Mid Sweden University

Background: Transitional care encompasses to ensure high-quality healthcare from illness onset through hospitalization to returning home. Relatives of intensive care patients are notably vulnerable to adverse emotional and psychological effects due to the sudden, life-threatening nature of their next of kins' conditions. Unfortunately, limited research explores the experiences of relatives in transitional care contexts. Therefore, the aim of this study was to explore the experiences of relatives as they navigate the process of transitional care, encompassing the journey from home to hospital, from intensive care to general ward settings, and the eventual return to their homes. 

Method: A qualitative research design was used, semi-structured individual interviews with 14 participants who had experience with transitional care, spanning from intensive care to general care, and their return home. Data were analyzed using reflexive thematic analysis as described by Braun and Clarke. 

Preliminary Findings: In the context of transitional care, relatives perceive themselves as frequently becoming invisible and subsequently abandoned by the healthcare system. Relatives perceived that they went in and out of being a part of the care- sometimes invited, other times, they were not, which led to fluctuations in their involvement and confusion regarding how the healthcare system operated.

Background: Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post-care, and finally, returning home. Aim: To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post-care, and returning home. Methods: The study employed a qualitative design, with data collected via semi-structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital. Findings: Family members’ experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non-linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury. Conclusion: The study suggested that family members with a next of kin who experienced life-threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit-survivors significantly impacts their lives and the healthcare systems should prioritise providing high-quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well-being. 

Bakgrund: Vårdmöten kan ha många orsaker och vara av olika komplexitet. Till vårdavdelningar kommer bland annat närstående till patienter som har förflyttats från intensivvårdsavdelning. På grund av den livsavgörande händelsen de varit med om kan dessa närstående vara mer sköra än andra. Forskning har visat att de kan uppleva vårdmöten otillfredsställande. Det finns otillräckligt med studier som beskriver hur närstående till vuxna patienter upplever förflyttningen från intensivvård till allmän vård.

Syftet: Att beskriva närståendes upplevelser av vårdmöten med sjuksköterskor under vårdtiden på allmän vårdavdelning efter förflyttning från intensivvårdsavdelning.

Metod: En kvalitativ beskrivande design med en induktiv ansats. Semi-strukturerade individuella intervjuer utfördes med närstående (n = 14) till patienter vid fem sjukhus i Sverige. Data analyserades med innehållsanalys.

Resultat: Närstående upplevde ett stort ansvar för att säkerställa att deras anhörig fick vård av god kvalitet. För närstående var det väsentligt att få möta tillgängliga, engagerade och medkännande sjuksköterskor på vårdavdelningen. Temat ’Längtan efter tillit och strävan efter att involveras i sin anhörigs vård’ illustrerades i två underteman ’Önskan att vara en viktig del i pusslet’ och ’Vara vaksam med oro över vårdens kvalitet’.

Slutsats: Närståendes delaktighet är nödvändig för att bygga upp livet efter sjukhusvistelsen för både dem själva och patienten. Deras oro och bekymmer gällande förflyttningen behöver tas på allvar och inkluderas i vårdplaneringen för att säkerställa deras välbefinnande. Sjuksköterskor behöver avancerade icke-tekniska färdigheter i att skapa vårdmöten byggda på tillit och respekt för närstående. Framtida forskning bör undersöka hur närståendes behov kan mötas i praktiken. Fortsatt omvårdnadsforskning är nödvändig för att strukturera möten med patienter och närstående som förflyttas från intensivvårdsavdelning; ett sätt kan vara att utveckla och använda specifika vårdplaner för mottagande av närstående.

Background

Care encounters at general wards have many reasons, and the complexity differs. Some arriving at the ward are relatives of discharged intensive care unit patients’, who are usually more fragile than others due to what had happened to them. Research indicates that care encounters leave relatives dissatisfied. There is a lack of studies describing how relatives of adult patients experience the transfer from the intensive care unit.

Aim

The purpose of this study was to describe relatives’ experiences of care encounters with nurses during their loved ones’ stay in the general ward after being discharged from the intensive care unit.

Methods

A qualitative descriptive design with an inductive approach was used. Semi-structured individual interviews were conducted with relatives [n = 14) of patients from different hospitals in Sweden. Data were analysed using content analysis.

Results

Relatives expressed feeling a huge responsibility for ensuring the quality of care for their loved ones. It was essential to encounter available, committed, and compassionate nurses in the general ward after being transferred from the intensive care unit. The theme ‘longing for trust and struggling to be involved in their loved one’s care’ was illustrated in the two subthemes of ‘wanting to be seen as an important piece of the puzzle’ and ‘being vigilant and worrying about the quality of care’.

Conclusion

The relatives of patients experience their needs as unfulfilled in care encounters with nurses at the general ward after transfer from ICU. In order to meet the needs of relatives, nurses require well-developed non-technical skills to establish a compassionate interaction founded on trust and respect for the individual. Future research should investigate how relatives’ needs can be met in practice. New nursing innovations are necessary to structure encounters with patients and relatives transitioning from the intensive care unit.