Author: Wong, Yuk-king Frandia
Title: Being in intensive care unit after surgery
Degree: M.Sc.
Year: 1998
Subject: Intensive care units
Patients -- Psychology
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: vi, 191 leaves : ill. ; 30 cm
Language: English
Abstract: With the rapid development of intensive care units (ICU), more patients are being cared for in the units. While in ICU, patients encounter a stressful and complex physical and interpersonal therapeutic environment that can lead to psychological disturbances. This study aims to explore the lived experience of patients after elective surgery and being cared for in a surgical ICU in the immediate post operative period. A phenomenological approach using unstructured interview was employed and 10 ICU nurses and 10 patients were recruited for the study. The data were treated with thematic data analysis. Most of the nurses believed that patients had memories of their ICU stay. The 2 core themes, 'feeling' and 'support' were emerged from the nurses' responses. The nurses expressed that patients had the feelings of anxiety, pain and tiredness. They were frightened by the environment and the unknown. The nurses provided support to the patients by pre operative visits, continuous and repeated explanation, to encourage family visits and to ensure adequate pain relief and sleep. All the patients could remember what happened during their stay in ICU. The 2 cores themes which emerged from patients' responses were 'feeling' and 'needs'. The patients recalled the feeling of anxiety on the reason of admission and a feeling of being safe in ICU. Six patients suffered from moderate to severe pain during movement and procedures and 2 patients complained of sleeping problems. They appreciated the preoperative visit and preferred the open unit design and flexible visiting hours. The 4 subthemes of pain, sleep, preoperative visit and family visit were discussed in detail and other studies were reviewed to compare the results. Continuous infusion of analgesic in the form of PCA and epidural route seems to yield better pain relief than the traditional PRN injection. Flexible visiting policies promote the satisfaction of patients and family members. The pre operative visits can prepare patients psychologically before operation and decrease fear and anxiety. Sleep deprivation is a common problem in ICU and its importance is usually neglected and noise is being a contributing factor. Strategies for promotion of sleep were discussed.
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