A trajectory towards partnership in care--Patient experiences of autonomy in intensive care: A qualitative study.
OBJECTIVE
The aim of this study was to describe and elucidate patient experiences of autonomy in an intensive care context from a caring perspective.


BACKGROUND
Patients in intensive care units (ICUs) are critically ill and in a dependent and vulnerable position. There is thus a risk of staff taking command not only of the patients' vital functions but also of their decision-making.


METHODS
A qualitative design was selected. Individual interviews were conducted with 11 adult patients with an intensive care episode of two days or more at six Swedish ICUs. The data were analysed using Inductive Content Analysis.


RESULTS
Patient autonomy in intensive care was shown to be 'A trajectory towards partnership in care depending on state of health and mutual understanding'. It was experienced through acknowledged dependence, being recognised as a person, invited participation and becoming a co-partner in care.


CONCLUSIONS
Patients in need of intensive care wanted to be involved in making decisions about their care as this creates a trusting and healthy care environment. Greater awareness is required about the ICU patient not only being a passive care recipient but also an active agent and where involvement in decision-making and participation in care are crucial.
Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden. Electronic address: catharina.lindberg@bth.se.
Catharina
C
Lindberg
Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
Bengt
B
Sivberg
Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; Department of Care Science, Malmö University, SE-205 06 Malmö, Sweden.
Ania
A
Willman
Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; Blekinge Centre of Competence, SE-371 81 Karlskrona, Sweden.
Cecilia
C
Fagerström
D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D003422:Critical Care; D064648:Critical Care Nursing; D003657:Decision Making; D005260:Female; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D026684:Personal Autonomy; D036301:Qualitative Research; D013548:Sweden; D035502:Trust
Caring; Content analysis; Intensive care; Interviews; Patient Autonomy; Qualitative research