Zeilani, Ruqayya Sayed Ali
Experiencing intensive care: women's voices in Jordan.
PhD thesis, University of Nottingham.
This study explores women's experiences of critical illness in Jordanian intensive care units. A narrative approach was employed to access Jordanian women's stories of their critical illness and to study how these accounts changed during the period following their discharge from intensive care. The study was conducted in two hospitals in a major Jordanian city. A purposive sample of 16 women who had spent at least 48 hours in intensive care was recruited over a period of six months, with each woman taking part in between one and three interviews during the six month period. Two focus group discussions were also conducted with 13 ICU nurses drawn from the hospitals in which the women had been patients. These had the aim of encouraging discussion about the development of new supportive care strategies for critically ill women in Jordanian intensive care units.
The study findings revealed three main areas: the women's experiences of suffering and pain; their experience of body care; and the impact of the ICU experiences on their lives after discharge home. Experiences of suffering were pervaded with physical, emotional, social and temporal dimensions, interlinked with pain that was often severe, overwhelming, and disturbing to their sleep. The notion of 'nafsi' suffering was employed to describe emotional and social losses, such as loss of family support, which the women experienced. The notion of 'vicarious death' was used to explain the mortal fear women experienced in witnessing the death of others. Loss of body control, the unfamiliar ICU environment, and the sudden onset of illness made it difficult for the women to make sense of their experiences.
This study shows that cultural norms and religious beliefs shape the ways in which these Muslim women made sense of their bodies. An analysis of the concept of 'bodywork' is presented: the 'dependent body' captures the women's experiences of changes of their physical status, which meant that from being care providers, they became those in need of care. This involved the experience of a sense of paralysis or disablement, and a complete dependence on their family or nurses. The 'social body' describes the women's feelings and emotions toward their family members. The latter assisted in the care of the women's bodies, but distress, frustration and a sense of loneliness were experienced by the women as a result of the loss of verbal communication with their relatives. The 'cultural body' describes the effect of cultural norms and Islamic religious beliefs on the women's interpretation of their experiences, and the interpretation of male nursing care in the ICU. The 'mechanical body' describes the women's experiences of the ICU machines as extensions of their bodies, and the senses of limbo and ambiguity they encountered during their ICU stay.
The recovery period raised many physical, emotional, social, and spiritual issues, which in turn impacted on the women's experiences of their everyday lives. Weakness and tiredness accompanied with difficulties in eating and sleeping made some women feel frustrated and uncertain about their health. Some felt they were a burden upon their families. The meaning of the critical illness experiences were interpreted by some women as an opportunity to value family unity and neighbours' support. For other women, the illness experiences gave them lessons which strengthened their role as mothers and helped them to think positively about their future.
This study highlights the importance of considering the cultural and religious preferences among Muslim women in critical care settings. The study recommendations focus on the need to base nursing care on an understanding of the physical, emotional, social, and religious elements of suffering, by exploring the potential of a palliative care approach for nursing critically ill people.
Thesis (University of Nottingham only)
||intensive care, critical care, comprehensive care, patient memories, patient recollection, patient experiences, stress, ICU delirium, post traumatic stress disorder, relocation stress, women, women experiences, narrative, illness narrative, storytelling, story, supportive care, nursing care, reflexivity, reflective practice, Muslim, Muslim woman, Islam, Islam and death, Jordan, Jordanian woman
||W Medicine and related subjects (NLM Classification) > WX Hospitals and other health facilities
||UK Campuses > Faculty of Medicine and Health Sciences > School of Nursing
||27 Jun 2008
||28 Apr 2017 13:46
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