Experiencing Care in the <scp>ICU</scp> After Brain Injury: A Hermeneutic Phenomenology of Nurses and Families

BACKGROUND: The quality of care provided to patients with traumatic brain injury (TBI) plays a critical role in their recovery and overall outcomes. Care provision for patients with TBI is a multifaceted and complex process. The lived experience of nurses and families has been less explored in depth. Therefore, the present qualitative study aimed to unravel, describe and explain the underlying phenomena. AIM: To explore how nurses and families experience and interpret the quality of care provided to patients with TBI in intensive care settings. STUDY DESIGN: A hermeneutic phenomenological approach based on Van Manen's framework was employed. Twenty-eight intensive care unit (ICU) nurses and family members participated in this study. Data were collected through field notes and in-depth, semi-structured interviews. Data analysis was performed simultaneously with data collection in MAXQDA. FINDINGS: The findings suggest that the quality of care for patients with TBI is dynamic, multifaceted and context-dependent. Data analysis led to the extraction of the main theme as 'ethical, high-quality care in a challenging context', with three categories: challenges in care management, ethical care and satisfaction with care. CONCLUSIONS: The results showed that although there are different challenges in providing care for patients with TBI, with an ethical, patient- and family-centred care approach, the quality and satisfaction with care provision can significantly improve. For future research, we suggest conducting action research to find solutions to the existing challenges in care provision for patients with TBI. RELEVANCE TO CLINICAL PRACTICE: The present findings can help intensive care nurses gain a deeper understanding of challenges in care provision for patients with brain injury. Additionally, these insights may support families in developing a more informed and realistic understanding of ICU care.