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Original Article

Role Adaptation Processes of Family Caregivers with Patients Transferred from Intensive Care Unit to General Ward: Becoming almost a Nurse with Hope and Fear

Heui-Kyeong Kwon1, Misoon Song2
Korean Journal of Adult Nursing 2014;26(6):603-613.
Published online: December 31, 2014

1Seoul National University Hospital, Seoul

2College of Nursing·The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Song, Misoon College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-740-8826, Fax: +82-2-765-4103, E-mail: msong@snu.ac.kr
• Received: September 1, 2014   • Accepted: December 2, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to explore and identify the role adaptation processes of family caregivers with patients transferred from intensive care unit to general ward.
  • Methods
    Using a grounded theory methodology, in-depth individual interviews were conducted. Data were collected from 11 participants. The participants were asked about their experiences of role adaptation considering situational contexts and interactional strategies. Transcribed data and field notes were analyzed using constant comparative analysis.
  • Results
    The core category was ‘becoming almost a nurse with hope and fear.’ The identified phenomena by the participants were the joy of being alive, having hope for a full recovery, anxiety and fear of uncertain future, feeling burdensome on a given role. The results included both role adaptation and maladaptation of caregivers.
  • Conclusion
    The role adaptation processes of family caregiver with patients transferred from intensive care unit to general ward can be explained as becoming almost a nurse with hope and fear. The findings of the study provided fundamental information for developing programs to support the given family caregivers for successful role adaptation.
  • Key Words: Intensive care units; Transfer; Family caregivers; Role; Qualitative research
Figure 1.
Role adaptation processes of patient's family caregiver transferred from intensive care unit to a general ward.
kjan-26-603f1.jpg
Table 1.
Dimensions, Categories and Sub-categories of the Experiences of Role Adaptation Processes of the Participants
Dimensions Categories Sub-categories
Phenomena Joy of alive and hope for a full recovery Joy of alive
Hope for a full recovery
Anxiety and fear of an uncertain future Anxiety about an uncertain patient's condition
Fear of transfer
Burden of a given role Stress for role in the future
Pressure for new role
Context Awareness of transfer Perceptions for recovery
Awareness of transfer plan
Experiences of the past transferred Experiences of the past in the general ward
Experiences of intensive care unit readmission
Information about role of caregiver in the general ward Information about environment of general ward
Information about goods required
Interactional strategies Becoming 'almost a nurse' Experiencing the caring role
Walking on eggshells
Asking for supports
Coping with feelings Sharing patient's feelings
Ventilation of emotions
Controlling over minds
Interventional conditions Internal conditions Types of thinking and behavior
Socio-economic status
Beliefs for family duty
Attitudes toward family care for women
External conditions Patient's conditions
Family support
Healthcare provider support
Results Role adaptation of caregiver Feeling familiar
Feeling supported
Being in control
Preparation for discharge
Role maladaptation of caregiver Feeling unfamiliar
Blame around people
Losing control
Fear of discharge
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  • 2.Kohlenberger C, Sprung C, Danis M, Armstrong C, Baily M, Chalfin D, et al. Consensus statement on the triage of critically ill patients. Journal of the American Medical Association. 1994;271(15):1200-3.
  • 3.Chick N, Meleis AI. Transitions: a nursing concern. School of Nursing Departmental Papers. 1986;9.
  • 4.Chaboyer W, James H, Kendall M. Transitional care after the intensive care unit: current trends and future directions. Critical Care Nurse. 2005;25(3):16-28.
  • 5.Cullinane JP, Plowright CI. Patients' and relatives' experiences of transfer from intensive care unit to wards. Nursing in Critical Care. 2013;18(6):289-96. http://dx.doi.org/10.1111/nicc.12047.
  • 6.Chaboyer W, Kendall E, Kendall M, Foster M. Transfer out of intensive care: a qualitative exploration of patient and family perceptions. Australian Critical Care. 2005;18(4):138-45.
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  • 8.Bouvé LR, Rozmus CL, Giordano P. Preparing parents for their child's transfer from the PICU to the pediatric floor. Applied Nursing Research. 1999;12(3):114-20.
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  • 10.Chaboyer W, Thalib L, Alcorn K, Foster M. The effect of an ICU liaison nurse on patients and family's anxiety prior to transfer to the ward: an intervention study. Intensive and Critical Care Nursing. 2007;23(6):362-9.
  • 11.Son YJ. Development and effects. Journal of Korean Clinical Nursing Research. 2009;15(3):143-55.
  • 12.Kim KH, Hong JS. A comparative study on attitudes toward family in Korea and Japan. Family and Culture. 2013;25(3):186-213.
  • 13.Corbin J, Strauss ABasics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed.. London, UK: Sage Publications; 2008. p. 1-400.
  • 14.Sandelowski M. The problem of rigor in qualitative research. Advances n Nursing Science. 1986;8:27-37.
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    Role Adaptation Processes of Family Caregivers with Patients Transferred from Intensive Care Unit to General Ward: Becoming almost a Nurse with Hope and Fear
    Korean J Adult Nurs. 2014;26(6):603-613.   Published online December 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.6.603
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    • Citation for the content below
    Role Adaptation Processes of Family Caregivers with Patients Transferred from Intensive Care Unit to General Ward: Becoming almost a Nurse with Hope and Fear
    Korean J Adult Nurs. 2014;26(6):603-613.   Published online December 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.6.603
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    Role Adaptation Processes of Family Caregivers with Patients Transferred from Intensive Care Unit to General Ward: Becoming almost a Nurse with Hope and Fear
    Image
    Figure 1. Role adaptation processes of patient's family caregiver transferred from intensive care unit to a general ward.

    Figure 1.

    Role Adaptation Processes of Family Caregivers with Patients Transferred from Intensive Care Unit to General Ward: Becoming almost a Nurse with Hope and Fear

    Dimensions, Categories and Sub-categories of the Experiences of Role Adaptation Processes of the Participants

    Dimensions Categories Sub-categories
    Phenomena Joy of alive and hope for a full recovery Joy of alive
    Hope for a full recovery
    Anxiety and fear of an uncertain future Anxiety about an uncertain patient's condition
    Fear of transfer
    Burden of a given role Stress for role in the future
    Pressure for new role
    Context Awareness of transfer Perceptions for recovery
    Awareness of transfer plan
    Experiences of the past transferred Experiences of the past in the general ward
    Experiences of intensive care unit readmission
    Information about role of caregiver in the general ward Information about environment of general ward
    Information about goods required
    Interactional strategies Becoming 'almost a nurse' Experiencing the caring role
    Walking on eggshells
    Asking for supports
    Coping with feelings Sharing patient's feelings
    Ventilation of emotions
    Controlling over minds
    Interventional conditions Internal conditions Types of thinking and behavior
    Socio-economic status
    Beliefs for family duty
    Attitudes toward family care for women
    External conditions Patient's conditions
    Family support
    Healthcare provider support
    Results Role adaptation of caregiver Feeling familiar
    Feeling supported
    Being in control
    Preparation for discharge
    Role maladaptation of caregiver Feeling unfamiliar
    Blame around people
    Losing control
    Fear of discharge
    Table 1. Dimensions, Categories and Sub-categories of the Experiences of Role Adaptation Processes of the Participants

    Table 1.

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