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“Please mind the gap”: A secondary analysis of discomfort and comfort in intensive care

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  • Helene Berntzen
  • Ida Torunn Bjørk
  • Ann‐Marie Storsveen
  • Hilde Wøien

Abstract

Aims and objectives To explore in depth discomfort in intensive care as experienced by patients and attended to by critical care nurses. Background Discomfort in illness is complex and persistent, and its alleviation is a challenge for nurses working in intensive care units (ICU). In previous studies, we showed that ICU patients described little actual pain but suffer from much discomfort. Critical care nurses had a systematic approach to the treatment of pain, but were more haphazard in dealing with other types of discomfort. Design Secondary qualitative analysis of data from two previous exploratory studies. Methods Content analysis was used on existing data from 28 interviews with ICU patients, and 16 field notes and interviews with critical care nurses. Kolcaba's Comfort Theory was applied for further analysis. The COREQ checklist was used. Results Three themes, “Being deprived of a functioning body”, “Being deprived of a functioning mind” and “Being deprived of integrity” characterised the discomfort experienced by ICU patients. The nurses appeared to attend to all areas of discomfort expressed by patients. In need of, and providing acknowledgment and alleviation became a common overarching theme. We identified a comfort gap caused by the discrepancy between the patients’ needs and the nurses’ achievements in fulfilling these needs. Conclusions A gap exists between ICU patients’ comfort needs and nurses’ achievements in fulfilling these, indicating that discomfort currently is an inevitable part of the critical illness trajectory. Increased knowledge about how the brain is affected in ICU patients and more systematic approaches to assessing comfort needs and enhancing comfort may support nurses in fulfilling patient needs and possibly diminish the existing comfort gap. Relevance for clinical practice An increased understanding of the complex experience of discomfort in ICU patients may bring about more systematic approaches to enhance comfort and direct for education and further research.

Suggested Citation

  • Helene Berntzen & Ida Torunn Bjørk & Ann‐Marie Storsveen & Hilde Wøien, 2020. "“Please mind the gap”: A secondary analysis of discomfort and comfort in intensive care," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2441-2454, July.
    • Handle: RePEc:wly:jocnur:v:29:y:2020:i:13-14:p:2441-2454
    DOI: 10.1111/jocn.15260
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    References listed on IDEAS

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    1. Helle Svenningsen & Ingrid Egerod & Pia Dreyer, 2016. "Strange and scary memories of the intensive care unit: a qualitative, longitudinal study inspired by Ricoeur's interpretation theory," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(19-20), pages 2807-2815, October.
    2. Paul T E Cusack, 2020. "On Pain," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 31(3), pages 24253-24254, October.
    3. Helene Berntzen & Ida Torunn Bjørk & Hilde Wøien, 2018. "“Pain relieved, but still struggling”—Critically ill patients experiences of pain and other discomforts during analgosedation," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 223-234, January.
    4. Ilme Aro & Anna‐Maija Pietilä & Katri Vehviläinen‐Julkunen, 2012. "Needs of adult patients in intensive care units of Estonian hospitals: a questionnaire survey," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(13-14), pages 1847-1858, July.
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