"Never in my mind to give up!" A qualitative study of long-term intensive care patients' inner strength and willpower-Promoting and challenging aspects.

Abstract

To explore aspects that promote and challenge long-term ICU patients' inner strength and willpower. Considerable research has been devoted to ICU patients' experiences; however, research on long-term ICU patients is limited. Studies in a health-promoting perspective focusing on long-term ICU patients' inner strength and willpower are scarce. A qualitative, hermeneutic-phenomenological approach, using in-depth interviews. Seventeen long-term Norwegian ICU patients were interviewed once, at 6-18months after ICU discharge. The consolidated criteria for reporting qualitative research was used (Data S1). The lived experience of the phenomenon "inner strength and willpower" and what promotes and challenges this phenomenon in long-term ICU patients were represented by four main themes and nine subthemes. Promoting aspects comprised of two main themes and five subthemes: (a) "No doubt about coming back to life" with subthemes; "Strong connectedness to life; feeling alive and present," "Meaning and purpose; feeling valuable to somebody." (b) "How to ignite and maintain the spark of life," with the subthemes: "Practical solutions, coping skills from previous life experiences," "Provocative and inspiring experiences" and "Vivid dream experiences that ignite the willpower." Two main categories and four subcategories represented challenging aspects: (a) Exhaustion, weakness and discomfort; subthemes; "Physical challenges" and "Mental discomfort" and (b) "Tiring delusions," subthemes; "Living in the worst horror movie" and "Feeling trapped." This study expands on previous studies by providing insights about what promotes and challenges long-term ICU patients' inner strength and willpower during their recovery trajectory. Insights into the variety of long-term ICU patients' experiences during the recovery trajectory are important for ICU nurses to support and facilitate ICU patients' inner strength and willpower.