OBJECTIVES: Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process. METHODS: Group interviews, individual interviews and participant observations were conducted with nurses in two hospitals in Sweden and were analysed using grounded theory. RESULT: The substantive theory shows the process of nursing care activities - from the contexts of the ICU and the general ward. The main concern was to achieve a coordinated, strengthening, person-centered standard of care to facilitate patient transitions. The core category "being perceptive and adjustable" was a strategy to individualise, that was related to the other categories; "preparing for a change" and "promoting the recovery". However, the nurses were forced to "balance between patient needs and the caregivers' resources" and consequently were compromising their care. CONCLUSIONS: To facilitate an ICU-patient's transition, individual care planning is needed. It is also essential that the patients are adequately prepared for the change to facilitate the transitional care. Knowledge about transitional needs, empowerment and patient-education seems to be important issues for facilitating transitions.
OBJECTIVES: Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process. METHODS: Group interviews, individual interviews and participant observations were conducted with nurses in two hospitals in Sweden and were analysed using grounded theory. RESULT: The substantive theory shows the process of nursing care activities - from the contexts of the ICU and the general ward. The main concern was to achieve a coordinated, strengthening, person-centered standard of care to facilitate patient transitions. The core category "being perceptive and adjustable" was a strategy to individualise, that was related to the other categories; "preparing for a change" and "promoting the recovery". However, the nurses were forced to "balance between patient needs and the caregivers' resources" and consequently were compromising their care. CONCLUSIONS: To facilitate an ICU-patient's transition, individual care planning is needed. It is also essential that the patients are adequately prepared for the change to facilitate the transitional care. Knowledge about transitional needs, empowerment and patient-education seems to be important issues for facilitating transitions.
Authors: Nelleke van Sluisveld; Gijs Hesselink; Johannes Gerardus van der Hoeven; Gert Westert; Hub Wollersheim; Marieke Zegers Journal: Intensive Care Med Date: 2015-02-12 Impact factor: 17.440