LAUSR

Background Patients on mechanical ventilator in ICU are subjected to various physical and emotional stressors which they may be unable to communicate causing further distress. Objective To describe the lived in experiences of critically ill patients who were on mechanical ventilation in medical-surgical ICU of a Tertiary care hospital in Delhi, India. Methods This Phenomenological hermeneutic study included patients above 18 years who were on mechanical ventilator for at least 48 hours in the medical-surgical ICU of a tertiary care hospital between August to November 2017 and fulfilling inclusion criteria. Ethical approval was obtained from institutional ethical committee. The data was collected using in-depth interview guide with six patients only out of the twelve enrolled (n=6 dropped out of study). Audio recorded interviews were transcribed and further analyzed by Van Manen’s approach. Results All patients were on ventilator via Endotracheal tube and the duration of mechanical ventilation ranged from 48 hours and 15 min to 299 hours and 30 min, had no previous experience of ET intubation, mechanical ventilation or ICU stay and interviewed within three days after extubation. The analysis of verbatim revealed emergence of twenty themes and corresponding subthemes which were grouped under four fundamental existentials of human experience which are spatiality, corporeality, temporality and relationality. Most of the patients reported discomfort due to ET tube, problems due to suctioning, impaired communication, altered thirst, hunger and sleep-wake cycle. Two of the patients expressed that they felt more at ease and less embarrassed with staff of same gender. Even comforting words from relatives sometimes caused irritation to patients. Conclusion There is a need for provision of routine mental health assessment of ICU patients by mental health professionals and interventions to minimize impact of traumatic experiences of patients who’re put on mechanical ventilation in order to promote healthy coping patterns.