Reba A Umberger1, Sandra P Thomas. 1. Reba A. Umberger, PhD, RN, CCRN-K, is assistant professor of nursing, Department of Acute and Tertiary Care, College of Nursing, The University of Tennessee Health Science Center, Memphis. Dr. Umberger's program of research is focused on improving long-term outcomes after sepsis for survivors and their informal caregivers. Her current research is focused on recovery and immune function after sepsis among sepsis dyads within a high-risk sepsis readmission period to better understand the mechanisms involved in subsequent infections after sepsis. Sandra P. Thomas, PhD, RN, FAAN, is professor of nursing, College of Nursing, The University of Tennessee, Knoxville. Dr. Thomas chairs the PhD program at the College of Nursing in Knoxville. She also chairs the transdisciplinary phenomenology research group that meets weekly there. Her primary research foci are women's mental health issues and recovery from abuse. Dr. Thomas has served as Editor of "Issues in Mental Health Nursing" since 1997. She serves on the board of the International Society of Psychiatric-Mental Health Nurses Foundation and the Expert Panel on Violence of the American Academy of Nursing. She is a Fellow of the Society of Behavioral Medicine.
Abstract
BACKGROUND: Hospital mortality rates related to sepsis have decreased over the last decade, increasing the number of survivors of sepsis who may experience long-term consequences. Yet, little is known about how they perceive their illness experience and its aftermath. OBJECTIVE: This study explores the experiences of sepsis survivors after 1 year of their index intensive care unit (ICU) stay. METHODS: This phenomenological study was guided by Merleau-Ponty's philosophy. Participants were adult patients admitted directly to the medical ICU with sepsis who had an ICU stay of at least 48 hours and had been discharged from their index ICU stay for at least 1 year. Participants were invited by letter to participate in face-to-face or telephone interviews and a brief survey. Interviews were audio recorded, transcribed verbatim, and verified. An interpretive group read transcripts aloud to increase rigor of identifying meaning units, existential grounds, and thematic structure. RESULTS: Eight participants were recruited over 20 months. Participants were primarily white (87.5%) females (75%) with an age range of 37 to 74 years who were interviewed between 1 and 2 years following an index sepsis ICU stay. Five major themes emerged from the transcripts: (1) how they survived, (2) blurring of time versus counting time by events, (3) helpful help versus unhelpful help, (4) powerless versus striving for control, and (5) survivor but not fully recovered. DISCUSSION: Findings reflected a long trajectory of chronic illness in which the index episode of sepsis was not necessarily what stood out as figural to participants. The meaning of participant experiences must be considered in the context of a health care system that offers little to no systematic follow-up care after sepsis and little prevention. Participants expressed a need for advocacy and follow-up support.
BACKGROUND: Hospital mortality rates related to sepsis have decreased over the last decade, increasing the number of survivors of sepsis who may experience long-term consequences. Yet, little is known about how they perceive their illness experience and its aftermath. OBJECTIVE: This study explores the experiences of sepsis survivors after 1 year of their index intensive care unit (ICU) stay. METHODS: This phenomenological study was guided by Merleau-Ponty's philosophy. Participants were adult patients admitted directly to the medical ICU with sepsis who had an ICU stay of at least 48 hours and had been discharged from their index ICU stay for at least 1 year. Participants were invited by letter to participate in face-to-face or telephone interviews and a brief survey. Interviews were audio recorded, transcribed verbatim, and verified. An interpretive group read transcripts aloud to increase rigor of identifying meaning units, existential grounds, and thematic structure. RESULTS: Eight participants were recruited over 20 months. Participants were primarily white (87.5%) females (75%) with an age range of 37 to 74 years who were interviewed between 1 and 2 years following an index sepsis ICU stay. Five major themes emerged from the transcripts: (1) how they survived, (2) blurring of time versus counting time by events, (3) helpful help versus unhelpful help, (4) powerless versus striving for control, and (5) survivor but not fully recovered. DISCUSSION: Findings reflected a long trajectory of chronic illness in which the index episode of sepsis was not necessarily what stood out as figural to participants. The meaning of participant experiences must be considered in the context of a health care system that offers little to no systematic follow-up care after sepsis and little prevention. Participants expressed a need for advocacy and follow-up support.
Authors: Roel van Oorsouw; Emily Klooster; Niek Koenders; Philip J Van Der Wees; Mark Van Den Boogaard; Anke J M Oerlemans Journal: J Adv Nurs Date: 2022-06-28 Impact factor: 3.057