Insights into the challenges faced by chronically critically ill patients, their families and healthcare providers: An interpretive description.

Dammann, Maria; Staudacher, Sandra; Simon, Michael; Jeitziner, Marie-Madlen (2022). Insights into the challenges faced by chronically critically ill patients, their families and healthcare providers: An interpretive description. Intensive & critical care nursing, 68, p. 103135. Elsevier 10.1016/j.iccn.2021.103135

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OBJECTIVE

To describe and understand the challenges of patients with chronic critical illness (CCI), their families and healthcare providers during the disease trajectory.

METHODOLOGY/DESIGN

This qualitative study follows Thorne's methodology of interpretive description and was guided by the ethnographic method of observation and participation. Five cases, each comprising one patient with chronic critical illness their family members and several healthcare providers, were followed from the intensive care unit of a university hospital in Switzerland across different settings. In total, five patients with chronic critical illness, 12 family members and 92 healthcare providers (nurses, nursing students, care assistants, physiotherapists and occupational therapists and physicians) were observed.

FINDINGS

Regardless of the medical diagnoses and disease trajectories of the patients with chronic critical illness, all cases faced three main challenges: 1. Dealing with the unpredictability of the disease trajectory beyond the underlying disease. 2. Coping with the complexity of care. 3. Perceiving communication challenges despite all involved parties' dependency on it.

CONCLUSION

Unpredictability is not only a unique characteristic of the prolonged disease trajectory of patients with chronic critical illness, but also one of the main challenges of the participants. Therefore, the way unpredictability is handled is dependent on changes in the complexity of care and communication, highlighting the need for participation, information, empathy, clarity and honesty among all participants.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Jeitziner, Marie-Madlen (B)

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1532-4036

Publisher:

Elsevier

Language:

English

Submitter:

Isabelle Arni

Date Deposited:

22 Nov 2021 16:44

Last Modified:

29 Mar 2023 23:37

Publisher DOI:

10.1016/j.iccn.2021.103135

PubMed ID:

34736830

Uncontrolled Keywords:

Chronic critical illness Chronic disease Collaboration Communication Complexity Intensive care unit Long-term care Qualitative research

BORIS DOI:

10.48350/160857

URI:

https://boris.unibe.ch/id/eprint/160857

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