Post-Extubation Recall of Thirst During Mechanical Ventilation Among Intensive Care Unit Patients: A Conventional Content Analysis.

BACKGROUND AND AIM: In ICU patients, particularly after extubation, thirst is a common and troubling symptom. Although earlier research has focused mainly on quantifying thirst severity and its clinical correlates, less is known about the subjective experiences of patients, including their emotional responses, sense of helplessness, help-seeking actions, and the challenges they face in obtaining relief within the ICU. Therefore, this study aimed to examine how post-extubation ICU patients experience thirst and the strategies they use to manage or alleviate it.

METHODS AND MATERIALS: Between January and August 2024, this qualitative research was carried out in Tehran, Iran, using conventional content analysis. Participants were recruited through purposive sampling, and data were collected via semi-structured interviews conducted in Persian with 20 patients admitted to the intensive care unit (ICU) following extubation. Interviews proceeded until data saturation occurred, and even though they were held after extubation, the thirst experiences participants reported mostly pertained to the time of mechanical ventilation and intubation. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was followed in this study.

RESULTS: Three main categories were identified in this study: 'Unrelieved Thirst' (Hope despite Disappointment and Cognitive and Emotional Burden of Thirst), 'Seeking Relief' (Spiritual Coping and Endurance and Non-Verbal Pleading for Water), and 'Emotional Collapse and Withdrawal' (Resigned Withdrawal and Emotional Isolation and Perceived Neglect). Participants experienced persistent thoughts about water, employed spiritual coping strategies, used gestures without words to express thirst, and eventually emotionally withdrew when their needs were persistently ignored.

CONCLUSION: The study revealed that post-extubation thirst is experienced as a deeply upsetting phenomenon affecting physical, psychological, and existential levels, where patients face physical discomfort, emotional distress, challenges in communication, and a sense of being overlooked in the ICU.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings highlight the urgent necessity for systematic thirst assessment, improved non-verbal communication techniques, and compassionate, patient-focused nursing care to reduce thirst-related distress. Healthcare providers must be trained to identify both verbal and non-verbal thirst signals and to incorporate patients' cultural and spiritual resources into supportive care.

IMPACT: The research delivers a comprehensive understanding of the multifaceted nature of thirst in ICU patients, demonstrating that unresolved thirst may result in emotional collapse and withdrawal. It highlights the significance of managing thirst as an essential human requirement in critical care.

REPORTING METHOD: The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.