The lived experience of ICU for persons who have experienced delirium: a phenomenological study

Whitehorne, Karen Mae Christine (2012) The lived experience of ICU for persons who have experienced delirium: a phenomenological study. Masters thesis, Memorial University of Newfoundland.

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Abstract

The experience of being in the intensive care unit (ICU) frequently includes the experience of delirium. Delirium is a phenomenon that is often not recognized by nurses but has serious implications not only for the patient's mortality but also for his/her psychological well-being. Therefore, there is a need for nurses to understand the experience of ICU for patients who had delirium. The purpose of this phenomenological study is to answer the question "What is the lived experience of ICU for persons who have experienced delirium?" Study participants, seven men and three women who ranged in age from forty-six to seventy years, were identified as having delirium using a validated tool for identifying delirium, the Confusion Assessment Method for the ICU (CAM-ICU). van Manen's (1997a) method of phenomenology was used to guide this study, and data collection entailed semistructured interviews which were audio recorded. Four themes were identified that describe the essence of the experience of ICU with delirium: I Can't Remember, Trying to Make a Connection, Trying to Get it Straight, and Fear and Safety Concerns. The first theme refers to the participants' reported loss of memory for part of the lCU stay and their reaction to the memory loss. The second theme is related to feeling disconnected from others and from reality as well as efforts to connect. The third theme means trying to make sense out of what was real or unreal such as the unusual experiences including hallucinations and disorientation in order to understand what happened to them in ICU. The final theme describes feeling safe or unsafe and the fear that loved ones were in danger. Participants identified ways that they were affected by this experience, which was at times confusing or frightening. The findings from this study have important implications for nursing interventions for patients in ICU including the need to assess for the presence of delirium as well as the mental status for patients who have delirium, and helping patients and families learn about and deal with the psychological effects of the ICU experience. The findings from this study provide direction for nursing interventions, policy development, administation, education, and further research to improve the care of the patient who experiences ICU and delirium.

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