Percepción del paciente en relación con la valoración de la fragilidad en las unidades de cuidados intensivos: estudio fenomenológico

Abstract

Frail patients admitted to the Intensive Care Unit (ICU) have a poorer outcome that may be related to Post ICU Syndrome, readmissions or death within a year of discharge. Assessing frailty can help guide decision-making and care planning.

Objective

To explore the perception of patients in relation to the assessment of frailty in the ICU.

Methodology

Qualitative phenomenological study through semi-structured interviews in the ICU of a public hospital of intermediate complexity. Thirteen patients with experience of admission to the ICU participated. A thematic analysis of the discourse was carried out following Braun and Clarke's proposal.

Results

Three themes and seven subthemes were identified as pivotal in describing the patients’ experience: perception of own frailty, coping styles and resources for dealing with frailty, and the value of monitoring the evolution of frailty. Participants understand frailty as opposed to strength, from a multidimensional perspective and linked to the idea of loss of capabilities. They try to deal with fragility by coping and struggling with it, drawing on intrapersonal and interpersonal resources. They place value on monitoring the evolution of frailty insofar as they feel considered and supported.

Conclusions

The patients’ narratives evidence the important repercussion that an ICU admission has on the physical and psycho-socio-emotional dimensions of patients and caregivers. The assessment of frailty and the monitoring of its evolution at discharge is valued as important to be able to adapt care and significant as a facilitator of emotional support. There is a clear need for support at discharge in the different spheres and for accompanying the patient throughout their recovery to enable an early return to their life prior to admission.