A post-transplant person : narratives of heart and lung transplantation and intensive care unit delirium

• Main Author: Flynn, Katy
• Published: Lancaster University 2012
• Subjects: 616.0019
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.657632

Technological advancements have led to improved physical outcomes after a stay in an intensive care unit (ICV), however less is known about the psychological impact of intensive care. Increasingly, qualitative research has been used to explore the psychological impact of ICV experiences and there is a need to integrate this body of evidence so that understandings gained can be accumulated and can influence service provision. Therefore, a meta-synthesis was conducted to review the findings of 14 qualitative studies which explored the psychological impact of intensive care from the patient's perspective. This resulted in six themes being identified and a lines-of-argument synthesis being developed. The first two themes captured how individuals oscillated between (1) 'embodied ICV memories' and being (2) 'out of time and place' . Themes of (3) 'powerlessness and vulnerability' and (4) 'existential thoughts' provided a formidable context for ICV memories however (5) 'support' was found to facilitate psychological recovery after the ICV. The final theme to emerge was (6) 'transformation of self, as critical illness and the impact of a stay in the ICV affected people's sense of identity. The clinical and service implications of these findings are discussed. Research Highlights: ~ Qualitative meta-synthesis of 14 studies which explore the psychological impact of intensive care. ~ A model of the psychological impact of intensive care from the perspective of the individual is proposed. ~ Improvements in ICV nursing care can minimise post-l CV psychological distress. ~ More psychological provision is required for people experiencing post-ICU emotional difficulties.