The Lived Experience of Adult Patients on Mechanical Ventilation: An Interpretative Phenomenological Analysis

BACKGROUND: Mechanical ventilation (MV) is a frequently used lifesaving treatment in intensive care units (ICUs); yet, earlier research suggests that it may expose patients to unpleasant physiological and psychological stressors. While international literature characterises MV as distressing, limited research has explored these experiences within the specific sociocultural context of Maltese and Mediterranean ICUs. AIMS: To explore the lived experience of adults who received MV during an ICU stay and how they made sense of this unique experience. STUDY DESIGN: A qualitative approach was adopted utilising Interpretative Phenomenological Analysis (IPA). Purposive, homogeneous sampling was used to recruit adults (n = 7) who were invasively ventilated for at least 4 days in a general ICU at a public hospital in Malta. Data collection took place in 2023 through semi-structured interviews and continued until sufficient idiographic depth was achieved. Data analysis was guided by the stages of IPA to identify shared patterns across participants while adhering to idiographic principles. FINDINGS: Four Group Experiential Themes emerged: (1) delivered into the hands of others, representing the transition to a state of profound vulnerability, voicelessness and dependence; (2) living in a disconnected world, involving a psychological detachment from reality characterised by vivid hallucinations and terrifying nightmares; (3) an agonising experience, encompassing both physical pain and a long-term emotional burden after discharge; and (4) Supportive encounters, highlighting the role of healthcare worker dedication, family networks and spirituality as vital mediators of suffering. CONCLUSION: Patients may perceive MV as a disorienting journey defined by a loss of autonomy and identity. The psychological impact of delusions often lingers long after discharge, which underscores the necessity of humanising critical care and providing compassionate interventions. RELEVANCE TO CLINICAL PRACTICE: The findings highlight the need for tailored communication strategies and the integration of spiritual care as a core component of the care for mechanically ventilated patients. Environmental adjustments, ICU diaries, flexible visiting hours and non-pharmacological interventions like music therapy should be prioritised to facilitate holistic recovery and reduce the risk of post-intensive care syndrome.