The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study.

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dc.cclicenceCC-BY-NCen
dc.contributor.authorCoombs, Maureen A.en
dc.contributor.authorde Vries, Kayen
dc.contributor.authorHales, C.en
dc.date.acceptance2017-02-28en
dc.date.accessioned2018-11-06T10:44:09Z
dc.date.available2018-11-06T10:44:09Z
dc.date.issued2017-03-18
dc.descriptionThe file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.en
dc.description.abstractBackground: Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges. However little is known about the care of these patients in intensive care. Objective: To explore medical and nursing practices and attitudes in intensive care when caring for critically ill morbidly obese patients. Methods: A focused ethnographic approach was adopted. Participant observation of care practices and interviews with intensive care doctors and nurses were undertaken over a four month period. Qualitative analysis was conducted using constant comparison. Setting: An 18 bedded tertiary intensive care unit in New Zealand. Participants: Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40 kg/m2. Findings: Morbidly obese patients present significant physical and language challenges for intensive care practice. The physical shape of morbidly obese patients did not appropriately fit the different equipment used. Staff used specific knowledge of the patient’s body size and shape to adapt care practices and keep patients safe and comfortable. There were also specific language challenges where staff expressed concern about what words were most appropriate to use to describe body mass when in the presence of morbidly obese patients. Conclusions: Bariatric care pathways need to be developed that use more suitable body measurements to inform the use of bariatric equipment. Intensive care staff need to engage in debate about what is acceptable, respectful, and appropriate language in the delivery of bariatric patient care.en
dc.exception.ref2021codes254aen
dc.funderN/Aen
dc.identifier.citationHales, C., Coombs, M. and de Vries, K. (2018) The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study. Australian Critical Care, 31(1), pp.37–41.en
dc.identifier.doihttps://doi.org/10.1016/j.aucc.2017.02.070
dc.identifier.issn1036-7314
dc.identifier.urihttp://eprints.brighton.ac.uk/17030/
dc.identifier.urihttp://hdl.handle.net/2086/17065
dc.language.isoenen
dc.peerreviewedYesen
dc.projectidN/Aen
dc.publisherElsevieren
dc.researchinstituteInstitute of Health, Health Policy and Social Careen
dc.subjectBariatricen
dc.subjectFocused ethnographyen
dc.subjectIntensive care uniten
dc.subjectMorbidly obeseen
dc.subjectCritical Care Medicineen
dc.subjectCritical Care Nursingen
dc.subjectObesityen
dc.titleThe challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study.en
dc.typeArticleen

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