Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world

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Title Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world
Author Johnson, Patricia Lee; St John, Winsome; Moyle, Wendy
Journal Name Journal of Advanced Nursing
Year Published 2006
Place of publication Oxford, UK
Publisher Blackwell Publishing Ltd
Abstract Aim. This paper reports a study to describe and interpret the meaning of being on long-term mechanical ventilation. Background. Patients who require mechanical ventilation in a critical care unit for prolonged periods of time are typically sicker than those who are ventilated for shorter periods. Despite advances in treatment modalities for critically ill patients, many still require long-term mechanical ventilation for 7 days or more. Therefore, caring for a long-term ventilated patient is often an everyday occurrence for critical care nurses; however, there is insufficient evidence of the meaning of this experience from a patient perspective. Method. We used an ontological phenomenological approach informed by the ideas of Heidegger. Data were collected using unstructured audio-taped interviews with nine former patients from critical care units unit in Queensland, Australia. The data were collected between January 2000 and December 2001 and analysed thematically using the method developed by van Manen. Findings. Thematic analysis revealed four themes. This paper presents the findings from the theme titled 'existing in an uneveryday world', which revealed what it meant for participants to exist, live through and survive the many physiological and psychological effects arising from their critical illness episode. For the most part, this was an unpleasant and frightening experience that involved bizarre nightmares and inability to distinguish time, place and the familiar body; disagreeable effects from the technology used and patient care activities; and reliance on external agents for survival. In addition, participants reported how they questioned their chances of surviving the critical illness ordeal. Conclusion. There is a need for further research in the areas of sedative and analgesic management in critically ill patients, methods of communicating with intubated and mechanically ventilated patients, and debriefing and follow-up support services for survivors.
Peer Reviewed Yes
Published Yes
Publisher URI http://www3.interscience.wiley.com/journal/118486802/home
Alternative URI http://dx.doi.org/10.1111/j.1365-2648.2006.03757.x
Copyright Statement Copyright 2006 Blackwell Publishing. The definitive version is available at [www.blackwell-synergy.com.]
Volume 53
Issue Number 5
Page from 551
Page to 558
ISSN 0309-2402
Date Accessioned 2006-09-17
Language en_AU
Research Centre Centre for Health Practice Innovation; Population and Social Health Research Program; Menzies Health Institute Qld
Faculty Griffith Health Faculty
Subject PRE2009-Clinical Nursing: Secondary (Acute Care)
URI http://hdl.handle.net/10072/11222
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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