Exploring the Unique Challenges of ICU-To-Ward Transitions for Patients and Families: A Meta-Synthesis of Qualitative Research

Background

The transition from the intensive care unit to the general ward is complex. Understanding patients' and families' experiences during this period is essential for optimising nursing care.

Aim

Explore the experiences of patients and families during the transition from the intensive care unit to the general ward.

Design

A qualitative meta-synthesis integrated and interpreted studies on intensive care unit patients' and families' experiences during transitions to general wards, involving systematic searches, appraisal, and integration analysis.

Data Sources

PubMed, Web of Science, Embase, EBSCO, CNKI, Wanfang, and VIP databases were searched using subject and free-text strategies, covering inception to July 2024.

Review Methods

Inclusion criteria included qualitative studies in English and Chinese that fit the study topic. Two researchers independently reviewed 42 full-text articles, of which 26 met the criteria. Quality appraisal used the JBI qualitative research assessment tool, and data were synthesised by the pooled integration method.

Results

Three key themes emerged from the analysis: (1) emotional duality of hope and anxiety before transfer, (2) heightened vulnerability and disorientation during ICU-to-ward transition, and (3) unmet needs. These themes were further divided into nine subcategories.

Conclusions

Transitions from intensive care units to general wards present patients and families with mixed emotions and challenges in adaptation. Continuity of care, family engagement, and tailored health education are vital to supporting patient recovery and family well-being.

Impact

• Assessing patient and family anxiety during ICU transitions and using evidence-based interventions to manage emotions can improve recovery and reduce complications.
• The healthcare team should prioritise early intensive care unit rehabilitation to prevent functional decline, particularly in lower-intensity ward care.
• Identify patient and family needs when designing transition interventions.
• Use personalised, targeted health education tailored to different patient and family characteristics to enhance effectiveness across varied healthcare settings.

No Patient or Public Contribution

This is a meta- synthesis without direct patient involvement.