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1 – 10 of 446This qualitative phenomenological study examined the experiences of patients, their family members, and the nurses in the intensive care unit during critical illness. Five…
Abstract
This qualitative phenomenological study examined the experiences of patients, their family members, and the nurses in the intensive care unit during critical illness. Five participants from each category participated in two interviews over a period of five months. Content analysis of the interview transcripts revealed five integrating common themes, each reflecting concepts from the Roy Adaptation Model (RAM). The ICU experience among all participants is interdependence. Adaptation in the ICU integrated family as a unit, physical care/comfort, physiological care and psychosocial support, resulting in transformation.
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Watchara Tabootwong, Katri Vehviläinen-Julkunen, Pornchai Jullamate, Edwin Rosenberg and Hannele Turunen
The purpose of this paper is to describe family caregivers’ experiences of providing care for older people with a tracheostomy during hospitalization.
Abstract
Purpose
The purpose of this paper is to describe family caregivers’ experiences of providing care for older people with a tracheostomy during hospitalization.
Design/methodology/approach
A descriptive phenomenological approach was used in this study. A total of 40 family caregivers were interviewed face-to-face in medical-surgical wards. Data was analyzed using Giorgi’s phenomenological method.
Findings
Family caregivers described meanings of providing care, learning how to provide care, caring activities, impacts of caregiving, support needs and qualities of being a caregiver. Meanings included filial responsibility, spousal attachment and end of life care. Caring activities were varied. Impacts experienced were reported as physical, psychological, social and financial. Caregivers expressed the need for information from the nursing team and assistance from their relatives. Positive caregiver qualities that were described included loving to provide care for older people and confidence and sincerity in caregiving.
Practical implications
Although caring for older people with a tracheostomy was difficult and came with challenging impacts, family caregivers were willing to support their loved ones due to feelings of family responsibility.
Originality/value
The paper addresses family participation in providing care for people with a tracheostomy. They experience physical, psychological, social and financial consequences of caregiving. Therefore, health-care professionals should support family caregivers with education, training and awareness of supports and resources for dealing with problematic impacts and other expressed needs.
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The purpose of this study is to comprehend the traumatic experiences of intensive care unit (ICU) patients during the COVID-19 pandemic and the impact of the same post-discharge…
Abstract
Purpose
The purpose of this study is to comprehend the traumatic experiences of intensive care unit (ICU) patients during the COVID-19 pandemic and the impact of the same post-discharge. It assesses the role of nature and open green spaces on the mental health and well-being of critically ill patients.
Design/methodology/approach
Using interpretative phenomenological analysis, this study highlights the major factors contributing to adverse mental health and well-being. The subjects were interviewed using semi-structured personal interview techniques. Thematic content analysis was adapted to derive the major themes apparent in the succinctly rich information gathered from the participants.
Findings
The findings cast light on the significant role of nature and open green spaces in psychotherapeutic healing post-discharge of intensive care survivors.
Originality/value
The study is novel and adds to the existing literature in an advanced manner. To the best of the author’s knowledge, no other study was witnessed, especially in the Indian context, confirming the relationship between humans and nature with ICU patients as a subset.
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Patricia Drentea, Beverly Rosa Williams, Karen Hoefer, F. Amos Bailey and Kathryn L. Burgio
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles…
Abstract
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles describing next-of-kins’ perceptions of end-of-life care in Veterans Affairs Medical Centers (VAMCs). The articles were based on the qualitative arm of the VA Health Services Research and Development (HSR&D) study entitled, “Best Practices for End-of-life Care and Comfort Care Order Sets for our Nation’s Veterans” (BEACON).
Design: The archival research consisted of an interactive methodological process of data immersion, analysis, and interpretation which resulted in the emergence of two overarching thematic frameworks called “losing control” and “holding on.”
Findings: “Losing control” is the process that occurs when the patient experiences a cascading sequence of deleterious biological events and situations rendering the caregiver no longer able to direct the timing or setting of the dying trajectory. The notion of “holding on” captures family member’s responses to the need to maintain control after relinquishing the patient’s care to the institutional setting. During the patient’s hospitalization, the dual dynamics of “losing control” and “holding on” unfolded in the spatial, temporal, and life narrative domains.
Originality: The findings not only contribute to better overall understanding of family members’ responses to death in the pre-COVID-19 hospital setting but also heighten the awareness of the complex spatial, temporal, and narrative issues faced by family members who lost a hospitalized loved one during the COVID-19 pandemic.
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Kimberley Holmes and Kara Sealock
The purpose of this paper is to explore storytelling in post-secondary instruction and to reflect upon the authors’ experiences as instructors in two diverse areas of study. Both…
Abstract
Purpose
The purpose of this paper is to explore storytelling in post-secondary instruction and to reflect upon the authors’ experiences as instructors in two diverse areas of study. Both nursing and education promote a theory-based approach that is disconnected from the practical application of skills required.
Design/methodology/approach
The authors propose that using storytelling in the undergraduate classroom promotes an emotional engagement with the material, creates authentic human connections and demonstrates a practical application of content. The sharing of personal narratives creates a portal through which we understand the meaningful human element of the work, and the collective essence of our world. The authors believe that these outcomes are essential for the development of an empathetic and compassionate professional who understands the significance of the emotional, social and cognitive component of holistic learning that is required for the eventual acquisition of mastery in our disciplines.
Findings
Based on the authors’ experiences, the authors have found that storytelling creates a bridge between the curriculum theory and the implementation of that theory in the living world within the respective disciplines.
Practical implications
As instructors at the University of Calgary, in the Faculty of Education and Nursing, the authors see many intersections in the work and the instructional methodologies that the authors implement in the undergraduate classrooms to allow for authentic learning experiences. These cross-curricular connections have caused us to reflect on the use of storytelling in the humanities to promote emotions, create connections and demonstrate a practical and authentic application of theoretic concepts in both the undergraduate education and nursing programs.
Originality/value
This is an original piece of duo-ethnographic work composed by two researchers who were reflecting on praxis.
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Richard Renaud and Sarah Phillips
Public Works and Government Services Canada (PWGSC) is the federal department responsible for housing over 190,000 Canadian federal public servants. During Y2K preparations, it…
Abstract
Public Works and Government Services Canada (PWGSC) is the federal department responsible for housing over 190,000 Canadian federal public servants. During Y2K preparations, it became apparent that a single source or form of integrated, emergency response information at the infrastructure level did not exist. A process had to be created and developed that would serve as a single vehicle and source for building‐based emergency response. These preparations for Y2K saw the creation of the Infrastructure Continuity Unit (ICU) and a system for the creation, validation, and maintenance of Infrastructure Continuity Plans (ICPs). An ICP is an event‐management document that contains a series of procedures and protocols to be used during a building‐based incident or disruption of services. The ICU is supported nationally by a network of Regional Coordinators who oversee the gathering of information needed to create ICPs for their own parts of the country. This paper demonstrates how this system, along with the ICU’s recent certification by the Canadian General Standards Board (CGSB) to the ISO 9000 standard, have contributed to the ICU’s success. This paper takes the reader through an in‐depth exploration of the ICU’s processes, methodologies and procedures and demonstrates why, in a post‐September 11th world, the ICU has begun to attract international attention.
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Christopher Raymond and Paul R. Ward
This chapter explores theory and local context of socially constructed pandemic fears during COVID-19; how material and non-material fear objects are construed, interpreted and…
Abstract
This chapter explores theory and local context of socially constructed pandemic fears during COVID-19; how material and non-material fear objects are construed, interpreted and understood by communities, and how fears disrupt social norms and influence pandemic behavioural responses. We aimed to understand the lived experiences of pandemic-induced fears in socioculturally diverse communities in eastern Indonesia in the context of onto-epistemological disjunctures between biomedically derived public health interventions, local world views and causal-remedial explanations for the crisis. Ethnographic research conducted among several communities in East Nusa Tenggara province in Indonesia provided the data and analyses presented in this chapter, delineating the extent to which fear played a decisive role in both internal, felt experience and social relations. Results illustrate how fear emotions are constructed and acted upon during times of crisis, arising from misinformation, rumour, socioreligious influence, long-standing tradition and community understandings of modernity, power and biomedicine. The chapter outlines several sociological theories on fear and emotion and interrogates a post-pandemic future.
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Marie Häggström, Kenneth Asplund and Lisbeth Kristiansen
Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of…
Abstract
Purpose
Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward.
Design/methodology/approach
The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden.
Findings
A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU.
Research limitations/implications
The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.
Practical implications
The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.
Originality/value
The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.
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Swati Paranjape and Amogh Patkar
The present study was aimed to explore and analyse the multifaceted impact of coronavirus disease 2019 (COVID-19) on quality-of-life of survivors, in physical, social…
Abstract
Purpose
The present study was aimed to explore and analyse the multifaceted impact of coronavirus disease 2019 (COVID-19) on quality-of-life of survivors, in physical, social, psychological and environmental health domains.
Design/methodology/approach
This explanatory mixed-method study was conducted on 20 patients admitted in the Intensive Care Unit (ICU) of a tertiary care hospital having mild-to-moderate clinical spectrum. Scores of WHO Quality of Life Brief Version (WHO QOL BREF) questionnaire, a quantitative data source, were recorded during admission and two months post-discharge. Qualitative data were collected through in-depth telephonic interviews 2 months post-discharge.
Findings
Statistically significant improvement in the quality-of-life was seen post-discharge in all four domains. Explanatory qualitative data derived four themes. This experience was life changing and metamorphic. Many participants experienced social exclusions. However, they outlived it with hope, faith and positive frame of mind. Quarantine, limiting social contact impacted largely the well-being and mental health of patients. Integrated care and multidisciplinary protocols are accentuated to combat future crisis.
Research limitations/implications
COVID-19 was a wake-up call to human race for radical change in healthcare policies. Researchers have emphasised the need to build resilient communities. The role of this research in building evidence as a basis for informed integrated care and decision making is vital. Study findings suggest that along with exhausting physical symptoms survivors experienced psychological symptoms highlighting the need of integrated approach and tailor-made strategies in assessment and treatment.
Originality/value
Lack of integrated approach in the system resulted in long-lasting physical and psychosocial impact on the survivors. This novel mixed methods research report, adding a valuable insight to body of knowledge through first-hand information, help provide evidence base which can account for future research, policy reforms and response.
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Ritva Rosenbäck and Ann Svensson
This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19…
Abstract
Purpose
This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19 pandemic and how the management learning is characterized.
Design/methodology/approach
The paper is based on a qualitative case study carried out during the COVID-19 pandemic at two different public hospitals in Sweden. The study, conducted with semi-structured interviews, applies a combination of within-case analysis and cross-case comparison. The data were analyzed using thematic deductive analysis with the themes, i.e. sensemaking, decision-making and meaning-making.
Findings
The COVID-19 pandemic was characterized by uncertainty and a need for continuous learning among the managers at the case hospitals. The learning process that arose was circular in nature, wherein trust played a crucial role in facilitating the flow of information and enabling the managers to get a good sense of the situation. This, in turn, allowed the managers to make decisions meaningful for the organization, which improved the trust for the managers. This circular process was iterated with higher frequency than usual and was a prerequisite for the managers’ learning. The practical implications are that a combined management with hierarchical and distributed management that uses the normal decision routes seems to be the most successful management method in a prolonged crisis as a pandemic.
Practical implications
The gained knowledge can benefit hospital organizations, be used in crisis education and to develop regional contingency plans for pandemics.
Originality/value
This study has explored learning during the COVID-19 pandemic and found a circular process, “the management learning wheel,” which supports management learning in prolonged crises.
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