Understanding Uncertainty among Critically Ill Patients and their Families: Perspective from a Phenomenological Study
Cypress, B.
(Lehman College City University of NY)
Uncertainty among family members of critically ill patients in the intensive care unit has been found in previous studies from early on. A gap noted from these investigations is that each research study does not include the patients as participants, rather the family members alone, the caregivers, and at times including the nurses. The purpose of this paper is to explore, describe, and understand the concept of uncertainty among patients and family members during critical illness in the intensive care unit from the perspective of a henomenological study. The concept ‘‘uncertainty’’ as the topic for this paper is one of the specific themes illuminated from a qualitative phenomenological study conducted in the intensive care unit in 2010. Five from each category of patients, family members, and nurses were interviewed until data saturation was achieved. The data were analyzed using van Manen’s wholistic, selective, and detailed line-by-line approach until themes were illuminated. Uncertainty is a patient-specific theme illuminated in this qualitative phenomenological study not noted among the family members. The patients perceived that they ‘‘do not know what is going to happen,’’ ‘‘if they are progressing or not,’’ or ‘‘if they will make it or not.’’ These themes described the overall meaning of the participant’s lived intensive care unit experience during critical illness. Understanding the concept of uncertainty and its effects to critically ill patients and their families may assist nurses render care that is geared toward helping them make more informed decisions about treatment options and subsequent interventions and the ability to construct meanings for illness events. A better conceptualization of uncertainty and its importance can change clinical practice and allow for the development of interventions that will help facilitate a positive adaptation to the critical illness experience.
(Lehman College City University of NY)
Uncertainty among family members of critically ill patients in the intensive care unit has been found in previous studies from early on. A gap noted from these investigations is that each research study does not include the patients as participants, rather the family members alone, the caregivers, and at times including the nurses. The purpose of this paper is to explore, describe, and understand the concept of uncertainty among patients and family members during critical illness in the intensive care unit from the perspective of a henomenological study. The concept ‘‘uncertainty’’ as the topic for this paper is one of the specific themes illuminated from a qualitative phenomenological study conducted in the intensive care unit in 2010. Five from each category of patients, family members, and nurses were interviewed until data saturation was achieved. The data were analyzed using van Manen’s wholistic, selective, and detailed line-by-line approach until themes were illuminated. Uncertainty is a patient-specific theme illuminated in this qualitative phenomenological study not noted among the family members. The patients perceived that they ‘‘do not know what is going to happen,’’ ‘‘if they are progressing or not,’’ or ‘‘if they will make it or not.’’ These themes described the overall meaning of the participant’s lived intensive care unit experience during critical illness. Understanding the concept of uncertainty and its effects to critically ill patients and their families may assist nurses render care that is geared toward helping them make more informed decisions about treatment options and subsequent interventions and the ability to construct meanings for illness events. A better conceptualization of uncertainty and its importance can change clinical practice and allow for the development of interventions that will help facilitate a positive adaptation to the critical illness experience.
How phenomenological sensitivity may contribute to a deeper insight of vulnerability in chronic illness
Oroy, A. (Molde University College)
Scientific knowledge that contributes to a more nuanced understanding of vulnerability in relation to chronic illness is sparse. People suffering from a chronic illness are often considered as vulnerable at times in a somewhat negative sense that may conceal the fact that living with an illness may also contribute to personal growth and development. We do not wish to play down the suffering entailed in being chronically ill, but rather explore patients’ experiences in relation to their own health. Since vulnerability is an invariable premise of life, it might be equally important to consider the positive aspects of vulnerability as the negative ones. An ongoing study aims at gaining greater insight into life with chronic illness and the ways different patient groups experience vulnerability. Methodologically the study is anchored in a phenomenological life world philosophy and has thus a qualitative design where phenomenological sensitivity is significant. Data are collected through three qualitative interviews with each
patient; the first during the hospital stay, the second two to three weeks after discharge and the third in another one to two months. The interviews are open, and the patients are encouraged to talk freely about how they have experienced being
vulnerable, in a positive as well as a negative sense. Based on preliminary findings the presentation will reflect on how insight in chronic ill patients’ own experience may contribute to differentiate the one-sided negative picture of vulnerability.
Scientific knowledge that contributes to a more nuanced understanding of vulnerability in relation to chronic illness is sparse. People suffering from a chronic illness are often considered as vulnerable at times in a somewhat negative sense that may conceal the fact that living with an illness may also contribute to personal growth and development. We do not wish to play down the suffering entailed in being chronically ill, but rather explore patients’ experiences in relation to their own health. Since vulnerability is an invariable premise of life, it might be equally important to consider the positive aspects of vulnerability as the negative ones. An ongoing study aims at gaining greater insight into life with chronic illness and the ways different patient groups experience vulnerability. Methodologically the study is anchored in a phenomenological life world philosophy and has thus a qualitative design where phenomenological sensitivity is significant. Data are collected through three qualitative interviews with each
patient; the first during the hospital stay, the second two to three weeks after discharge and the third in another one to two months. The interviews are open, and the patients are encouraged to talk freely about how they have experienced being
vulnerable, in a positive as well as a negative sense. Based on preliminary findings the presentation will reflect on how insight in chronic ill patients’ own experience may contribute to differentiate the one-sided negative picture of vulnerability.
Ensnared in the talk of the "They" - Health Professionals experiences of vulnerability in mental health care work
Bacmann, L. (Molde University College)
Michaelsen, R. (Molde University College)
Vatne, S. (Molde University College)
To be a professional in a mental health care context is in many ways defiant. In addition to caring for vulnerable patients, the health professionals experience challenges in their daily work conditions that make them vulnerable. Organizational, psychosocial and cultural factors affect their care for the patients and the relationship to colleagues. Vulnerability is described as: being in an unanticipated landscape, being afraid of losing face, feeling guilt and insecure in how to act professional. Based on observational data and interviews we will in this presentation shed light on this phenomenon, discussed against the
background of Heidegger’s philosophy of “being with”. We especially deliberate on how the “talk of the they” disburden the
feeling of guilt, but also hinders professional development. Knowledge about health professionals experience might throw light on the importance of the working conditions in caring
relationships, and efforts in developing the disciplines practice norms in line with values that underlie the profession.
Keywords: Vulnerability, working conditions, health professionals, lived experience, mental health care
Michaelsen, R. (Molde University College)
Vatne, S. (Molde University College)
To be a professional in a mental health care context is in many ways defiant. In addition to caring for vulnerable patients, the health professionals experience challenges in their daily work conditions that make them vulnerable. Organizational, psychosocial and cultural factors affect their care for the patients and the relationship to colleagues. Vulnerability is described as: being in an unanticipated landscape, being afraid of losing face, feeling guilt and insecure in how to act professional. Based on observational data and interviews we will in this presentation shed light on this phenomenon, discussed against the
background of Heidegger’s philosophy of “being with”. We especially deliberate on how the “talk of the they” disburden the
feeling of guilt, but also hinders professional development. Knowledge about health professionals experience might throw light on the importance of the working conditions in caring
relationships, and efforts in developing the disciplines practice norms in line with values that underlie the profession.
Keywords: Vulnerability, working conditions, health professionals, lived experience, mental health care