (consisted of two subthemes: “anxiety of separation from the equipment” and “anxiety of separation from ICU staff”); and “spiritual development” (consisted of two subthemes: “being thankful to God” and “well-wishing toward others”).
Conclusion: The findings of the present study showed that recognizing and focusing on each patient’s individual needs, emotions, and expectations is essential to provide more holistic and patient- centered care during the process of transition from ICU to a general ward. Accordingly, there is a potential need to develop structured and formal discharge planning in the clinical settings like Iran where this topic has not been touched yet.

Timmins F. Critical care nursing in the 21st century. Intensive Crit Care Nurs 2002; 18(2): 118-27.

Cullinane JP, Plowright CI. Patients' and relatives' experiences of transfer from inten- sive care unit to wards. Nurs Crit Care 2013; 18(6): 289-96.

Chaboyer W, James H, Kendall M. Transi- tional care after the intensive care unit: cur- rent trends and future directions. Crit Care Nurse 2005; 25(3): 16-2, 24.

Coyle MA. Transfer anxiety: preparing to leave intensive care. Intensive Crit Care Nurs 2001; 17(3): 138-43.

Jones C, Griffiths RD, Humphris G, Skirrow PM. Memory, delusions, and the develop- ment of acute posttraumatic stress disorder- related symptoms after intensive care. Crit Care Med 2001; 29(3): 573-80.

Cognet S, Coyer F. Discharge practices for the intensive care patient: a qualitative ex- ploration in the general ward setting. Inten- sive Crit Care Nurs 2014; 30(5): 292-300.

Chaboyer W, Gillespie B, Foster M, Kendall M. The impact of an ICU liaison nurse: a case study of ward nurses' perceptions. J Clin Nurs 2005; 14(6): 766-75.

Strahan EH, Brown RJ. A qualitative study of the experiences of patients following transfer from intensive care. Intensive Crit Care Nurs 2005; 21(3): 160-71.

Gustad LT, Chaboyer W, Wallis M. ICU pa- tient's transfer anxiety: a prospective cohort study. Aust Crit Care 2008; 21(4): 181-9.

Odell M. The patient's thoughts and feelings about their transfer from intensive care to the general ward. J Adv Nurs 2000; 31(2): 322-9.

Carpenito-Moyet LJ. Nursing diagnosis: application to clinical practice. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.

Chick N, Meleis AI. Transitions: A nursing concern. In: Meleis AI, Editor. Transitions theory: middle range and situation specific theories in nursing research and practice. New York, NY: Springer Publishing; 2010.

Russell S. Continuity of care after discharge from ICU. Prof Nurse 2000; 15(8): 497-500.

Diekelmann N, Allen D, Tanner CA. The NLN criteria for appraisal of baccalaureate programs: a critical hermeneutic analysis. 6th ed. Washington, DC: National League for Nursing; 1989.

Speziale HS, Streubert H, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia, PA: Lippincott Williams & Wilkins; 2011.

Polit D, Beck CT. Essentials of nursing re- search: appraising evidence for nursing practice. Philadelphia, PA: Lippincott Wil- liams & Wilkins, 2013.

Wojnar DM, Swanson KM. Phenomenolo- gy: an exploration. J Holist Nurs 2007; 25(3): 172-80.

Guba EG, Lincoln YS. Fourth generation evaluation. Washington DC, Sage Publica- tions, 1989.

Holloway I, Wheeler S. Qualitative research in nursing and healthcare. Hoboken, NJ: John Wiley & Sons, 2010.

Hays DG, Singh AA. Qualitative inquiry in clinical and educational settings. New York, NY: Guilford Press; 2012.

Bench S, Day T. The user experience of crit- ical care discharge: a meta-synthesis of qual- itative research. Int J Nurs Stud 2010; 47(4): 487-99.

Centre for Clinical Practice at NICE (UK). Acutely ill patients in hospital. recognition of and response to acute illness in adults in hospital. London, UK: National Institute for Health and Clinical Excellence (UK); 2007.

Lin F, Chaboyer W, Wallis M, Miller A. Factors contributing to the process of inten- sive care patient discharge: an ethnographic study informed by activity theory. Int J Nurs Stud 2013; 50(8): 1054-66.

Eriksson T, Bergbom I. Visits to intensive care unit patients--frequency, duration and impact on outcome. Nurs Crit Care 2007; 12(1): 20-6.

James S, Quirke S, Lecturer BH. Staff per- ception of patient discharge from ICU to ward-based care. Nursing in Critical Care 2013; 18(6): 297-306.

Saarmann L. Transfer out of critical care: freedom or fear? Crit Care Nurs Q 1993; 16(1): 78-85.

Ball C, Kirkby M, Williams S. Effect of the critical care outreach team on patient surviv- al to discharge from hospital and readmis- sion to critical care: non-randomised popula- tion based study. BMJ 2003; 327(7422): 1014.

Dawson D, McEwen A. Critical care with- out walls: The role of the nurse consultant in critical care. Intensive Crit Care Nurs 2005; 21(6): 334-43.

Byers JF, Smyth KA. Application of a trans- actional model of stress and coping with critically ill patients. Dimens Crit Care Nurs 1997; 16(6): 292-300.

Ludin SM, Arbon P, Parker S. Patients' tran- sition in the intensive care units: concept analysis. Intensive Crit Care Nurs 2013; 29(4): 187-92.

Beard H. Does intermediate care minimize relocation stress for patients leaving the ICU? Nurs Crit Care 2005; 10(6): 272-8.

National Institute for Health and Care Excel- lence. Rehabilitation after critical illness. London, UK: NICE clinical guideline; 2009.

Papathanassoglou ED, Patiraki EI. Trans- formations of self: a phenomenological in- vestigation into the lived experience of sur- vivors of critical illness. Nurs Crit Care 2003; 8(1): 13-21.

McColl MA, Bickenbach J, Johnston J, Nishihama S, Schumaker M, Smith K, et al. Changes in spiritual beliefs after traumatic disability. Arch Phys Med Rehabil 2000; 81(6): 817-23.

Zeilani R, Seymour JE. Muslim women's experiences of suffering in Jordanian inten- sive care units: a narrative study. Intensive Crit Care Nurs 2010; 26(3): 175-84.

Cheraghi MA, Payne S, Salsali M. Spiritual aspects of end-of-life care for Muslim pa- tients: experiences from Iran. Int J Palliat Nurs 2005; 11(9): 468-74.

Sharifnia S, Hojjati H, Nazari R, Qorbani M, Akhoondzade G. The effect of prayer on men- tal health of hemodialysis patients. Iran J Crit Care Nurs 2012; 5(1): 29-34. [In Persian].

Shahriari M, Mohammadi E, Abbaszadeh A, Bahrami M, Fooladi MM. Perceived ethical values by Iranian nurses. Nurs Ethics 2012; 19(1): 30-44.

TaghizadehKarati K, Asadzandi M, Tadrisi S, Ebadi A. Effect of prayer on severity of patients illness in intensive care units. Iran J Crit Care Nurs 2011; 4(1): 1-6. [In Persian].

Cheraghi MA, Manookian A, Nasrabadi AN. Human dignity in religion-embedded cross-cultural nursing. Nurs Ethics 2014; 21(8): 916-28.

Galvin KT. Revisiting caring science: some integrative ideas for the 'head, hand and heart' of critical care nursing practice. Nurs Crit Care 2010; 15(4): 168-75.

Files
IssueVol 2 No 2 (2015): Spring QRcode
SectionOriginal Article(s)
Keywords
intensive care units patient discharge transfer qualitative research hermeneutics nursing

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Manookian A, Dehghan Nayeri N, Negarandeh R, Shali M. The lived experiences of intensive care patients on transfer to a general ward. NPT. 2015;2(2):52-61.