'Never in my mind to give up!' A qualitative study of long-term intensive care patients' inner strength and willpower - promoting and challenging aspects

Ingeborg Alexandersen, Berit Stjern, Regina Eide, Hege Selnes Haugdahl, Tove Engan Paulsby, Stine Borgen Lund, Gørill Haugan
Journal of Clinical Nursing 2019 June 26

AIMS AND OBJECTIVES: To explore aspects that promote and challenge long-term ICU patients' inner strength and willpower.

BACKGROUND: Considerable research has been devoted to ICU patients' experiences, however research on long-term ICU patients is limited. Studies in a health promoting perspective focusing on long-term ICU patients' inner strength and willpower are scarce.

DESIGN: A qualitative, hermeneutic-phenomenological approach, using in-depth interviews.

METHODS: Seventeen long-term Norwegian ICU patients were interviewed once, at six to 18 months after ICU discharge. The consolidated criteria for reporting qualitative research was used (Supplementary File 1).

RESULTS: The lived experience of the phenomenon 'inner strength and willpower' and what promotes and challenges this phenomenon in long-term ICU patients were represented by four main themes and nine sub-themes. Promoting aspects comprised of two main themes and five sub-themes: (1)'No doubt about coming back to life' with sub-themes; 'Strong connectedness to life; feeling alive and present', 'Meaning and purpose; feeling valuable to somebody'. (2)'How to ignite and maintain the spark of life', with the sub-themes: 'Practical solutions, coping skills from previous life experiences', 'Provocative and inspiring experiences', and 'Vivid dream experiences that ignite the willpower'. Two main categories and four sub-categories represented challenging aspects,: (1) Exhaustion, weakness, and discomfort; sub-themes; 'Physical challenges' and 'Mental discomfort', and (2)'Tiring delusions', sub-themes; 'Living in the worst horror movie', and 'Feeling trapped'.

CONCLUSION: This study expands on previous studies by providing insights about what promotes and challenges long-term ICU patients' inner strength and willpower during their recovery trajectory. This article is protected by copyright. All rights reserved.


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