Patients' experience of thirst while being conscious and mechanically ventilated in the intensive care unit

Abstract

Background: Because of changes in sedation strategies, more patients in the intensive care unit (ICU) are conscious. Therefore, new and challenging tasks in nursing practice have emerged, which require a focus on the problems that patients experience. Thirst is one such major problem, arising because the mechanical ventilator prevents the patients from drinking when they have the urge to do so. To gain a deeper understanding of the patients' experiences and to contribute new knowledge in nursing care, this study focuses on the patients' experiences of thirst during mechanical ventilation (MV) while being conscious.

Aims: To explore patients' experience of thirst while being conscious and mechanically ventilated.

Design: This hermeneutic study used qualitative interviews of 12 patients.

Method: Data were analyzed based on content analysis. Interviews were conducted between September and October 2014 in two large ICUs in Denmark.

Result: Four themes relating to the patients' experiences of thirst during MV were identified: a paramount thirst, a different sense in the mouth, deprivation of the opportunity to quench thirst and difficulties associated with thirst.

Conclusion: Patients associate feelings of desperation, anxiety and powerlessness with the experience of thirst. These feelings have a negative impact on their psychological well-being. A strategy in the ICU that includes no sedation for critically ill patients in need of MV introduces new demands on the nurses who must care for patients who are struggling with thirst.

Relevance to clinical practice: This study shows that despite several practical attempts to relieve thirst, it remains a paramount problem for the patients. ICU nurses need to increase their focus on issues of thirst and dry mouth, which are two closely related issues for the patients. Communication may be a way to involve the patients, recognize and draw attention to their problem.

Keywords: Awake; Conscious; Content analysis; ICU; Intensive care nursing; Patient experience; Qualitative research; Thirst.