On May 16, Sven-Tore Dreyer Fredriksen will defend his DrPH thesis The enigmatic knowledge of intensive care patients which aims to increase knowledge about what it is like to be critically ill and how experience-based knowledge is of significance to teaching in an intensive care context.
“The knowledge I am highlighting stands in contrast to scientific knowledge,”, says Sven-Tore Dreyer Fredriksen, who himself is an intensive care nurse Associate Professor at Harstad University College, Norway, since 1998.
The severe stress patients experience during a critical illness is worsened by nurses not being able to catch and manage the patients’ own possibilities to master the situation.
“The existential situation characterized by marginalization is often one that could be handled better by the patient, if the patient is seen and supported,” continues Dreyer Fredriksen.
The first three sub-studies of the thesis cover patients giving accounts of stress related to body, space and relationship, about the experience of body, power and movement during a critical stage of the illness and about the physical experience of time spent with relatives.
”The findings show that the body is affected by disrupted sleep, pain, anxiety and loss of control over both body and situation,” says Dreyer Fredriksen.
A sense of “stress related to space” arises by the room becoming a mirror of the situation, representing life but also the fear of dying. The patient’s horizontal position causes disempowerment. Stress is often related to contexts of observation and treatment. Stress in the intensive care unit affects relationships, at the expense of a sense of safety and hope among others.
Intensive care patients experience disempowerment and limitations to movement, which has an impact on the dependence on others, causing conflict.
”The patient handles the situation by mobilizing his or her family, at the same time as another way of protecting oneself can be to exclude oneself from family matters. The struggle for survival can also be managed by the use of gallows humour and the cry for help,” continues Dreyer Fredriksen.
The fourth sub-study covers how knowledge is conveyed in the situation, by the intensive care unit nurse.
“The knowledge intensive care unit personnel subsequently convey to students is also different from the experience of the patients, and must therefore be seen as an important supplementary factor in public health work,” asserts Sven-Tore Dreyer Fredriksen.
Thesis Title: The enigmatic knowledge of intensive care patients – experience and interpretation based knowledge in intensive care tutoring (Intensivpasientens gåtefulle kunnskap – om erfart kunnskap og kunnskapsformidling i en intensivkontekst)