Patient Experience Journal

Volume 4 | Issue 3 Article 17

2017

Patient experiences in intensive care units: a

systematic review
Serpil Topçu
Koç University, stopcu@ku.edu.tr

Şule Ecevit Alpar

2- Marmara University Institute of Health Sciences, salpar@marmara.edu.tr

Bilgi Gülseven
2- Marmara University Institute of Health Sciences, bgulseven@marmara.edu.tr

Ayda Kebapçı
Koç University School of Nursing, akebapci@ku.edu.tr

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Recommended Citation
Topçu, Serpil; Ecevit Alpar, Şule; Gülseven, Bilgi; and Kebapçı, Ayda (2017) "Patient experiences in intensive care units: a systematic
review," Patient Experience Journal: Vol. 4 : Iss. 3 , Article 17.
Available at: https://pxjournal.org/journal/vol4/iss3/17

This Research is brought to you for free and open access by Patient Experience Journal. It has been accepted for inclusion in Patient Experience Journal
by an authorized editor of Patient Experience Journal.
 Patient Experience Journal
Volume 4, Issue 3 – 2017, pp. 115-127

Research

Patient experiences in intensive care units: a systematic review

Serpil Topçu, Koç University School of Nursing, Istanbul, Turkey, stopcu@ku.edu.tr
Şule Ecevit Alpar, Marmara University Institute of Health Sciences Istanbul, Turkey, salpar@marmara.edu.tr
Bilgi Gülseven, Marmara University Institute of Health Sciences Istanbul, Turkey, bgulseven@marmara.edu.tr
Ayda Kebapcı, Koç University School of Nursing, Istanbul, Turkey, akebapci@ku.edu.tr

Abstract
The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient
experiences in intensive care and levels of the recollection of the intensive care period that were published between
December, 1998 – April, 2013. The systematic review was carried out screening of the related publications. The findings
of the systematic review were studied under the following two titles: “remembering the intensive care period” and
“recalled experiences” of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review
indicated that majority of the patients had recollection of the intensive care process. The physical experiences of the
patients were pain, sleep disturbances, discomfort, inactivity or over-activity, noise, thirst, headache, discomfort due to
the endotracheal tube (ET), technological support, medical activities, and difficulties in aspiration and swallowing. On
the other side, psychological experiences were hallucination, nightmares, fear, worry, anxiety, depression, loneliness, and
thoughts about death, panic, nervousness, uncertainty, and despair. In addition, it was seen that patients experienced
some communication difficulties. As a result of the systematic review, it was seen that patients could remember the
intensive care period, and the number of negative experiences in intensive care were more than the positive ones.

Keywords
Intensive care, intensive care unit, memory, patient experiences

Introduction Many studies show that patients negatively evaluate their

intensive care period due to experiencing many physical
Intensive care units (ICU) are where patients whose problems such as pain, discomfort, and sleeplessness in
survivor functions are impaired and who need further the intensive care unit.5-7 Additionally, patients with the
technology, intense medication, close follow-up, and care support of many equipment and healthcare professionals
to be able to continue their normal functions are located. 1 that are not familiar and stranger for them, called as simply
Thanks to the improvements in technology, the increase in “patient.” This affects both the psychological and the
the number of qualified research, and guidebooks that are physical well-being of patients.5,7,8 An increasing number
frequently renewed, necessities on physical care have been of studies show that there were a relation between post-
met successfully and rates of survival have increased.2,3 A traumatic stress disorder and patients’ negative experiences
positive intensive care process could enable the physical in intensive care.9,10 Patients’ experiences regarding
and psychological well-being of patients after the intensive care are also the quality indicators of an ICU.5 A
discharge, and thus would prevent a negative change in the better understanding of patients’ experiences could help
quality of their lives. Therefore, patient care necessitates a health professionals create better intensive care
health team with special training, which has full knowledge experiences and outcomes for patients.
of the practices related to intensive care, follows and
adopts research findings based on evidence, and would This systematic review was conducted with the purpose of
exercise the precautions regarding the complications that reaching scientific consensus through the findings of
may occur after discharge due to the intensive care period. papers that analyzed the experiences of intensive care
The teams working at intensive care units, where keeping patients and the levels of recollection of the intensive care
patients alive is of top priority, sometimes may ignore the period.
fact that patients have psychological needs and focus
mainly on fulfilling physiological needs. Precision towards Method
psychological needs would increase with the guidance of
studies4,5 which show that psychological support during The purpose of this study was to systematically review
the recovery period contributes positively to patients. studies that examine patient experiences and recollection

Patient Experience Journal, Volume 4, Issue 3 – 2017

© The Author(s), 2017. Published in association with The Beryl Institute and Patient Experience Institute
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Patient experiences in intensive care units, Topçu et al.

of the intensive care period. Literature review for the sample group consisted of patients who stayed in intensive
studies conducted between March, 23 – April, 24, 2013. care for at least a day, g) whose sample group consisted of
patients whose extensive care experience was maximum 6
The steps for the systematic review are as follows: months prior to the relevant study.

Determining the proper questions for the analysis Compounding the studies reached
Patients in intensive care units are primarily monitored for A total of 1390 papers were reached with the keywords
their physiologic changes by a health care team. and 15 papers that matched specified criteria were
Communicating with the patient is of secondary included into the research. The process of choosing and
importance and mostly forgotten. It is thought that eliminating the papers that matched the inclusion criteria is
patients are not aware of what is going on around them shown in Figure 1.
and they will not remember the process that they
experience.12 This systematic review planned to define the Analyzing and Locating the Findings
experiences of patients in intensive care units. Questions The findings of the 15 studies that were selected for the
generated in this context were 1) “Do patients remember systematic review were analyzed and discussed in this
their ICU experiences?” and 2) “How do patients define paper.
their ICU experiences?”
Ethical Considerations
Literature review All of the papers that were published in journals and were
Literature review was carried out in three steps: a) reached through open databases.
electronic databases, b) manual research in relevant
journals, c) references of the papers used. The databases Results
where papers were screened and the number of studies
reached is given in Table 1. Keywords used during the Samples of the 15 studies that were included into the
electronic database search were “yoğun bakım”, “yoğun systematical review included between 4 – 464 patients and
bakımdaki hasta deneyimleri”, “intensive care”, “memory”, consisted of individuals that were at least 18 years old.
“patient experiences.” Duration of stay in the intensive care unit ranged between
36 hours and 133 days. In all selected papers, data were
Determining the inclusion criteria for the systematic collected after the patients were transferred out of the
review intensive care unit. Face-to-face interviews and data
The studies with the following features were included in collection by phone/email methods were used for data
the systematic review: the papers a) which were published collection by the studies that were designed as descriptive,
between 1998 and 2013, b) which were published in prospective, qualitative, and/or quantitative. The findings
English or Turkish, c) whose sample group consisted of were discussed under two titles (Table 2 at end of article):
patients that were 18 years old and above, d) whose
sample group consisted of patients who were conscious Remembering the Intensive Care Period
and could be communicated with after the intensive care, As a result of the systematic analyze, it was found that the
e) whose sample group consisted of patients who were duration and feature of sedation was not clearly referred in
transferred or discharged from the intensive care, f) whose

Table 1: Databases and the number of studies reached

Database Number of Studies

Medline 33
EBSCO 276
CINAHL 5
Google Scholar 242
Ovid SP 770
Intensive and Critical Care Nursing 12
Nursing in Critical Care 18
Searching by hand from relevant journals 14
References of the papers acquired 20
Total 1390

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 Patient experiences in intensive care units, Topçu et al.

Figure 1. The process of choosing and eliminating the papers

Detailed reference search

(n= 1390)
ü Excluded published articles 1998-2013 (n= 846)
ü Published in a language other than English or Turkish (n= 3)
ü Sample does not consist of intensive care patients (n= 390)
ü Review studies and case presentation papers (n= 116)

The papers that were analysed

(n= 35)
ü Intensive care experiences of the sample group is more
than 6 months (n=12)
ü Sample consists of patients that stayed in intensive care
less than one day (n=2)
ü Younger than 18 (n= 6)
The papers included into the
research (n=15)

some papers, while in some others sedation was not Patient Experiences in an Intensive Care Unit
mentioned at all.4-6,13-17 Leur et al., whose sample consisted Intensive care experiences of patients were discussed
of patients that were sedated while they were already under two titles: physical and psychological experiences. It
intubated, indicated that a total of 125 patients recalled was found that patients describe both positive and/or
their intensive care process, although they were sedated.18 negative experiences, according to the studies that were
Similarly, the other three studies showed that patients included in the systematic review (Table 2).
recall intensive care days despite being sedated.7,19,20 Other
studies in which duration of sedation was not addressed Physical Experiences
found that patients mostly recall the intensive care process The physical experiences described by the patients as
as well as the physical and psychological discomfort.4, negative were mostly pain, sleeplessness, discomfort,
6,14,16,17 Özdemir concluded that patients who had pain
inactivity or over-activity, noise, thirst, headache,
recall their intensive care experiences more than the discomfort due to ET, technological support, medical
others.21 Out of the fifteen studies that were included in activities, aspiration and swallowing difficulty.4-8,13,14-18,20-
the review, only the patients in Adamson et al.15 stated that 22,23 Patients usually remembered the intubation period as a
they could barely remember the process but could describe negative experience. Similarly, equipment like the oxygen
some moments that they had been through. Some patient mask, saturation prop, and nasogastric tubes caused loss of
expressions about recollection were specified in the comfort.6,18,20,22 Patients expressed their physical
qualitative studies are as follows: experiences as following:

“It was not nice to be in intensive care, but I cannot “Being tied to the machine. Alarms, continuous rush. Pushing,
remember much.”15 poking, pain, seeing a lot of ill people around is frightening. All the
IV fluids, dripping serum. Doctors all the time. A peculiar smell.” 4
“Intensive care was like a factory. Everybody was busy
taking care of the patients. They were running here and “I will never forget the pain that I went through. I could never ask
there. So intense, I am used to beats and crashing noises in the doctors or nurses what was happening to me. This is just one of
the factory. It disturbed me so much to watch patients.”4 the many things I experienced there.” 15

“I remember thinking that I would never go home again.”8 “It was impossible to sleep because of the noise.”22

“It was a quite distressing atmosphere. It looked like a “It was extremely cold; I was cold all the time I remained in intensive
battle field. I remember a patient making animal noises.” 4 care.”8

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Patient experiences in intensive care units, Topçu et al.

“I was very thirsty and they gave me some water by syringe. I panic
each time I remember that thirst.”8 “A nurse has lots of work to take care of in a service. However,
while in intensive care, we want one of the nurses to be there for us
Psychological Experiences whenever we need them.”13
Patients have both positive and negative psychological
experiences related to the intensive care period. “There were angels (the nurses) there. They did everything for me,
Experiences are associated with the individual perception they treated me as if I was a baby, a princess. They took very good
of the patient and/or the manner and behavior of the care of me, but I still want to go back home.”22
health team. The majority of the patients noted
communication blocks and difficulties such as having “The nurse was tired of my requests.”8
difficulty in speaking and communication due to the
ET.6,7,13,14,18 Other experiences of the patients were “I remember them say, the blood pressure is falling down 60, 57,
hallucination, nightmare, fear, worry, anxiety, depression, 55... Another voice said, let me know when it falls down to 50,
loneliness, thoughts of death, panic, nervousness, that’s when we can kill them all/cut it. I still think of this from time
uncertainty, and despair4-7,13-16,20. Patients expressed their to time.”4
psychological experiences as follows:
The psychological demands that patients experience
“I thought I could not go home because I had lost my wallet and during ICU are to see and come together with their family.
passport.”8 Wang et al. stated that family support and visits are
effective during the recovery period.16 Patients reported
“The need to communicate is not only verbal; non-verbal that they missed their spouses and friends,14 scared of
communication can be set up in many ways. The person is right by losing their loved ones23 and worried about their family
you, with you, knows what you want, and gives you what you want, during hospitalization in the ICU.6
in non-verbal communication.”13
Discussion
“I felt that I had changed… I could not figure out what was
imagination and what was reality. I had never had such a dilemma This review evaluates the intensive care experiences of
before. It was a really strange feeling.”13 patients and their recollection of these experiences,
through the findings acquired from fifteen studies.
“My doctor told me I looked fine, but I was not feeling well.” 4 Defining patient experiences will provide a guide for all
health care personnel to help them plan their approach
“I was in another world. I saw faces and talked to them. There were and care of patients. Although the studies were conducted
some strange things. I believed all those were real.”15 with different sample sizes and types and many common
points were determined on patient experiences. The
“I was embarrassed to lie naked in bed.”8 argument was structured under two titles which was
supported by other findings from the literature.
According to Granberg et al.,22 patients evaluated the
nurses who did not communicate much with them and Remembering the Intensive Care Period
practiced the procedures without any explanations as There is no sample group that includes patients who
“bad”, while they evaluated the nurses who took recollect whole period of the intensive care. The patients
continuous care of them, talked to them, and treated them reported either complete or partial recollection.
kindly as “good.” Another study found that some verbal Recollection requires to be conscious and awake during
and non-verbal communication techniques help patients to the incident. The incidence of delirium in intensive care,
feel better and ease the pain.13 Özdemir noted that patients which can affect recollection and correct recollection, is
with pain have more positive intensive care experiences between 40 – 80%.23 The cohort study by Roberts et al.
compared with the patients with no pain.21 Studies showed determined a decrease in the skills to perceive and
that patients feel better and intensive care experiences interpret reality of the patients in delirium, compared to
become positive with the caring attitude of the healthcare the patients who were not.24 The same study noted that
staff.7,13,15,16 Positive behavior raise the trust towards recollection levels of the majority of the patients were
healthcare staff.6 realistic. Other factors that block patients to recall
memories are sedation, medical treatments, the severity of
Negative experiences of the patients were: lack of illness, and data collection
respect,4,7 an unfriendly, tense atmosphere,6 and lack of time 14. Seven studies discussed in this systematic review
communication.4 which evaluated the intensive care period recollection of
patients found high recollection rates,4-7,14,17,19 whereas
Patients expressed their experiences related to the health three studies found that most patients had no recollection
personnel as the following: or did not have clear recollection.14,15,20 Sedating patients

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 Patient experiences in intensive care units, Topçu et al.

in intensive care in order to put them to sleep is used to explanations to the patient before any intervention, trying
suppress the stress response in critically ill patients, to eliminate the causes of the pain, helping the patient to
decrease anxiety, increase the tolerance for ventilator have the proper position to be comfortable, and before the
support, facilitate nurse/doctor interventions such as painful invasive attempts administering analgesic drug.27
aspiration, invasive attempts, and dressings, and to Hunt noted that a majority of the patients reported that
improve patient comfort.25 Recollection of the intensive they recollect the pain relief as a result of the attempt
care can be harder for patients who were sedated. The made by nurses.13
study by Capuzzo et al., found that sedation negatively
effects recollection.20 However, one third of the patients It was seen that difficulty in communicating, fear due to
of the same study reported clear recollection of the uncertainty, hallucinations, nightmares, anxiety, and
intensive care period, despite sedation. Therefore, nurses, intensive care responses lead to psychological discomfort
who spend the longest time with patients in the clinic need in patients. Granberg et al. stated that patients evaluated
to use their communication skills at the highest level and the nurses who made explanations and talked to them, and
also make the other health care personnel use their took care of them as “good”, while they evaluated the
communication skills. nurses who applied the procedures without making
explanations as “bad.”22 Hunt noted that patients were
Patient Experiences in an Intensive Care Unit focused on the presence of nurses and reported feeling
Turkish and English studies included in this review show better when they took care for them.13 Similarly, Wang et
no differences in terms of patient experiences. The al. denoted that patients reported feeling safe with the
common experiences singled out in all studies were positive attitudes of the health personnel.16 Patients’
grouped under the titles “discomfort” and “difficulty in comfort can be increased by simple nursing responses like
communication”. The reasons of discomfort were mainly checking into the factors that increase and decrease
the endotracheal tube, medical responses, noise, anxiety, encouraging the family/relatives to pay more
hallucination, and pain. There are studies showing that frequent visits, informing patients, using nonverbal
Endotracheal Tube leads to discomfort in ICU communication in order to enhance communication, and
patients.6,13,16,18,20,26 The discomforts recalled by patients teaching alternative communication techniques to the
were not being able to speak because of the ET13 and patients. According to Russell et al., patients reported
discomfort due to the ET18,20 and the aspiration anxiety due to noise.4 Avoiding patients from seeing other
process.6,16 It is impossible to make a patient feel patients going through an immediate treatment or die,
completely comfortable without ending the intubation; making explanations about the noise around, orienting the
however, a partial comfort can be provided during the patients about the environment they are in can be counted
unavoidable intubation process by the responses of nurses. among the interventions that are effective in decreasing
The level of discomfort caused by the ET can be the fear. Wang et al. stated that patients reported the
decreased by methods such as using non-verbal positive effect of the family’s visits and support for their
communication techniques, closely monitoring patient- recovery.16
mechanical ventilator compliance, evaluating the
respiratory rate, pulse and blood pressure, regularly Sleep disturbances withdrawal is another problem faced by
checking the location and fixation of the intubation tube, patients.5,7,14,18 Tunçay et al. found that 60% of the
frequently cleaning the oral secretions, and by explaining intensive care patients had sleeping problems. 34 The
all procedures to the patient.27 common reasons were continuous illumination inside
ICUs, not being able to differentiate between day and
Pain is a cause of discomfort which is seen frequently in night, being subject to diagnosis, treatment, and care with
ICU and whose severity varies from person to person. frequent intervals, and interruption of sleep due to pain
Many studies show that that patients in intensive care and noise. The problems related with sleeping can be
experience pain due to various reasons. 28-32 Pain-related solved by planning nursing interventions in a way that
experiences of patients result from variety of reasons such would not disrupt patients’ sleep, performing as few
as drain tube, endotracheal tube, inserting and removing procedures as possible during night time, reducing the
the catheter, trauma, immobility for long time, routine noise sources –staff voices, alarms, telephones, etc. –
nursing care, aspiration, surgical attempts, changing the minimizing sounds, switching off the lights by bedsides
dressing, and existing diseases.33 Özdemir stated that after a certain hour at night, controlling the ambient
patients with pain have more positive experiences of the temperature, helping the patient relax, feel better, and have
intensive care period.21 Although this result seems to be a suitable position that facilitates sleeping, and the most
conflictive, the fact that patients who had pain got more important of all, trying to relieve pain or stressful
attention and their pain was tried to be eliminated might situations. Nightmares during sleep in intensive care are
cause to this result. What nurses can do to prevent the among bad experiences reported by patients. 6,7,14,20,23
pain are evaluating the location and severity of the pain as Nightmares are associated with lying under lights all the
well as the factors that increase/decrease the pain, making day, sedation, being at an unfamiliar place, not being able

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Patient experiences in intensive care units, Topçu et al.

to see the loved ones, and post-traumatic stress disorder.35 patients in the ICU. Intensive Crit Care Nurs. 2008; 24
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Limitations life. Crit Care. 2005; 9:R96-R109.
6. Samuelson KAM. Unpleasant and pleasant memories
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is the difficulty in generalizability of the results due to patients—Findings from 250 interviews. Intensive Crit
methodological differences (type of the study, question Care Nurs. 2011; 27 (2): 76—84.
forms, number of samples). Secondly, the explanations 7. Meriläinen M, Kyngäsb H, Ala-Kokkoa T. Patients’
regarding the sedation of patients and status of the interactions in an intensive care unit and their
patients connected to mechanical ventilator were not memories of intensive care: A mixed method study.
specified in some of the studies that were included into the Intensive Crit Care Nurs. 2013; 29 (2): 78—87.
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there may be some selection bias or insufficient report of following critical illness: a randomized controlled trial.
null findings. Crit Care. 2010, 14:R168.
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Conclusion synthesis of qualitative research on patient
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Table 2. Characteristics of Studies Included in Review

Study Type of Participants Time spent in Sedation Data collection Recalling Outcomes
study intensive care (discharge/tra the ICU n(%)
nsfer from the ) n(%)
1- Qualitative First >36 hours Patients 6 days- 6 weeks 27 (54) recall Recollection:
Granberg Meeting who were intensive ▪ Patients recall pain, discomfort, ventilator support
et. al. N= 31 not sedated care. times, ET (Endotracheal) tube, and waking up times
(1998) Second for a long Patient Experiences:
Meeting time ▪ The nurses who did not communicate much with
N= 19 them and practiced the procedures without any
Age 25- 82 explanations were evaluated as bad, while the nurses
who took continuous care of them, talked to them,
and treated them kindly were evaluated as good.
▪ Sleeping problems due to noise, uncomfortable beds,
and fear
▪ Disturbance due to the equipment (mask, central
catheter, SpO2 prob, nasogastric catheter)

2-Hunt Qualitative N=12 - - In the hospital, 12 (100) Patient Experiences:

(1999) Age 51- 86 after transfer recall pain ▪ Patients were focused on feeling the presence of the
from the ICU experience. nurse
▪ Verbal and non-verbal communication as well as
attention of nurses made patients feel better
▪ Some patients had communication problems because
of the IT
▪ Disturbance due to noise
▪ 4 patients recall having hallucinations
▪ 3 patients recall experiencing pain; however, all
patients expressed that nursing care helped ease their
pain
▪ Patients reported experiencing fear, distress, anxiety,
hallucination, and unexpected things.

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 Patient experiences in intensive care units, Topçu et al.

3-Rusell Mixed N= 298 >7 days - - 6 months after 71 (24) of the Recollection:
(1999) Age >18 being discharged patients recall ▪ 126 (42) reported recalling just a little, 71 (24)
from the ICU reported full recollection. 3 (8) did not have any
recollection.
Patient Experiences (n=217):
137 (63) felt the care of the health personnel, 29 (13) felt
the technological support, 13 (6) felt the visits of their
loved ones, 11 (5) felt the duration of the treatment, 11 (5)
were disturbed by the noise , 9 (4) felt the presence of
other patients, 3 (1,8) felt safe, 3 (1,2) felt fear.
Sad Experiences (n=61);
15 (24) recall having difficulty in communicating with the
nurse, 13 (21) recall lack of privacy, 10 (16) recall feeling
fear, 10 (16) recall having pain and discomfort during
treatment,8 (13) recall being stressed due to noise, 3 (5)
recall feeling lonely, 2 (3) recall not being respected.

4- Prospective N= 150 Patients who - After being 100 (66.6) of Recollection:

Rotondi cohort >18 were subject to transferred from the patients ▪ 50 (48.5)% do not remember the intensive care or IT
et study mechanical the ICU to recall. ▪ 112 (75) remember the intubation tube.
al.(2002) ventilator for service Patient Experiences:
at least 48 75 (78.1) reported having difficulty in speaking, 73 (76)
hours reported thirst, 49 (51) reported noise, 44 (45.4) reported
depression, 43 (44.3) reported feeling fearful, 43 (44.8)
remember being restrained, 41 (42.7) reported missing
their spouses and friends, 38 (40.0) reported feeling as if
something bad would happen, 38 (39.6) reported thoughts
of death, 37 (38.5) reported not being able to sleep
(insomnia), 37 (38.5) reported pain, 17 (17.7) reported
having nightmares, 10 (10.3) reported headaches.
5-Leur et Descriptive N= 125 2-133 days + In 3 days, after *Only the Patient Experiences:
al. (2004) Age >18 being transferred patients with 66 patients sources of discomfort; 27 (42) reported ailment
from the ICU recollection due to IT 21 (32) reported hallucination, 14 (9) reported
were noise, 12 (8) reported pain, 9 (6) reported thirst, 9 (6)
included. reported not being able to speak, 6 (4) reported feeling
fear.
In young patients experiencing physical discomfort due to
pain was in a positive relationship with discomfortability.

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Patient experiences in intensive care units, Topçu et al.

6- Prospective N= 67 3- 72 days + A week after, 187 (28.4) Patient Experiences:

Capuzzo study Age >18 and 3 months have clear They reported remembering noise, lights, faces, IT tube,
et.al. after being recollection. aspiration, darkness, nasogastric catheter, discomfort,
(2004) transferred from confusion, pain, hallucination, nightmares and dreams.
the ICU

7- Qualitative N= 6 > 2 days - 6 months after There are no Patient Experiences:

Adamson Age 57-83 being discharged patients with ▪ They reported remembering dreams and
et.al. from the full hallucinations, the nurses, noise, and the equipment
(2004) intensive care recollection. ▪ They reported not feeling pain or anxiety
▪ One patient recalls a nurse treating her/him very
kindly
▪ They reported there was no time orientation

8-Granja Prospective N= 464 An avr. of 4 - 6 months after 13 (3.1) of Recollection:

et al. study Age >18 days being discharged the patients ▪ 319 (77) remember the hospital
(2005) from the do not recall. Patient Experiences:
intensive care ▪ 189 (93) reported that intensive care atmosphere was
friendly and quiet, 62 (27) reported not getting enough
sleep, 98 (30) reported having nightmares,
▪ The activities on which the patients stated to have distress
were: 113 (81) aspiration, 127 (75) nasotracheal tube,
129 (71) worrying about the family, 121 (64) pain, 121
(64) immobility in bed, 114 (61) daily IV attempts, 111
(59) difficulty in communication, 93 (58) being
dependent on the ventilator, 90 (56) urinary catheter,
and 83 (54) noise and not being able to sleep at night.
9-Akıncı Descriptive N= 35 >24 hours + 24 hours after - Patient Experiences:
et al. Age >18 being transferred 35 (100) the feeling of something bad would happen, 31
(2007) from the (90) headache, 30 (89) fear, 30 (88) losing loved ones, 29
intensive care (87.5) nightmares, 29 (83) thirst, 28 (80) pain, 28 (81)
nervousness, 27 (78) feeling depressed, 26 (74) noise, 25
(71) distress, 24 (69) difficulty in swallowing

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 Patient experiences in intensive care units, Topçu et al.

10 Mixed n= 11 > 48 hours - 6-14 days after 17 (34) recall Recollection:

Hofhuis (Qualitative) being transferred ▪ 13 (26) reported no recollection while 19 (38) reported
et al. n= 50 from the recalling just a little
(2008) (Quantitative intensive care ▪ 19 (53) of the patients remember the intensive care as
) “pleasant”. 10 (28) as “unpleasant”, and 7 (19) as
Age 54- 82 “definitely not nice”.
Patient Experiences:
23 (46) reported pain, 20 (40) reported being disturbed by
the noise, 24 (48) reported sleeping problems
11.Wang Qualitative N= 11 48- 303 hours - 3-14 days after * The Patient Experiences:
et al. ( Age 33-78 being transferred patients with 1-Physical problems
2008) from the recollection ▪ Majority of the patients reported having pain during
intensive care were aspiration.
included. 2-Psychological problems
▪ Obscurity about the treatment and care
▪ Feeling despair, having hallucinations and nightmares,
▪ Fluctuations in the level of consciousness
▪ Depending on technology and the others for survival
▪ Anxiety after extubation
3-Self motivation
▪ Most of the patients had thought they would heal faster
with a positive attitude
▪ They reported that family support and visits were
effective for recovery
▪ Some patients reported that the keen approach of the
health personnel made them feel safe

12.Hintis Descriptive N= 52 1-6 days - - Intensive Recollection:

tan et al. Age 39-60 Care ▪ Patients were aware of the atmosphere
(2009) Awareness ▪ The score for recollection is low
levels are Patient Experiences:
above ▪ They had a high level of bad experiences
average ▪ Their satisfaction with the nursing is intermediate

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Patient experiences in intensive care units, Topçu et al.

13.Özde Descriptive N= 85 >4 days - - The scale Patient Experiences:

mir Age 22- 55 score of ▪ Score of the intensive care experience scale was: 46,1
(2010) recollection (min:19-max: 95)
of the ▪ Scale score of being aware of the environment was: 19,4
intensive care (min:6- max: 30)
is; 8,4 points ▪ Bad experiences of intensive care: 7,5
(min:4- max: 20)
(min: 4 - ▪ Score of the satisfaction with the nursing care in intensive
max: 20 care: 10,5 ( min:5-max: 25)
points) ▪ The intensive care experiences of patients with pain were
found to be more positive
▪ Patients with pain had a clearer recollection of their
intensive care experiences
▪ The intensive care experiences of women were found to be
more positive
14- Qualitative N= 250 >24 hours + 3-5 days after 203 (81) of Recollection:
Samuelso Age 49- 72 the ICU transfer the sample 178 (71) of the patients remember unpleasant experiences
n (2011) has 1- Unpleasant Experiences (n=178)
recollection 44 (25)% disturbing responses, 37 (21) noise, 33 (19) scary
dreams, 30 (17) not being able to communicate,28 (16)
uncertainty, 28 (16) unpleasant intensive care responses,
27 (15)% pain, 20 (11) fear and panic, 16 (9) bad
hallucinations,14 (8) disrespectful staff, 12 (7) anxiety, 12
(7) despair, 10 (6) unable to sleep, 9 (5) disturbing daily
procedures, 9 (5) fear of death.
2- Pleasant Experiences (n=147):
57 (39) nice personality, 30 (21) respect and empathy, 19
(13) comforting nurses, 17 (12) feeling safe, 13 (9) care
needs were met,10 (7) communication and explanations, 10
(7) hygiene.

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 Patient experiences in intensive care units, Topçu et al.

15- Mixed n= 4 An avr. of 13.5 + 3 and 6 months - Patient Experiences:

Meriläine days after the 1-Internal Experiences
n et al. ( Age 20-45 discharge of ▪ Feeling pain, cold, and thirst
2013) patient ▪ Not being able to distinguish between being asleep or
- awake
▪ Thinking that they would not be able to make it out of the
intensive care
2-External Experiences
▪ Nurse responses
▪ Remembering visits of the loved ones
▪ Remembering communicating with the nurse

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