Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Pia Dreyer, Aarhus University, Denmark
- Second opponent: Professor Pål Klepstad, Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Researcher Berit Hofset Larsen, University of Oslo
Chair of the Defence
Professor emeritus Per Nortvedt, University of Oslo
Principal Supervisor
Dean and Professor Marit Kirkevold, Oslomet
Summary
Symptom distress is a major concern for patients in intensive care units (ICU), and common symptoms include pain, anxiety, dyspnoea, thirst, and tiredness. Symptoms are subjective experiences that cannot be monitored or measured objectively but must somehow be communicated by the patient. Communication in the ICU is challenged due to intubation, treatment, and illness, and challenges to communication cause challenges to symptom assessment and management.
The aim of this fieldwork study was to explore symptom communication between patients, family members, and clinicians in the ICU to identify communication challenges, patterns of symptom communication, and forms of family engagement.
Mechanically ventilated patients were observed in interaction with family and clinicians. Following participant observation, the same patients, and a sample of family members and clinicians were interviewed individually, providing a combination of perspectives not previously explored in research on symptom communication in the ICU.
This thesis shows how clinicians, through vigilance and behaviour, used clinical expertise to foresee possible symptoms, prevent and manage them when necessary, but it also shows when symptom communication failed to be successful. Family members took an active role in symptom communication, and patients described them as extremely important.
The serious condition of patients caused communication challenges beyond lack of speech, some of which were not evident until the findings from the participant observation and interviews with patients, family members, and clinicians were combined.
Due to the complexity of symptoms, assessment tools and task-oriented communication are insufficient to provide clinicians with the full symptom experience of patients, and patients are left with unrelieved symptoms.
Additional information
Contact the research support staff.