From powerlessness to striving for control - experiences of invasive treatment while awake.
OBJECTIVE
To describe patients' experiences of being cared for during invasive monitoring and treatment while awake.


BACKGROUND
Patients with acute heart failure treated in cardiac intensive care are awake during invasive monitoring and treatment and forced to remain in bed rest, sometimes for several days.


METHODS
Exploratory qualitative design.


METHODS
Eight patients were interviewed during invasive treatment. Analyses were conducted according to qualitative content analysis.


RESULTS
The participants described their way from a sense of powerlessness and striving to regain control when undergoing invasive monitoring and treatment. Due to their severe illness, they were exposed to the treatment implying a forced loss of empowerment. They surrendered to hospital care. To feel hope and resting from the illness helped the participants to endure the situation. When their condition improved, the need to regain control increased and they wanted to influence their daily care. The participants in present study did not desire to participate in decisions about the medical treatment, but wanted comprehensible information.


CONCLUSIONS
This study shows how the patients' illness forced them to surrender to the staff's knowledge and treatment. As the patients became more aware, it was important that the healthcare staff did not take over decisions and functions the patients could manage themselves. This helped the patients to endure.


CONCLUSIONS
The result of present study could provide guidance for healthcare staff working with the patients cared for using invasive monitoring and treatment while they are awake. If staff has an increased insight of how the patients' condition affects their ability to be involved, they have better understanding of the patients' individual needs. Thus, the staff easier can respond to where the patients are in the process of powerlessness and striving to regain control.
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.|Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Johanna
J
Wermström
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.|Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eva
E
Ryrlén
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.|Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Åsa B
ÅB
Axelsson
D000556:Ambulatory Surgical Procedures / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology*; D010361:Patients / Q000706:statistics & numerical data*; D036301:Qualitative Research; D013548:Sweden
cardiac intensive care; empowerment; heart failure; invasive monitoring; invasive treatment; patient experience