The various equipment and devices in the intensive care unit (ICU) make it the most technologically sophisticated environment in any hospital. But, from a patient’s perspective, being connected to various devices; experiencing unsettling noises, smells, lighting, and uncomfortable temperatures; and enduring the perceptions of other patients as care objects can cause both physical and mental stress. This study combined a 24-hour video recording of patients in an ICU with in-depth interviews of the patients at 3 and 6 months postdischarge. While the study had a very small sample size (4), it was a unique opportunity to hear what the patient remembers of his or her ICU experience, in terms of communication and caregiving as well as the physical environment.
This study took place in Finland.
The aim of this study was to describe the interaction between patients and the ICU environment from the perspective of the hospital bed and patients’ memories.
Four adult patients in an ICU were recorded on DVD over a 24-hour period. The patients were also interviewed 3 months and 6 months after discharge. The data generated regarding their interactions with the ICU environment were then analyzed using qualitative and quantitative content analysis.
The DVD material was annotated in writing and then the acquired data were subjected to inductive content analysis, including open coding, creating categories, and abstraction.
The patient’s day in ICU is occupied with episodes of brief contact with nursing staff in an environment that the patient experiences as confusing or incomprehensible. The day and night rhythm is disturbed while the patient’s opportunities for rest or concentration are limited. Most interactions affect the patient, and it is important for staff to be aware of the impact of potentially unsettling events. This study shows the need for discussion and future research exploring the ICU patient’s environment and develop better understanding of patients’ perceptions of care in the ICU.
The main limitation of this study was the low number (4) of patients involved. However, the research provided 96 hours of rich data material focused on a single day of each patient’s stay in the ICU. These data provide a vivid description of the ICU environment, and the patients’ interactions, although they do not provide the whole picture about all the events that affected the individuals during their ICU treatment. However, they provide abundant audio-visual information about events during single days, allowing problems that arise in ICU treatment to be explored, including: brief contact events and lack of verbal communication, lack of time for patients to react to information, and limited time for them to rest. During this study, the patients who were interviewed attended the ICU aftercare clinic, where physicians go through the events that led to the patient’s ICU admission, as well as events in ICU that can influence the patient’s memories and experiences of the ICU. In this study staff behavior was not analyzed. Such an analysis would complement the results.