J Korean Acad Nurs.  2019 Aug;49(4):423-436. 10.4040/jkan.2019.49.4.423.

Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study

Affiliations
  • 1College of Nursing, Seoul National University, Seoul, Korea.
  • 2College of Nursing·The Research Institute of Nursing Science, Seoul National University, Seoul, Korea. sungjae@snu.ac.kr

Abstract

PURPOSE
The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care.
METHODS
Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data.
RESULTS
Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced "˜balancing emotions' and "˜authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory.
CONCLUSION
The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

Keyword

Critical Care; Empathy; Intensive Care Units; Nurse-Patient Relations; Qualitative Research

MeSH Terms

Critical Care Nursing
Critical Care*
Education
Empathy
Humans
Intensive Care Units
Monitoring, Physiologic
Nurse-Patient Relations
Nursing
Nursing Care
Qualitative Research

Figure

  • Figure 1. Data analysis procedure based on Interpretative phenomenological analysis.

  • Figure 2. Study findings of person-centered relational care experienced by intensive care unit nurses.


Reference

References

1. Watson J. Nursing: Human science and human care: A theory of nursing. Sudbury (MA): Jones & Bartlett Publishers;1999. p. 1–111.
2. Drahošová L, Jarošová D. Concept caring in nursing. Central European Journal of Nursing and Midwifery. 2016; 7(2):453–460. https://doi.org/10.15452/CEJNM.2016.07.0014.
Article
3. O’Connell E. Therapeutic relationships in critical care nursing: A reflection on practice. Nursing in Critical Care. 2008; 13(3):138–143. https://doi.org/10.1111/j.1478-5153.2008.00273.x.
Article
4. Bridges J, Nicholson C, Maben J, Pope C, Flatley M, Wilkinson C, et al. Capacity for care: Meta‐ethnography of acute care nurses’ experiences of the nurse‐patient relationship. Journal of Advanced Nursing. 2013; 69(4):760–772. https://doi.org/10.1111/jan.12050.
Article
5. Happ MB, Garrett K, Thomas DD, Tate J, George E, Hou-ze M, et al. Nurse-patient communication interactions in the intensive care unit. American Journal of Critical Care. 2011; 20(2):e28–e40. https://doi.org/10.4037/ajcc2011433.
Article
6. Wilkin K, Slevin E. The meaning of caring to nurses: An investigation into the nature of caring work in an intensive care unit. Journal of Clinical Nursing. 2004; 13(1):50–59. https://doi.org/10.1111/j.1365-2702.2004.00814.x.
Article
7. Alasad J, Ahmad M. Communication with critically ill patients. Journal of Advanced Nursing. 2005; 50(4):356–362. https://doi.org/10.1111/j.1365-2648.2005.03400.x.
Article
8. McGrath M. The challenges of caring in a technological environment: Critical care nurses’ experiences. Journal of Clinical Nursing. 2008; 17(8):1096–1104. https://doi.org/10.1111/j.1365-2702.2007.02050.x.
Article
9. Elliott R, Wright L. Verbal communication: What do critical care nurses say to their unconscious or sedated patients? Journal of Advanced Nursing. 1999; 29(6):1412–1420. https://doi.org/10.1046/j.1365-2648.1999.01028.x.
Article
10. Topçu S, Ecevit Alpar Ş, Gülseven B, Kebapçı A. Patient experiences in intensive care units: A systematic review. Patient Experience Journal. 2017; 4(3):115–127. https://doi.org/10.35680/2372-0247.1137.
Article
11. Dinç L, Gastmans C. Trust in nurse-patient relationships: A literature review. Nursing Ethics. 2013; 20(5):501–516. https://doi.org/10.1177/0969733012468463.
12. Hinderer KA. Reactions to patient death: The lived experience of critical care nurses. Dimensions of Critical Care Nursing. 2012; 31(4):252–259. https://doi.org/10.1097/DCC.0b013e318256e0f1.
13. Price AM. Caring and technology in an intensive care unit: An ethnographic study. Nursing in Critical Care. 2013; 18(6):278–288. https://doi.org/10.1111/nicc.12032.
Article
14. Kang HJ, Bang KS. Neonatal intensive care unit nurses’ experience in caring for infants who are dying. Child Health Nursing Research. 2013; 19(4):252–261. https://doi.org/10.4094/chnr.2013.19.4.252.
Article
15. Seol EM, Koh CK. Experiences of critical care nurses caring for dying patients. Journal of Korean Critical Care Nursing. 2018; 11(2):1–10.
16. Yi M. Nurses’ experience of caring for dying patients in hospitals. Journal of Korean Academy of Nursing. 2003; 33(5):553–561. https://doi.org/10.4040/jkan.2003.33.5.553.
Article
17. Travelbee J. What do we mean by rapport? The American Journal of Nursing. 1963; 63:70–72.
Article
18. Travelbee J. What’s wrong with sympathy? The American Journal of Nursing. 1964; 64:68–71. https://doi.org/10.2307/3452776.
Article
19. Travelbee J. Interpersonal aspects of nursing. 2nd ed. Philadelphia (PA): F.A. Davis Company;1971. p. 1–242.
20. Smith JA, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory, method and research. London: SAGE Publications;2009. p. 1–217.
21. Pringle J, Drummond J, McLafferty E, Hendry C. Interpretative phenomenological analysis: A discussion and critique. Nurse Researcher. 2011; 18(3):20–24. https://doi.org/10.7748/nr2011.04.18.3.20.c8459.
Article
22. Benner P. From novice to expert. The American Journal of Nursing. 1982; 82(3):402–407.
Article
23. Yardley L. Dilemmas in qualitative health research. Psychology & Health. 2000; 15(2):215–228. https://doi.org/10.1080/08870440008400302.
Article
24. Jakimowicz S, Perry L. A concept analysis of patient‐centred nursing in the intensive care unit. Journal of Advanced Nursing. 2015; 71(7):1499–1517. https://doi.org/10.1111/jan.12644.
Article
25. Sinclair S, Beamer K, Hack TF, McClement S, Raffin Bouchal S, Chochinov HM, et al. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliative Medicine. 2017; 31(5):437–447. https://doi.org/10.1177/0269216316663499.
Article
26. Errasti-Ibarrondo B, Pérez M, Carrasco JM, Lama M, Zaragoza A, Arantzamendi M. Essential elements of the relationship between the nurse and the person with advanced and terminal cancer: A meta-ethnography. Nursing Outlook. 2015; 63(3):255–268. https://doi.org/10.1016/j.outlook.2014.12.001.
27. Hong S. A phenomenological study of the caring in nursing science. Research in Philosophy and Phenomenology. 2011; 50:213–241.
28. Engström Å, Söderberg S. Close relatives in intensive care from the perspective of critical care nurses. Journal of Clinical Nursing. 2007; 16(9):1651–1659. https://doi.org/10.1111/j.1365-2702.2005.01520.x.
29. Lawrence M. The unconscious experience. American Journal of Critical Care. 1995; 4(3):227–232.
Article
30. Chen C, Chow AYM, Tang S. Bereavement process of profes- sional caregivers after deaths of their patients: A meta-ethnographic synthesis of qualitative studies and an integrated model. International Journal of Nursing Studies. 2018; 88:104–113. https://doi.org/10.1016/j.ijnurstu.2018.08.010.
Full Text Links
  • JKAN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr