Grasping the nutritional situation: a grounded theory study of patients' experiences in intensive care.
OBJECTIVE
The aim of this study was to provide a theoretical understanding of nutritional experiences for patients with enteral nutrition (EN) during their stay in the intensive care unit (ICU).


BACKGROUND
It is well known that EN can result in underfeeding for patients in ICUs. How the patients experience their nutritional care during their stay in the ICU remains somewhat unclear.


METHODS
In this study, a grounded theory approach was chosen to conduct and analyse 14 interviews with patients and 21 observations of nutritional care during the patients' stay in an ICU.


RESULTS
The core category 'grasping nutrition during the recovery process' was reflected in, and related to, the categories 'facing nutritional changes', 'making sense of the nutritional situation' and 'being involved with nutritional care'. While grasping the nutrition, the patients were emotionally shifting between worry, fear and failure, and relief and hope. Turning points were having the appetite back, getting rid of the feeding tube and regaining a functioning gut.


CONCLUSIONS
The patients' views of nutritional care during their stay in the ICU may contribute to understanding of how patients make sense of their nutritional changes and how they are involved in their nutritional care. This study shows that grasping the nutrition can be a way to regain some control in a situation where the patients are highly dependent on professional care. Further research is needed to develop this substantive theory in other intensive care settings to support patients' nutritional journey in intensive care.


CONCLUSIONS
Nurses can promote patients' abilities to grasp their nutritional situation during their recovery process. There is a need to focus not only on the patients' physical needs but also on their emotional and social needs.
Persenius
Mona W
MW
Department of Nursing, Karlstad University, Karlstad, Sweden. mona.persenius@kau.se
Hall-Lord
Marie L
ML
Wilde-Larsson
Bodil
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015400:Clinical Nursing Research; D003422:Critical Care / Q000523:psychology*; D004750:Enteral Nutrition / Q000523:psychology*; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009742:Nursing Theory; D013894:Thirst