A multicase study of prolonged critical illness in the intensive care unit: Families' experiences
A multicase study of prolonged critical illness in the intensive care unit: Families' experiences
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DOI：
10.1016/j.iccn.2018.08.010
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发表时间：
2019-02-01
影响因子：
5.3
通讯作者：
Huntington, Annette
中科院分区：
文献类型：
--
作者：
Minton, Claire;Batten, Lesley;Huntington, Annette
背景：众所周知，危重疾病不仅对患者而且对其家人来说都是一种压力性的生活事件；当疾病持续时间较长时，影响是深远的。预计随着医疗技术的进步，患者在重症监护室的停留天数将会增加。因此，护士了解家庭成员在重症监护病房中如何经历长期危重病非常重要。目的：从家庭的经历中探索重症监护病房中长期危重病的轨迹。方法：定性、纵向、多病例设计，包括来自新西兰重症监护病房的六个病例。尽管患者和医疗保健专业人员构成了每个病例的一部分，但本文提出的研究结果仅涉及家庭的经历。数据收集方法包括观察、对话、访谈和文件审查。使用主题分析、插图开发和轨迹图进行分析。调查结果：在一名家庭成员在重症监护病房长期患重病期间，无情的不确定性主导了家庭轨迹的各个阶段。当面临重病时，一家人迅速陷入了未知的世界。家庭成员努力克服主导其家庭成员疾病各个阶段的许多不确定性。结论：护士需要了解家庭所承受的不确定性程度，以便提供符合以家庭为中心的护理哲学基础的护理。 (C) 2018 Elsevier Ltd. 保留所有权利。
Background: It is widely acknowledged a critical illness is a stressful life event for not only the patient but also their family members; when an illness becomes prolonged, the impact is profound. It is suggested that as medical technologies advance, the number of days patients stay in an intensive care unit will increase. Therefore, it is important nurses understand how families experience a prolonged critical illness of their family member in an intensive care unit.Objective: To explore the trajectory of a prolonged critical illness in the intensive care unit from the experiences of family.Methods: A qualitative, longitudinal, multi-case design consisting of six cases from New Zealand intensive care units.Findings presented in this article only relate to the family's experiences, although patients and healthcare professionals formed part of each case. Data collection methods included observation, conversations, interviews and document review. Analysis was undertaken using thematic analysis, vignette development and trajectory mapping. Findings: Relentless uncertainty dominated all phases of the trajectory for the family during a family member's prolonged critical illness in the intensive care unit. When faced with a critical illness, family shifted rapidly into a world of unknowns. Family worked hard to navigate their way through the many uncertainties that dominated each phase of their family member's illness.Conclusions: Nurses need to understand the levels of uncertainty families endure in order to provide care that meets the philosophical underpinnings of family centred care. (C) 2018 Elsevier Ltd. All rights reserved.