MAKING SENSE OF IT - A NEURO-INTERACTIONAL MODEL OF MEANING EMERGENCEIN CRITICALLY ILL VENTILATED PATIENTS

Emphasis on meaning underpins a current thrust of knowledge developmen t in nursing, especially in the client domain. Examination of meaning in the interactional context and through varying levels of consciousne ss has not been examined. initially, an integrated model was developed deductively from philosophical, theoretical and research-oriented sou rces, This model was meant as a guide to begin examining how patients with varying levels of consciousness make sense of their intensive car e unit experience. Over a 10-month period of fieldwork, this author ob served patients twice daily through their intensive care unit stay to capture the nature and content of thinking processes. The resulting ne uro-interactional model describes patients' thinking processes and sco pe of meaning as a function of levels of consciousness as well as fact ors which affect thinking and meaning. Theory, research and practice i mplications are presented.