The lived experience of a tracheostomy tube change: a phenomenological study

Aim. To investigate the lived experience patients have of a tracheostomy tube change. Background. Few interpretive studies have looked at specific nursing interventions in relation to nursing practice. This study has investigated the lived experience of patients from an intensive care unit that have had a tracheostomy tube change. The tracheostomy is a significant intervention for many patients within critical care. Method. Using a phenomenological approach, guided by the insights of Martin Heidegger and Max van Manen, participants were interviewed with their responses being transcribed into a text. This text has been subject to hermeneutic analysis using the theories of Paul Ricoeur. This hermeneutic approach has required using the text (discourse) as the focus of the interpretation. Findings. The findings of this study imply that the experience of a tracheostomy tube change is more complex than that of simply a physical sensation. There is a need for participants to prepare themselves psychologically, a process that requires not only the trust of nursing staff but also the assessment by the participant that the nursing staff member has a level of competence to perform the task. The need for maintaining communication and the ability to speak were at times more significant for participants than even the risk of other airway complications. Relevance to clinical practice. This study has highlighted the potential for further interpretive studies into some of the more specific aspects of caring for patients that have been or are critically ill. The themes revealed will enable the nurse, required to change a tracheostomy tube, to do so with an improved level of empathy and understanding.