Abstract
IntroductionMany patients experience 'relocation stress' when they are transferred from an intensive care unit (ICU) to step-down (high dependency) or general ward care, and much has been written about the psychological causes. This qualitative analysis of in-depth, narrative interviews with former ICU patients explores and examines patients' accounts in order to identify additional causes of relocation stress.MethodsForty former ICU patients were recruited throughout the UK, using maximum variation sampling, to achieve a broad range of experiences of intensive care. Interviews in people's homes were recorded on video and audio equipment as part of a study for the Database of Personal Experiences of Health and Illness (DIPEx) web resource. All interviews were transcribed, checked and returned to respondents. For this report, a qualitative thematic analysis was used to explore experiences of transfer.ResultsWe found that most people experienced relocation distress not only because of physical and emotional difficulties relating to their illness and treatment and the inevitable anxiety resulting from leaving a protected environment, but also from concrete, practical causes. These included specific concerns about communication, feeding, nursing care and support, as well as ward organization and environment. Written excerpts from the interviews and two video excerpts taken from the DIPEx website illustrate our findings.ConclusionWe conclude that there are several aspects of care that deserve further examination by researchers and service providers, and that not all of the factors associated with relocation stress should be seen as an inevitable consequence of the psychological adjustment involved in transfer from an ICU.
Highlights
Many patients experience 'relocation stress' when they are transferred from an intensive care unit (ICU) to stepdown or general ward care, and much has been written about the psychological causes
We found that most people experienced relocation distress because of physical and emotional difficulties relating to their illness and treatment and the inevitable anxiety resulting from leaving a protected environment, and from concrete, practical causes
We conclude that there are several aspects of care that deserve further examination by researchers and service providers, and that not all of the factors associated with relocation stress should be seen as an inevitable consequence of the psychological adjustment involved in transfer from an ICU
Summary
Many patients experience 'relocation stress' when they are transferred from an intensive care unit (ICU) to stepdown (high dependency) or general ward care, and much has been written about the psychological causes. This qualitative analysis of in-depth, narrative interviews with former ICU patients explores and examines patients' accounts in order to identify additional causes of relocation stress. Patients admitted to intensive care units (ICUs) need constant, close monitoring and specialist nursing to keep them alive [1]. After discharge from the ICU, patients may experience altered sleep patterns, anxiety, depression [6,7], disorientation, mood changes [8], and lapses of memory and concentration [9,10]. Some former ICU patients continue to have hallucinations, nightmares, or delusions even after their discharge from hospital [11]
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