Returning to normal: The role of eating in recovery from a critical illness

Abstract

Much emphasis is placed on proactive early establishment of nutrition support during critical illness. Eating on an intensive care unit (ICU), on the other hand, is a more infrequent occurrence and is often overlooked, as is the social aspect of eating or the inability to eat. Currently there is a dearth of published work investigating any aspect of eating during the critical care phase; patients' experiences of eating at this time and the importance they place on it is not known. This qualitative study aims to explore and accurately describe patients' experiences of eating in a critical care environment. It is intended to seek out the essence of what eating and drinking following a critical illness signifies to those who have experienced it. Eight participants were recruited from the neuro-critical care unit at the National Hospital for Neurology and Neurosurgery, and engaged in tape- recorded in-depth interviews. Sampling was undertaken using purposive sampling and findings were analysed to create themes using Colazzi's phenomenological (1978) approach to qualitative analysis. All interviews were conducted, transcribed and analysed by the researcher. Following data analysis, examination of the phenomena revealed commonalities in experiences, which were organized into four key themes: perceptions of eating, returning to normality, eating with a tracheostomy, eating in critical care. This study suggests that eating and drinking played a fundamental role in the psychological wellbeing of the participants by helping provide a positive milestone to identify that recovery is possible. The overwhelming emotions expressed by patients were derived from their desire to return to normality. The critical care environment also influenced the ability to eat and drink, with most participants depicting a period of adaptation to the environment. After this period of adjustment, patients felt that the environment no longer mattered and that other emotions took precedence.