Intensive Care Survivors’ Experiences During Acute Hospitalization in Critical Care Unit Kenyatta National Hospital

Abstract

Background: Majority of intensive care survivors suffer physical and psychosocial traumatic experiences during acute hospitalization. A prolonged ICU stay influences the quality of life through stressful memories that affect the physical, mental and social wellbeing. ICU care is costly and these impairments may vary in severity, lasts for years and can greatly affect the lives in ICU survivors. These impairments are recognized as public health burdens and are related to clinical conditions, treatments provided, and stressful factors during ICU care. These patients are fraught with challenges, for which they receive little or no support or preparation. Main objective: To explore intensive care survivors’ experiences during acute hospitalization in Critical Care Unit, Kenyatta National Hospital. Method: This was a descriptive phenomenological qualitative study to investigate intensive care survivors’ experiences during acute hospitalization in the intensive care unit, Kenyatta National Hospital. Purposive sampling method was used to identify study participants (patients discharged home post ICU care). Ten (10) participants were included in the study. Data was collected from participants using an in-depth interview guide and participant observation. The interviews were audio-taped and transcribed verbatim and common themes identified iteratively. Data analysis was done thematically by use of Nvivo software. Results: Five major themes emerged from analysis: Reminiscence of ICU experience, Interaction with the ICU environment, adverse psychosocial experiences, quality of care and enabling practice. Recollection of ICU experiences found that majority of the participants could remember the experiences they had in ICU. Most of them reported positive experiences which related to interaction with healthcare providers and the environment. Only few of the participants reported knowing when they were being admitted in ICU from theatre. Majority of the participants had positive interaction with physical environment derived from the cleanliness of the ICU, responsive nature of many of healthcare providers and commitment to meeting patient needs. Further, noise from staff, machines, needle punctures and constant change of diapers were the most common stressors among ICU patients. Psychosocial experiences included trauma experiences, period of delirium and feeling helplessness. Majority of the participants reported high level of confidence in quality of care provided and having received respectful care while in ICU. Challenges in delivery of quality care involved just a few healthcare providers who did not practice respectful care. Conclusion and recommendation: The findings have shown that the quality of care in ICU is relatively high although there are major challenges that need to be addressed in improving the quality of care. Thus, conduct training and workshops for health care providers on dealing with critically ill patients to avoid mishandling of patients. Increasing the number of counsellors and psychologists in ICU to control the occurrence of psychosocial issues which are highly prevalent will be essential in improving ICU patient experiences.