Feeling safe: the psychosocial needs of ICU patients.

PURPOSE To describe the psychosocial needs of critically ill patients, including descriptions of patients' experiences when these needs are not met, and behaviors of families, friends, and ICU staff that help or impede meeting these needs. DESIGN A qualitative research design was used. Participants were 45 adult critically ill patients in the medical or surgical ICU for a minimum of 3 days in a large, rural American tertiary care center. METHODS Data collection and analysis were conducted using methods of grounded theory, including theoretical sampling and the constant comparative process. Unstructured tape-recorded interviews were conducted with patients once they were stable in the ICU or immediately following their transfer to a general unit. Data were collected and analyzed simultaneously. This process continued until saturation was reached and a model of the psychosocial needs of ICU patients was developed. FINDINGS The overwhelming need of ICU patients was to feel safe. The perception of feeling safe was influenced by family and friends, ICU staff, religious beliefs, and feelings of knowing, regaining control, hoping, and trusting. CONCLUSIONS ICU patients in this study said that feeling safe was their overarching need. Patients described feelings of distress when they did not feel safe and stated how family, staff, and religion could both positively and negatively affect this feeling. Nurses can intervene in numerous areas to foster the feeling of safety in critically ill patients.