Patients' and relatives' experiences of cognitive impairment following an intensive care unit admission. A qualitative study

被引:1
作者
Alro, Anette Bjerregaard [1 ,2 ]
Svenningsen, Helle [3 ]
Nedergaard, Helene Korvenius [5 ]
Jensen, Hanne Irene [4 ,6 ,7 ,8 ,9 ,10 ]
Dreyer, Pia [1 ,2 ]
机构
[1] Aarhus Univ Hosp, Dept Intens Care, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
[2] Aarhus Univ, Inst Publ Hlth, Sect Nursing, Bartholins Alle 2,3 Sal,Bldg 1260, DK-8000 Aarhus C, Denmark
[3] VIA Univ Coll, Res Ctr Hlth & Welf Technol, Campus Aarhus N,Hedeager 2, Aarhus, Denmark
[4] Univ Hosp Southern Denmark, Dept Anaesthesiol & Intens Care, Sygehusvej 24, DK-6000 Kolding, Denmark
[5] Univ Southern Denmark, Dept Reg Hlth Res, Winslovspk 19,3, DK-5000 Odense C, Denmark
[6] Univ Hosp Southern Denmark, Kolding Hosp, Dept Anaesthesiol, Kolding, Denmark
[7] Univ Hosp Southern Denmark, Kolding Hosp, Dept Intens Care, Kolding, Denmark
[8] Univ Hosp Southern Denmark, Vejle Hosp, Dept Anaesthesiol, Vejle, Denmark
[9] Univ Hosp Southern Denmark, Vejle Hosp, Dept Intens Care, Vejle, Denmark
[10] Univ Southern Denmark, Dept Reg Hlth Res, Odense, Denmark
关键词
Patients' experience; Intensive care; Intensive care unit; Cognitive impairment; Rehabilitation; Post-intensive care syndrome; Relatives' experience; CRITICALLY-ILL PATIENTS; CRITICAL ILLNESS; RISK-FACTORS; SURVIVORS; OUTCOMES; INTERVENTIONS; SEDATION; FEASIBILITY; LIGHT;
D O I
10.1016/j.aucc.2024.05.004
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Cognitive impairment poses a significant challenge following critical illness in the intensive care unit. A knowledge gap exists concerning how patients experience cognitive impairments. Objectives: The aim was to explore patients' and relatives' experiences of patients' cognitive impairment due to critical illness following an intensive care unit admission. Methods: A qualitative multicentre study was conducted in Denmark with 3- and 6-month follow-ups using single and dyadic interviews. A phenomenological hermeneutic approach was adopted using a Ricoeur-inspired textual in-depth analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used. Results: Three themes emerged from interviews with 18 patients and 14 relatives: 'It feels like living in a parallel world', 'Getting back to a normal everyday life with a vulnerable self', and 'Managing everyday life using self-invented strategies'. Patients used self-invented strategies to manage their vulnerability and newly acquired cognitive impairments when no help or support was provided specifically targeting their cognitive impairments. Not being as cognitively capable as they previously had been turned their lives upside down. Losing control and not being themselves made them vulnerable. Patients did not want to burden others. However, support from relatives was invaluable in their recovery and rehabilitation. Conclusions: Patients experienced multiple cognitive impairments affecting their adaption to everyday life. They strove to overcome their vulnerability using a variety of self-invented strategies and activities. (c) 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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页数:9
相关论文
共 47 条
[1]   Cognitive impairment in intensive care unit patients: A qualitative exploration through observations and interviews [J].
Alro, Anette Bjerregaard ;
Svenningsen, Helle ;
Nedergaard, Helene Korvenius ;
Jensen, Hanne Irene ;
Dreyer, Pia .
INTENSIVE AND CRITICAL CARE NURSING, 2024, 81
[2]   Patients' experiences of cognitive impairment following critical illness treated in an intensive care unit: A scoping review [J].
Alro, Anette Bjerregaard ;
Nedergaard, Helene Korvenius ;
Svenningsen, Helle ;
Jensen, Hanne Irene ;
Dreyer, Pia .
JOURNAL OF CLINICAL NURSING, 2023, 32 (15-16) :4374-4390
[3]  
American Psychological Association, 2023, APA Dictionary of Psychology: Intergenerational trauma
[4]  
[Anonymous], 2000, JAMA, V284, P3043
[5]   Evaluating the feasibility and effectiveness of a critical care discharge information pack for patients and their families: a pilot cluster randomised controlled trial [J].
Bench, Suzanne ;
Day, Tina ;
Heelas, Karina ;
Hopkins, Philip ;
White, Catherine ;
Griffiths, Peter .
BMJ OPEN, 2015, 5 (11)
[6]  
Brinkmann S, 2015, InterViews: Learning the craft of qualitative research interviewing, V3e
[7]   Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial [J].
Brummel, N. E. ;
Girard, T. D. ;
Ely, E. W. ;
Pandharipande, P. P. ;
Morandi, A. ;
Hughes, C. G. ;
Graves, A. J. ;
Shintani, A. ;
Murphy, E. ;
Work, B. ;
Pun, B. T. ;
Boehm, L. ;
Gill, T. M. ;
Dittus, R. S. ;
Jackson, J. C. .
INTENSIVE CARE MEDICINE, 2014, 40 (03) :370-379
[8]   Patient and Family Post-Intensive Care Syndrome [J].
Davidson, Judy E. ;
Harvey, Maurene A. .
AACN ADVANCED CRITICAL CARE, 2016, 27 (02) :184-186
[9]   Distanciation in Ricoeur's theory of interpretation: narrations in a study of life experiences of living with chronic illness and home mechanical ventilation [J].
Dreyer, Pia Sander ;
Pedersen, Birthe D. .
NURSING INQUIRY, 2009, 16 (01) :64-73
[10]   Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) [J].
Ely, EW ;
Margolin, R ;
Francis, J ;
May, L ;
Truman, B ;
Dittus, R ;
Speroff, T ;
Gautam, S ;
Bernard, GR ;
Inouye, SK .
CRITICAL CARE MEDICINE, 2001, 29 (07) :1370-1379