in other studies also highlights a concern with recall. The
interviews were conducted very soon after patients were
discharged from critical care. This not only reinforces the
primacy of the critical care stay for the researchers, as
described above, but also a concern with the facts of
the experience as recalled by the informant rather than
the experience and its meaning for the individual in the
context of the whole illness-recovery trajectory. Two phenomenological
studies (Jablonski, 1994; Papathanassoglou and
Patiraki, 2003) that were interested in personal meaning as
a way of understanding rather than accurate recall, interviewed
patients 2—108 and 12—24 months after discharge
respectively. This clearly represents a longer-term view, but
one that is limited by the paucity of research. Storli et al.
(2008) conducted interviews with patients 10 years after discharge
from ICU since they were specifically interested in
living with long term memories.
Understanding an experience in terms of meaning does
not rely upon a factually accurate recall of the situation
(Madjar and Walton, 1999); for example, the exact time and
sequence of events, who said exactly what and how things
are laid out in the clinical environment. Even if, as humans
we share ways in which we derive meaning, it is argued here
that personal meaning is not objective or rational but is contextual
and individual (Benner and Wrubel, 1989; Heidegger,
1927; Van Manen, 1990).
These implicit themes highlight that there is clearly scope
in future research for deepening and expanding what is
known about the way people understand their experiences
through the personal meaning it has for them.
Conclusion
This paper has outlined a critical review and synthesis of
the qualitative research literature that explores first hand
experiences of critical illness. The aim was to describe the
common themes associated with the experience of critical
illness and consider how these inform patients understanding.
Some patients clearly have significant recall of their critical
illness and stay in the ICU. Common themes amongst
these recalled experiences have been distilled in this review.
However, analysis of the research has highlighted, through
more implicit themes, the way patients understand their
experiences through its personal meaning for them. This
signposts a way and frames a research focus to develop this
area of knowledge about critical illness in the future.
Exploring the whole illness recovery trajectory, including
those who have had a significant length of stay in ICU, and
allowing time for recovery and reflection before interviewing
patients are argued here as the important next steps in
this area of research.