Being an observer of one’s own life—a meta-synthesis on the experience of mechanically ventilated patients in intensive care units

IF 8.8 1区医学 Q1 CRITICAL CARE MEDICINE

Critical Care Pub Date : 2025-03-08 DOI:10.1186/s13054-025-05326-6

Fritz Sterr, Mareike Hechinger, Lydia Bauernfeind, Christian Rester, Rebecca Palm, Sabine Metzing

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Abstract

The experience of patients under mechanical ventilation in the intensive care unit is described as complex and multifaceted, but an overarching and in-depth understanding of the experience is still missing. To provide an in-depth analysis and synthesis of patients’ experience when being mechanically ventilated in intensive care units. We conducted a meta-synthesis according to the methodological recommendations of Sandelowski and Barroso. Our systematic literature search in Medline, CINAHL, and Cochrane was complemented by hand and citation searches. We included only qualitative studies with a rich description of conscious patients’ experience under mechanical ventilation. Studies on children, step-down units, noninvasive ventilation and non-scientific journal articles were excluded. After the title, abstract and full-text screening by three reviewers, we performed initial, axial and selective coding and in-depth analysis in MAXQDA. The synthesis was supported by multiple discussion rounds. Of the 2,563 records identified, 20 studies were included in our synthesis. This revealed the central phenomenon of patients being observers of their own lives. They are yearning for a stable picture of reality and developing various situation-specific needs. Finally, patients are finding ways to deal with the situation. These concepts are interwoven in time and are experienced repeatedly in different dimensions. Patients under mechanical ventilation are highly perceptive. Healthcare professionals are particularly responsible for patients. They should reflect on their role in intensive care and must be sensitized to patients’ differentiated experience. Registration, Protocol: https://doi.org/10.17605/OSF.IO/G8Q6X

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成为自己生命的观察者——重症监护病房机械通气患者经验的综合

重症监护室机械通气患者的经历被描述为复杂和多方面的，但对这种经历的全面和深入的理解仍然缺失。对重症监护室机械通气患者的经验进行深入分析和综合。我们根据Sandelowski和Barroso的方法论建议进行了meta-synthesis。我们在Medline、CINAHL和Cochrane中进行了系统的文献检索，并辅以人工检索和引文检索。我们只纳入了对机械通气下有意识患者经验有丰富描述的定性研究。排除了儿童、降压装置、无创通气和非科学期刊文章的研究。经过三位审稿人对标题、摘要和全文的筛选，我们在MAXQDA中进行了初始编码、轴向编码和选择性编码，并进行了深入分析。这一综合得到了多轮讨论的支持。在确定的2563份记录中，有20份研究纳入了我们的综合研究。这揭示了病人是自己生活的观察者这一核心现象。他们渴望一幅稳定的现实图景，并根据具体情况发展出各种需求。最后，患者正在寻找应对这种情况的方法。这些概念在时间上交织在一起，在不同的维度上反复体验。机械通气患者具有高度的感知能力。医疗保健专业人员对病人负有特别的责任。他们应该反思自己在重症监护中的作用，必须对患者的差异化体验敏感。注册，协议：https://doi.org/10.17605/OSF.IO/G8Q6X

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来源期刊

Critical Care 医学-危重病医学

CiteScore

20.60

自引率

3.30%

发文量

348

审稿时长

1.5 months

期刊介绍： Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.