title: The experiences of rural and remote families involved in an inter-hospital transfer to a tertiary ICU: a hermeneutic study.
abstract: BACKGROUND
  Inter-hospital transfers are necessary for critically ill patients to improve their chance of survival. Rural and remote families experience significant disruption to family life when critically ill patients are required to undergo a transfer to a tertiary hospital. What is not known is how ICU staff can assist these families who are involved in an inter-hospital transfer to a tertiary ICU.
  
  
  OBJECTIVE
  To gain an understanding of rural and remote critical care families' experiences during an inter-hospital transfer to a tertiary ICU.
  
  
  METHODS
  A hermeneutic phenomenological approach was adopted informed by the philosophical world views of Heidegger and Gadamer. Data collection occurred by in-depth conversational interviews from a purposeful sample of seven family members. Interview transcripts, field notes and diary entries formed the text which underwent hermeneutic analysis.
  
  
  RESULTS
  Being confused, being engaged, being vulnerable and being resilient emerged as significant aspects of the rural and remote family members' experience during a transfer event.
  
  
  CONCLUSIONS
  A better understanding of the experiences of rural and remote families during an inter-hospital transfer journey can inform the practice of ICU nurses. This study highlights the specific experiences of rural and remote families during an inter-hospital transfer journey to a tertiary ICU. It also informs nurses of the meaningful ways in which they can support these families with the uncertainty and chaos experienced as part of this journey.
authors.affiliation: Institute for Resilient Regions, University of Southern Queensland and Griffith University School of Nursing and Midwifery, QLD 4350, Australia. Electronic address: Benjamin.Mackie@usq.edu.au.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Mackie
authors.affiliation: Centre for Health Practice Innovation, Griffith University, School of Nursing & Midwifery, QLD 4111, Australia.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kellett
authors.affiliation: Princess Alexandra Hospital and NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Brisbane, QLD, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Mitchell
authors.affiliation: Intensive Care Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, QLD 4102, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Tonge
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D005190:Family / Q000523:psychology*; D005260:Female; D066297:Hermeneutics; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D011368:Professional-Family Relations; D011793:Queensland; D012424:Rural Population
keywords: Critical care; Critically ill; Families; Hermeneutic phenomenology; Intensive care; Inter-hospital transfer; Relatives; Rural and remote areas