Date of Award

Summer 1978

Document Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

The chronically ill individual experiencing an exacerbation of his illness was studied through an analysis of data kept on two patients who were defined as experiencing a long term intensive care unit (ICU) stay. Stressors experienced in the ICU were identified and categorized and illness-coping behaviors were identified as related to the stressors. Nursing strategies related to the stressors were proposed. Data were collected qualitatively using the process recording. A total of thirty-three recordings were collected. Each recording averaged fifty-five minutes in length. The researcher acted as a participant observer. A total of 135 stressors were identified. The stimuli were separated into three major categories: 1) environmental - the five senses and other patients; 2) staff interactions; and 3) patient - internal. and external. The greatest number of stimuli were in the patient category - external (forty-six) and internal (forty--four). Identified illness-coping behaviors were categorized as anxiety, depression, helplessness, denial, and hopelessness in the order of frequency exhibited. No orderly sequence of behaviors was found. Instead, all five behaviors were evenly dispersed throughout the ICU stay. Specific nursing strategies related to the experienced stressors were suggested. These strategies were developed from the researcher's past experience and study on nursing strategies as well as from established nursing practices in the literature. The goal of the strategies was to reestablish patient control in a situation where coping is difficult and patient control almost nonexistent. the significance of patient control was discussed and questions for further study proposed.

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