Strange and scary memories of the intensive care unit: a qualitative, longitudinal study inspired by Ricoeur's interpretation theory

TY - JOUR

T1 - Strange and scary memories of the intensive care unit

T2 - a qualitative, longitudinal study inspired by Ricoeur's interpretation theory

AU - Svenningsen, Helle

AU - Egerod, Ingrid

AU - Dreyer, Pia

PY - 2016/10

Y1 - 2016/10

N2 - Aims and objectives: To describe the content of former intensive care unit patients’ memories of delusions. Background: Intensive care unit patients often have strange and frightening experiences during the critical stage of illness. Earlier studies have provided small-sample in-depth descriptions of patient experiences in intensive care unit, but large-scale studies are also needed to inform intensive care unit follow-up. Methods: The study had a qualitative design using phenomenological hermeneutic analysis inspired by Ricoeur's interpretive theory. Patients were assessed with Confusion Assessment Method of the Intensive Care Unit for delirium in intensive care unit, and after discharge, memories of delusions were described by 114 of 325 patients in face-to-face (after two weeks) and telephone interviews (after two and six months) using the Intensive Care Unit Memory Tool. Results: Four themes emerged: the ever-present family, dynamic spaces, surviving challenges and constant motion. Memories of delusions were a vivid mix of fact and fiction, demonstrating dynamic shifts in time, place and motion, but not dependent on the presence of delirium assessed by Confusion Assessment Method of the Intensive Care Unit. Conclusions: Analysis based on Ricoeurian phenomenological hermeneutics provided insights into themes in intensive care unit patients’ memories of delusions. More studies are needed to understand the meaning of memories of delusions, the commonality of themes and the association between delusions and delirium after an intensive care unit stay. Relevance to clinical practice: Understanding patients’ memories of delusions is beneficial to nurses caring for patients that are anxious, upset or agitated. It opens a window to the world of the patient who is unable to communicate due to intubation and general weakness. We recommend the provision of nurse-led intensive care unit follow-up enabling patients to describe and discuss their intensive care unit experiences.

AB - Aims and objectives: To describe the content of former intensive care unit patients’ memories of delusions. Background: Intensive care unit patients often have strange and frightening experiences during the critical stage of illness. Earlier studies have provided small-sample in-depth descriptions of patient experiences in intensive care unit, but large-scale studies are also needed to inform intensive care unit follow-up. Methods: The study had a qualitative design using phenomenological hermeneutic analysis inspired by Ricoeur's interpretive theory. Patients were assessed with Confusion Assessment Method of the Intensive Care Unit for delirium in intensive care unit, and after discharge, memories of delusions were described by 114 of 325 patients in face-to-face (after two weeks) and telephone interviews (after two and six months) using the Intensive Care Unit Memory Tool. Results: Four themes emerged: the ever-present family, dynamic spaces, surviving challenges and constant motion. Memories of delusions were a vivid mix of fact and fiction, demonstrating dynamic shifts in time, place and motion, but not dependent on the presence of delirium assessed by Confusion Assessment Method of the Intensive Care Unit. Conclusions: Analysis based on Ricoeurian phenomenological hermeneutics provided insights into themes in intensive care unit patients’ memories of delusions. More studies are needed to understand the meaning of memories of delusions, the commonality of themes and the association between delusions and delirium after an intensive care unit stay. Relevance to clinical practice: Understanding patients’ memories of delusions is beneficial to nurses caring for patients that are anxious, upset or agitated. It opens a window to the world of the patient who is unable to communicate due to intubation and general weakness. We recommend the provision of nurse-led intensive care unit follow-up enabling patients to describe and discuss their intensive care unit experiences.

KW - delirium

KW - intensive care unit

KW - memories

KW - narratives

KW - nursing

KW - phenomenological hermeneutics

U2 - 10.1111/jocn.13318

DO - 10.1111/jocn.13318

M3 - Journal article

C2 - 27457029

AN - SCOPUS:84990218903

SN - 0962-1067

VL - 25

SP - 2807

EP - 2815

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

IS - 19-20

ER -