Att vara invasivt mekaniskt ventilerad intensivvårdspatient : En kvalitativ litteraturöversikt

Sammanfattning

Background: Light sedation is recommended for invasive mechanical ventilation, which means more awake patients in intensive care units. Intensive care nurses and relatives describe the care of these patients as complex. They highlight advantages such as increased participation and the opportunity for early mobilization but also disadvantages in the form of anxiety and increased motor activity. Aim: To create an overview of patients' experiences of being awake or slightly sedated in invasive mechanical ventilation. Method: A qualitative literature review based on nineteen scientific articles. Searches were conducted in CINAHL Plus and PubMed. The analysis followed inductive content analysis according to Elo and Kyngäs (2008). Results: The analysis resulted in three categories with nine subcategories: multidimensional suffering, the striving to preserve autonomy and communicative interaction. The patients described multidimensional suffering, communication difficulties and loss of control, but also security when the intensive care nurse was present, responsive and supportive. Alertness enabled participation but at the same time reinforced vulnerability. Conclusion: The patients were in a complex borderland between increased participation and increased vulnerability. They experienced pain, discomfort, and frustration over limited communication. The results show that effective communication and the experience of safety are central to reducing suffering and strengthening the participation of patients in intensive care units.