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Making sense of it : intensive care patients phenomenological accounts of story construction

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Stayt, L., Seers, Kate and Tutton, Elizabeth (2016) Making sense of it : intensive care patients phenomenological accounts of story construction. Nursing in Critical Care, 21 (4). pp. 225-232. doi:10.1111/nicc.12224 ISSN 1362-1017.

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Official URL: https://doi.org/10.1111/nicc.12224

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Abstract

Background
Patients entering intensive care encounter physical and psychological stress that may lead to psychological morbidity such as depression, anxiety and post‐traumatic stress. It has been suggested that constructing a story may assist psychological recovery. However, this has been minimally investigated in intensive care patients.

Aim
The aim of this article is to examine the process of story construction in people's phenomenological accounts of being a patient in the technological environment of intensive care.

Study design
The study design was informed by Heideggerian phenomenology.

Methods
Semi‐structured interviews were conducted with 19 patients who had been in intensive care for at least 4 days. Interviews were digitally recorded, transcribed and analysed utilizing Van Manen's framework for thematic analysis.

Findings
Making sense of their experiences in an intensive care unit appeared to be fundamental to story construction. Themes that arose were ‘why am I here?’, ‘filling in the gaps’, ‘sorting the real from the unreal’ and ‘searching for familiarity’. These themes describe how participants sought temporal and causal coherence in order to construct their integrated and understandable story. Families appeared to play a critical role in helping participants fill in the gaps, sorting the real from the unreal and their subsequent psychological recovery.

Conclusions and relevance to clinical practice
The importance of early support from health care professionals to facilitate patients' story construction is highlighted. The study also emphasizes the role families play in supporting patients while they make sense of their experiences and the associated psychological recovery process. Further research to evaluate methods of facilitating story construction, such as nurse‐led debriefing and patient diaries, is recommended. In addition, an investigation of families' perceptions of their role in assisting patients construct their story may facilitate the development of strategies by health care professionals to effectively support families in their role.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing > Royal College of Nursing Research Institute (RCN) (- July 2017)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Nursing in Critical Care
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 1362-1017
Official Date: July 2016
Dates:
DateEvent
July 2016Published
9 November 2015Available
Volume: 21
Number: 4
Page Range: pp. 225-232
DOI: 10.1111/nicc.12224
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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