Phenomenological Study on the Lived Experience of Patients After Major Cardiac Surgery in Intensive Care Units

Abstract

Background: Intensive care unit (ICU) experiences after cardiac surgery significantly influence patient outcomes, including psychological disorders, quality of life and overall comfort. The existing literature emphasises psychological impacts and transitions from ICU to general wards, but there is a paucity of qualitative research focussing specifically on post-cardiac surgery ICU experiences.

Aim: This study aimed to explore the lived experiences of patients in the ICU following major cardiac surgery, providing a comprehensive understanding of their emotional and psychological challenges.

Study design: Utilising Cohen's phenomenological approach, we conducted in-depth interviews with 20 patients from a cardiothoracic ICU in Southern Italy. Participants were chosen through purposive sampling. Data were analysed using thematic analysis to identify recurring themes.

Results: Five main themes emerged from the data: (1) 'Closing the eyes and not opening them', highlighting pervasive fear and anxiety; (2) 'Confusion upon awakening', marked by disoriented memories and the fear of not being able to breathe; (3) 'Time stood still', describing a distorted perception of time; (4) 'The closeness of my angels: the nurses', underscoring the critical role of nursing support; and (5) 'The other side: exclusion from care', reflecting feelings of marginalisation during the care process.

Conclusions: The study underscores the complex experiences of ICU patients' post-cardiac surgery, emphasising the need for psychological support and inclusive communication strategies to enhance patient outcomes. Further research should focus on developing tailored interventions to support these patients through their recovery process.

Relevance to clinical practice: There is a clear need for enhanced psychological support for patients before, during and after the ICU stay. Preoperative education programmes that set realistic expectations and provide coping strategies can significantly reduce anxiety and improve patient outcomes. Additionally, enhancing the role of nurses in offering emotional support and involving patients in care decisions can lead to a more positive ICU experience. Psychological interventions can optimise preoperative expectations and reduce hospital stays, offering significant cost-benefit advantages for healthcare systems.

Keywords: cardiac surgery; intensive care unit (ICU); nursing support; patient experience; psychological impact; qualitative research.