Patients' Experiences of Discomfort in the ICU Following Open-Heart Surgery.

PURPOSE: The purpose of this study was to gain a better understanding of patients' experiences with discomfort in the intensive care unit following open-heart surgery. DESIGN: A qualitative descriptive design was used to give participants an opportunity to express their experiences of discomfort in their own words. METHODS: Following institutional review board approval, participants were consented. Semi-structured interviews were conducted in cardiovascular step-down units. Participants were asked to reflect on their intensive care unit experiences. Thematic analysis occurred simultaneously with data collection. RESULTS: Five themes emerged from participant interviews: Pain, Feeling Safe and Cared for, Physical Discomfort, Psychological Discomfort, and Expectations. Various factors both mitigated and exacerbated participants' pain, which was generally described as severe. Participants' experiences of discomfort were impacted by expectations from previous surgical encounters. Nursing care impacted participants' experiences of pain, physical discomfort, and psychological discomfort. Participants expressed that nurses' caring behaviors created feelings of safety and comfort. CONCLUSIONS: This study highlights that intensive care unit discomfort following open-heart surgery extends beyond pain to include sleep disturbance, device-related discomfort, confusion, and loss of dignity. Participant expectations and nursing care both influenced experiences of discomfort. Understanding discomfort from the patient's perspective can guide improvements in care and minimize the psychological effects of critical illness. CLINICAL IMPLICATIONS: Findings support targeted nursing interventions including assessment of nonpain discomfort, preservation of dignity, and education on what to expect to reduce distress and improve patient experiences.