The lived experience of delirium in intensive care unit patients: A meta-ethnography |
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| Affiliation: | 1. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada;2. Heart Health and Stroke Strategic Clinical Network-AHS, Canada;3. Division of Cardiac Surgery, Faculty of Medicine, Canada;1. Department of Nursing, Taipei Medical University Hospital, 252 Wuxing Street, Xinyi District, Taipei 11031, Taiwan;2. School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia;3. Illawarra Health and Medical Research Institute (IHMRI), Northfields Ave, Wollongong, NSW 2522, Australia;4. College of Nursing, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei 11031, Taiwan;5. School of Nursing and Midwifery, Western Sydney University, Narellan Road, Cnr David Pilgrim Drive & Goldsmith Avenue, Campbelltown, NSW 2560, Australia;1. Department of Intensive Care Unit, The Jinling Hospital Affiliated Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, PR China;2. Department of Professional Training of Clinical Nursing, the Jinling Hospital Affiliated Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, PR China;1. Epworth Healthcare, Richmond, Vic 3121, Australia;2. Deakin University, School of Nursing & Midwifery, Geelong, Vic 3220, Australia;3. Centre for Quality and Patient Safety Research, Deakin University, Geelong, Vic 3220, Australia;4. Epworth Deakin Centre for Clinical Nursing Research, Richmond, Vic 3121, Australia;1. ICU Staff Nurse, Royal Columbian Hospital, 633 First St., New Westminster, BC, V3L 2H3, Canada;2. Pre-Admission Clinic, Jim Pattison Outpatient Care and Surgery Center, 9750 140 St., Surrey, BC, V3T 0G9, Canada;3. Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB, T9S 3A3, Canada;1. Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Australia;2. Faculty of Medicine, University of Queensland, Brisbane, Australia;3. Physiotherapy Department, The Prince Charles Hospital, Brisbane, Australia;4. Royal Brisbane and Women''s Hospital, Brisbane, Australia;5. School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia;6. Menzies Health Institute QLD, Griffith University, Gold Coast, Australia;7. School of Dentistry, University of Queensland, Brisbane, Australia |
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| Abstract: | ![]()
ObjectivesThe objectives were to interpretatively synthesise qualitative findings on patients' lived experience of delirium in the intensive care unit (ICU) and to identify meanings and potential existential issues that affect them during and after their experience. Patients may face existential challenges when they are vulnerable in their confusion, all while confronting the reality of their mortality in the critically ill state.Review methodsThe study involved meta-ethnographic synthesis of published qualitative studies addressing the lived experience of delirium for patients in ICU based on a systematic literature search.Data sourcesMEDLINE, PsycINFO, Embase, Scopus, CINAHL, ProQuest, and Cochrane were the sources. Studies were selected based on the predefined inclusion/exclusion criteria. The identified studies were subjected to a quality appraisal based on a Critical Appraisal Skills Programme tool.ResultsBased on the eligibility criteria, nine qualitative studies were included, of overall medium to high quality. One core theme, “a perturbing altered reality” and four main themes were identified: “disturbed sense of time”, “omnipresent feeling of fear”, “impact of human connection”, and “perceiving surreal events”. These four themes illustrate how the three salient existential issues of uncertainty, self-perceived helplessness, and death that are present in delirium make it a highly distressing experience for patients in ICU.ConclusionsCritically ill patients who experience delirium appear to face intense existential issues, which may not be identified by care providers and may remain unaddressed during their ICU stay and after discharge. Patients report that addressing the memories of these issues would be therapeutic. Future research needs to explore care approaches to meet the unique psychosocial needs of critically ill patients with delirium. |
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| Keywords: | Delirium Intensive care unit Lived experience Meta-ethnography Meta-synthesis |
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