Acute Crit Care.  2021 May;36(2):133-142. 10.4266/acc.2020.00626.

Challenges of the patient transition process from the intensive care unit: a qualitative study

Affiliations
  • 1Ph.D. Candidate in Nursing, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • 2Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran
  • 3Behavioral Sciences Research Center, Lifestyle Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
  • 4Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • 5Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • 6Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden

Abstract

Background
The transition of patients from the intensive care unit (ICU) to the general ward is challenging. This study aimed to explain the challenges that patients face during the transition process.
Methods
In this qualitative research of conventional content analysis, data collection was conducted between February 2018 and July 2019 in educational hospitals. After obtaining informed consent, purposive sampling was performed with 22 nurses, intensive care physicians, anesthesiologists, and patients and their families using in-depth semi-structured interviews until data saturation.
Results
The content analysis yielded three main themes in the challenges patients face during the transition process from the ICU: mixed feelings regarding transition (happiness/hope, worry/uncertainty, abandonment); care break (different atmosphere, the difference between the program and the quality of care, assigning care to the patient and family, and care culture and beliefs); and search for support and information (ineffective communication, self-care capacity of patient and family, ineffective and disrupted training, and weak follow-up programs), which inflicts care shock in the patients.
Conclusions
The results showed that patients and their families were in a state of care shock during the ICU transition process and were sometimes disconcerted. It is necessary to design and implement care models according to the needs and challenges patients face during the transition period from ICU (patient-centered), based on the evidence available, and after considering the field of medicine and the accessibility of care in the country. The transition process can be improved and enhanced by obtaining knowledge about ICU care and related challenges as well as organizing a learning environment.

Keyword

intensive care unit; patient transfer; transition care; qualitative research
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