Exploring the Unique Challenges of ICU‐To‐Ward Transitions for Patients and Families: A Meta‐Synthesis of Qualitative Research

批判性评价 定性研究 护理部 重症监护室 心理干预 医学 焦虑 脆弱性(计算) 心理学 重症监护 精神科 重症监护医学 替代医学 社会学 病理 计算机科学 计算机安全 社会科学
作者
Junru Zhang,Hongting Zhou,Weijing Sui,Zhuang Yiyu,Li Wang
出处
期刊:Journal of Advanced Nursing [Wiley]
标识
DOI:10.1111/jan.16848
摘要

The transition from the intensive care unit to the general ward is complex. Understanding patients' and families' experiences during this period is essential for optimising nursing care. Explore the experiences of patients and families during the transition from the intensive care unit to the general ward. A qualitative meta-synthesis integrated and interpreted studies on intensive care unit patients' and families' experiences during transitions to general wards, involving systematic searches, appraisal, and integration analysis. PubMed, Web of Science, Embase, EBSCO, CNKI, Wanfang, and VIP databases were searched using subject and free-text strategies, covering inception to July 2024. Inclusion criteria included qualitative studies in English and Chinese that fit the study topic. Two researchers independently reviewed 42 full-text articles, of which 26 met the criteria. Quality appraisal used the JBI qualitative research assessment tool, and data were synthesised by the pooled integration method. Three key themes emerged from the analysis: (1) emotional duality of hope and anxiety before transfer, (2) heightened vulnerability and disorientation during ICU-to-ward transition, and (3) unmet needs. These themes were further divided into nine subcategories. Transitions from intensive care units to general wards present patients and families with mixed emotions and challenges in adaptation. Continuity of care, family engagement, and tailored health education are vital to supporting patient recovery and family well-being. Assessing patient and family anxiety during ICU transitions and using evidence-based interventions to manage emotions can improve recovery and reduce complications. The healthcare team should prioritise early intensive care unit rehabilitation to prevent functional decline, particularly in lower-intensity ward care. Identify patient and family needs when designing transition interventions. Use personalised, targeted health education tailored to different patient and family characteristics to enhance effectiveness across varied healthcare settings. This is a meta- synthesis without direct patient involvement.
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