title: The lived experience of a tracheostomy tube change: a phenomenological study.
abstract: OBJECTIVE
  To investigate the lived experience patients have of a tracheostomy tube change.
  
  
  BACKGROUND
  Few interpretive studies have looked at specific nursing interventions in relation to nursing practice. This study has investigated the lived experience of patients from an intensive care unit that have had a tracheostomy tube change. The tracheostomy is a significant intervention for many patients within critical care.
  
  
  METHODS
  Using a phenomenological approach, guided by the insights of Martin Heidegger and Max van Manen, participants were interviewed with their responses being transcribed into a text. This text has been subject to hermeneutic analysis using the theories of Paul Ricoeur. This hermeneutic approach has required using the text (discourse) as the focus of the interpretation.
  
  
  RESULTS
  The findings of this study imply that the experience of a tracheostomy tube change is more complex than that of simply a physical sensation. There is a need for participants to prepare themselves psychologically, a process that requires not only the trust of nursing staff but also the assessment by the participant that the nursing staff member has a level of competence to perform the task. The need for maintaining communication and the ability to speak were at times more significant for participants than even the risk of other airway complications.
  
  
  CONCLUSIONS
  This study has highlighted the potential for further interpretive studies into some of the more specific aspects of caring for patients that have been or are critically ill. The themes revealed will enable the nurse, required to change a tracheostomy tube, to do so with an improved level of empathy and understanding.
authors.affiliation: Department of Clinical Nursing, University of Adelaide, Adelaide, Australia. frank.donnelly@adelaide.edu.au
authors.forename: Frank
authors.initials: F
authors.lastname: Donnelly
authors.forename: Rick
authors.initials: R
authors.lastname: Wiechula
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D002983:Clinical Competence; D003144:Communication Barriers; D003422:Critical Care / Q000379:methods / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008960:Models, Psychological; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology; D010146:Pain / Q000209:etiology; D010687:Philosophy, Nursing; D036301:Qualitative Research; D012107:Research Design; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000009:adverse effects / Q000451:nursing / Q000523:psychology*; D035502:Trust