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Qualitative Health Research
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Cultural Changes in ICU Sedation Management

Ingrid Egerod

University of Copenhagen, Copenhagen, Denmark

The aim of this study was to explore physicians' views and perceptions of sedation, and offer a new approach to the understanding of issues of sedation. I used a qualitative, descriptive, and explorative multicenter design. Data were generated by seven key-informant interviews using a semistructured interview guide. One experienced doctor was selected at each of the seven largest intensive care units in Denmark. Interpretational analysis was performed by comprehensive overview, individual case analysis, cross-case analysis, and integrated thematic analysis and identification of emerging themes. The following themes emerged: a paradigm shift from sedated to more awake and comfortable patients, cultural changes toward intracollegial openness, increased interdisciplinary and staff/patient/family collaboration, patient and environmental normalization, and humanization. The study findings provide an understanding of contextual issues of sedation, safety, and comfort, and suggest that a cultural change in sedation strategies might reduce the duration of sedation and mechanical ventilation while containing cost and improving the well-being of the patients.

Key Words: care • critical • integrative therapies • interpretive methods • interviews • semistructured • medical/health care discourse • posttraumatic stress disorder (PTSD) • qualitative methods • general

Qualitative Health Research, Vol. 19, No. 5, 687-696 (2009)
DOI: 10.1177/1049732309334014
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