This study investigated associations among relationships, states of relatedness, comfort, and therapeutic physical activity in chronically critically ill (CCI) patients. The study framework, developed from Hagerty and colleagues’ Theory of Human Relatedness and Kolcaba’s Comfort Theory, emphasizes the centrality of relationships, states of relatedness, comfort as an holistic experience, and the health-seeking behavior of therapeutic physical activity.
This study used a convenience sample of 24 CCI adults admitted to a long-term acute care hospital. Participants completed the Visual Measure of Relatedness (VMR), the Chronic Critical Illness Comfort Questionnaire (CCICQ), and the Functional Independence MeasureTM (FIM) at two time points: upon enrollment and one month later. Six participants were randomly chosen to participate in a second part of the study, yielding Social Network Analysis (SNA) data using the Social Network Questionnaire and additional VMRs. Descriptive and correlational statistics were used to investigate associations among relationships, states of relatedness, comfort, and therapeutic physical activity. Relationships are described using graphical analysis and Pajek©-generated sociograms.
Results indicated most participants perceived a state of connectedness with important relationships despite lengthy illness periods, however there was a tendency towards disconnectedness over time. There was a statistically significant association between states of relatedness and holistic comfort at baseline and over time, but not between states of relatedness and therapeutic physical activity. Egocentric sociograms created from SNA data for relationships that participants identified as ‘important’ suggest that family and friends constitute the major portion of a CCI patient’s social network.
This study will advance nursing science and practice through new insights into relationships, comfort and physical functioning in the CCI. The instruments and methodology of the VMR and SNA are relatively new to clinical studies.