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From breaking point to breakthrough during the ICU stay: A qualitative study of family members’ experiences of long‐term intensive care patients’ pathways towards survival

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  • Hege S Haugdahl
  • Regina Eide
  • Ingeborg Alexandersen
  • Tove Engan Paulsby
  • Berit Stjern
  • Stine Borgen Lund
  • Gørill Haugan

Abstract

Aims and objectives To explore family members’ experiences of long‐term intensive care unit (ICU) patients’ pathways towards survival and to highlight family members’ efforts to promote the patient's health during the ICU stay. Background Although considerable research has been devoted to the substantial burden of long‐term ICU patients, less attention has been paid to health‐promoting factors that facilitate patients’ health and survival during ICU stays. Support from family members can improve patient outcome. However, there is little knowledge of the specific contributions provided by family members. Design A hermeneutic phenomenological approach, within the context of Antonovsky's salutogenic theory and Merleau‐Ponty's phenomenology of the body, involving the body as the fundament of experience and understanding. Methods In‐depth qualitative interviews. Thirteen family members of long‐term ICU patients were interviewed once, at six to 18 months after ICU discharge. The consolidated criteria for reporting qualitative research were used. Results Three themes were identified: (i) A body at a breaking point; (ii) family members’ presence; and (iii) breaking through. In the perspective of the family members, their beloved ones were at a breaking point between life and death. The family's presence was significantly health promoting, demonstrating and communicating love and sensitivity. Moreover, family members’ understanding of the patient's unique characteristics and personality was crucial to the patient's experience of being understood, recognised and acknowledged. Inner strength represented a life force capable of moving the patient from the breaking point towards a breakthrough towards life. Family members purposely used their knowledge about the patient to trigger, nurture and release the patient's inner strength. Conclusions Family presence helps to trigger, arouse and release a patient's inner strength, representing important health‐promoting factors facilitating patients’ health and survival during an ICU stay. Relevance to clinical practice Insights into the unique and vital health‐promoting influence of family participation indicate the responsibility of the ICU team to provide support for families.

Suggested Citation

  • Hege S Haugdahl & Regina Eide & Ingeborg Alexandersen & Tove Engan Paulsby & Berit Stjern & Stine Borgen Lund & Gørill Haugan, 2018. "From breaking point to breakthrough during the ICU stay: A qualitative study of family members’ experiences of long‐term intensive care patients’ pathways towards survival," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3630-3640, October.
    • Handle: RePEc:wly:jocnur:v:27:y:2018:i:19-20:p:3630-3640
    DOI: 10.1111/jocn.14523
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    References listed on IDEAS

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    1. Susanne Kean & Graeme D Smith, 2014. "Editorial: Surviving critical illness: Intensive care and beyond," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(5-6), pages 603-604, March.
    2. Abbas Saleh Al‐Mutair & Virginia Plummer & Anthony O'Brien & Rosemary Clerehan, 2013. "Family needs and involvement in the intensive care unit: a literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(13-14), pages 1805-1817, July.
    3. Julianne Holt-Lunstad & Timothy B Smith & J Bradley Layton, 2010. "Social Relationships and Mortality Risk: A Meta-analytic Review," PLOS Medicine, Public Library of Science, vol. 7(7), pages 1-1, July.
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    1. Ingeborg Alexandersen & Berit Stjern & Regina Eide & Hege Selnes Haugdahl & Tove Engan Paulsby & Stine Borgen Lund & Gørill Haugan, 2019. "“Never in my mind to give up!” A qualitative study of long‐term intensive care patients’ inner strength and willpower—Promoting and challenging aspects," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(21-22), pages 3991-4003, November.
    2. Anne Mette Nygaard & Hege Selnes Haugdahl & Berit Støre Brinchmann & Ranveig Lind, 2020. "Information concerning ICU patients’ families in the handover—The clinicians’ «game of whispers»: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(19-20), pages 3822-3834, October.
    3. Ingeborg Alexandersen & Hege S. Haugdahl & Tove Engan Paulsby & Stine Borgen Lund & Berit Stjern & Regina Eide & Gørill Haugan, 2021. "A qualitative study of long‐term ICU patients' inner strength and willpower: Family and health professionals as a health‐promoting resource," Journal of Clinical Nursing, John Wiley & Sons, vol. 30(1-2), pages 161-173, January.

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