Intensivsykepleieres opplevelser med langtids-intensivpasienters indre styrke og vilje til overlevelse

Abstract

Background: Inner strength and willpower are deemed essential salutogenic resources for recovery and survival among long-term critically ill patients. However, little is known of how these resources are promoted by health professionals. Aim: This study aims to provide knowledge of how intensive care unit (ICU) nurses promote long-term critically ill patients’ inner strength and will to survive. Methods: Qualitative data were collected by means of three focus group interviews involving ten experienced ICU nurses in three Norwegian hospitals. The data were analyzed by means of systematic text condensation. Results: Knowledge of the patient as a person was a vital resource for ICU nurses to support long-term ICU patient’s inner strength and willpower; attentive and respectful ICU nurses were more likely to encourage long-term ICU patient’s inner strength and willpower. However, in the acute, critical part of the ICU-trajectory this concern received less attention, whereas during the awakening periods the nurses utilized consciously the patient’s goal of coming home in boosting patients’ inner strength and will to survive. Moreover, family support was vital to strengthen long-term critically ill patients’ inner strength and will to survive. The ICU nurses demonstrated a variety of professional actions and attitudes of significance in promoting long-term critically ill patients’ salutogenic resources. Even when survival was most uncertain. Conclusion: This study provides new knowledge of how ICU nurses support long-term critically ill patients, primarily in their awakening periods. The ICU nurses exposed intuitive understanding of patient’s inner strength and willpower as well as how to promote these salutogenic resources. This intuitive knowledge should be further developed and integrated in clinical practice and educational settings. Keywords: health promotion; salutogenic ICU nursing; qualitative study; long-term critically ill patients; inner strength; willpower