RESUMEN
BACKGROUND: The physiological state of critically ill patients is severely impaired by illness or trauma and is uncomfortable. Such experiences cause long-term anxiety and post-traumatic stress disorder. OBJECTIVE: This study aimed to understand discomfort and comfort based on the experiences of critically ill adult patients in the intensive care unit and to explore ways to improve their comfort. METHODS: This qualitative descriptive study was conducted with 15 critically ill patients (age range: 46-81 years; six females) in the intensive care unit using semistructured interviews and participant observation. The data collected were analysed using Braun and Clarke's thematic analysis. Data were collected from the intensive care unit and general ward of a university hospital in Japan. FINDINGS: Six themes related to discomfort and comfort were identified. The three themes related to discomfort were "overlapping uncertainties", "being unable to control physical discomfort", and "having to endure psychologically and situationally". The three themes related to comfort were "feeling connected brings calm", "routine care relieves pain and thirst", and "ease when one can decide for oneself". Participants' discomfort involved physical and psychological factors and was related to treatments, procedures, care, and the environment. Moreover, more than half of the patients endured unmet needs. Comfort was brought about by providing routine care for physical discomforts that critically ill patients often experience, feeling alive and connected to others and encouraging independence. CONCLUSION: Recognising the potential for physical and psychological discomfort, as well as communication and other difficulties, in critically ill patients is crucial. Patients may also experience discomfort when healthcare providers take the lead, which underscores the importance of involving patients in their care. By showing respect for patients' intentions and involving them in decision-making, healthcare providers can improve patient comfort and promote a more collaborative approach to care.
RESUMEN
AIM: The purpose of this study was to clarify the thoughts and attitudes of patients with type 1 diabetes during disasters. METHODS: We conducted a qualitative descriptive study. The participants were 10 adult patients with type 1 diabetes who were selected through purposeful sampling. None of them had experienced a disaster. Data were collected through semi-structured interviews. Thematic analysis was used to analyze the data. RESULTS: Type 1 diabetes patients described a variety of thoughts and attitudes regarding disaster and preparedness. Based on their experiences, 528 codes were extracted. The codes were categorized based on their patterns and similarities. Then, 11 sub-themes and three main themes were identified. The three main themes were (a) "being unprepared since one could not relate to disasters"; (b) "managing well with insulin and food"; and (c) "hiding the fact that one has diabetes." CONCLUSIONS: This study identified three important characteristics of the thoughts and attitudes of patients with type 1 diabetes toward disasters. These provide perspectives for education in pre-disaster preparation and support when disasters occur. Patients with type 1 diabetes are aware of the importance of insulin, food adjustment, and self-management on a daily basis. Therefore, it is necessary to educate them so that they can apply their knowledge in times of disaster. In addition, healthcare providers who provide support in times of disaster need to be aware that there are victims who cannot talk readily about their illness.