Nielsen AH, Kvande ME, Angel S. Humanizing and dehumanizing intensive care: Thematic synthesis (HumanIC).
J Adv Nurs 2023;
79:385-401. [PMID:
36281216 PMCID:
PMC10092106 DOI:
10.1111/jan.15477]
[Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/13/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND
Critical illness and the intensive care unit can be a terrifying experience to patients and relatives and they may experience the extreme life-saving measures as dehumanizing. Humanizing intensive care is often described as holism or dignity, but these abstract concepts provide little bodily resonance to what a humanized attitude is in concrete situations.
OBJECTIVE
To explore what contributes to patients' and relatives' experience of intensive care as humanized or dehumanized.
DESIGN
Thematic synthesis.
MATERIALS
Findings from 15 qualitative papers describing patients' and/or relatives' perceptions of humanizing or dehumanizing care.
METHODS
A systematic literature search of PubMed, CINAHL, Scopus and EMBASE from 1 January 1999 to 20 August 2022 identified 16 qualitative, empirical papers describing patients' and relatives' experiences of humanizing or dehumanizing intensive care, which were assessed using Critical Appraisal Skills Programme Qualitative Checklist, 15 papers were included and analysed using Thematic Synthesis and Ricoeur's model of the text.
FINDINGS
Intensive care was humanized when patients felt connected with healthcare professionals, with themselves by experiencing safety and well-being and with their loved ones. Intensive care was humanized to relatives when the patient was cared for as a unique person, when they were allowed to stay connected to the patient and when they felt cared for in the critical situation.
CONCLUSION
Patients and relatives experienced intensive care as humanized when healthcare professionals expressed genuine attention and supported them through their caring actions and when healthcare professionals supported patients' and relatives' opportunities to stay connected in the disrupted situation of critical illness. When healthcare professionals offered a connection to the patients and relatives, this helped them hold on and find meaning.
PATIENT OR PUBLIC CONTRIBUTION
No patient and public contribution.
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