title: Making sense of it: intensive care patients' phenomenological accounts of story construction.
abstract: BACKGROUND
  Patients entering intensive care encounter physical and psychological stress that may lead to psychological morbidity such as depression, anxiety and post-traumatic stress. It has been suggested that constructing a story may assist psychological recovery. However, this has been minimally investigated in intensive care patients.
  
  
  OBJECTIVE
  The aim of this article is to examine the process of story construction in people's phenomenological accounts of being a patient in the technological environment of intensive care.
  
  
  METHODS
  The study design was informed by Heideggerian phenomenology.
  
  
  METHODS
  Semi-structured interviews were conducted with 19 patients who had been in intensive care for at least 4 days. Interviews were digitally recorded, transcribed and analysed utilizing Van Manen's framework for thematic analysis.
  
  
  RESULTS
  Making sense of their experiences in an intensive care unit appeared to be fundamental to story construction. Themes that arose were 'why am I here?', 'filling in the gaps', 'sorting the real from the unreal' and 'searching for familiarity'. These themes describe how participants sought temporal and causal coherence in order to construct their integrated and understandable story. Families appeared to play a critical role in helping participants fill in the gaps, sorting the real from the unreal and their subsequent psychological recovery.
  
  
  CONCLUSIONS
  The importance of early support from health care professionals to facilitate patients' story construction is highlighted. The study also emphasizes the role families play in supporting patients while they make sense of their experiences and the associated psychological recovery process. Further research to evaluate methods of facilitating story construction, such as nurse-led debriefing and patient diaries, is recommended. In addition, an investigation of families' perceptions of their role in assisting patients construct their story may facilitate the development of strategies by health care professionals to effectively support families in their role.
authors.affiliation: Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straw Lane, Oxford, UK.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Stayt
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Seers
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Tutton
mesh_terms: D001007:Anxiety; D020811:Biomedical Technology; D003422:Critical Care / Q000523:psychology*; D003863:Depression; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D033262:Narration; D036301:Qualitative Research; D013315:Stress, Psychological / Q000523:psychology
keywords: Intensive care; Patient stories; Qualitative research