OAR@UM Community:

Life after intensive care : identity, recovery, and the evolving needs of post-ICU patients

2026-04-09T09:00:08Z

Title: Life after intensive care : identity, recovery, and the evolving needs of post-ICU patients Abstract: Objectives: This study aimed to explore how former Intensive Care Unit (ICU) patients interpreted their critical care experiences and how these influenced their evolving identity, emotional recovery, and reintegration into everyday life following discharge. Research Design: A qualitative research design was employed, using narrative inquiry (NI) as its methodological framework. The study was underpinned by Clandinin and Connelly’s three-dimensional narrative structure: temporality, sociality, and spatiality. Identity Theory (IT) provided a framework to understand how participants’ sense of self changed after ICU. Narrative inquiry and Identity Theory guided both data collection and interpretation. Settings: The study was conducted within the community setting in Malta. All interviews took place after the participants had returned home from their ICU stay. Participants: Six former ICU patients who had spent a minimum of four days in intensive care were recruited through purposive and snowball sampling. All participants had been discharged home, fluent in Maltese or English and able to reflect on their experience. Methods: Data were collected through semi-structured, in-depth interviews conducted in Maltese. The interviews were transcribed, translated, and analysed thematically using Braun and Clarke’s approach. Results: 1) Emotional and Psychological Struggles, including vivid memories and coping strategies like faith and inner strength; 2) Interpersonal Support and Recovery, highlighting the role of family and continuity of care in emotional healing and validating survivors’ experiences; 3) Transformations through Survival, reflecting changes in self-perception, priorities, and identity, with a renewed sense of purpose. Discussion: The study highlights that ICU recovery extends beyond physical healing. Survivors undergo a complex emotional and identity reconstruction process, influenced by both personal resilience and the quality of support received. Recommendations: Post-ICU care should adopt trauma-informed, identity-sensitive, and person-centred approaches. Structured follow-up, family engagement, and opportunities for narrative expression may enhance long-term recovery. Further research is recommended to explore gendered identity shifts and relational aspects of survivorship. Description: M.Sc.(Melit.)

Mapping emergency medical calls : a retrospective spatiotemporal analysis of ambulance calls in Malta

2026-04-09T08:56:49Z

Title: Mapping emergency medical calls : a retrospective spatiotemporal analysis of ambulance calls in Malta Abstract: Background: Emergency medical services (EMS) represent a critical component of Malta’s healthcare system, yet little research has examined the spatial and temporal dynamics of ambulance demand. Understanding when, where, and under what conditions emergency calls occur is essential to improving operational efficiency, equitable service coverage, and data driven resource allocation. Objectives: This study aimed to analyse the spatiotemporal and environmental patterns of emergency ambulance calls in Malta between 2022 and 2024. Specifically, it sought to (1) identify spatial and temporal trends in EMS demand, (2) explore their interaction across geographic and temporal dimensions, and (3) assess the relationship between ambulance call volumes and daily maximum temperature. Design and Methods: A retrospective, observational, and quantitative design was employed. Anonymised ambulance dispatch data were obtained from the national Computer-Aided Dispatch (CAD) system and processed into a dataset of 132,500 unique calls. Descriptive and inferential statistics were performed using SPSS, while spatial and spatiotemporal mapping were conducted in ArcGIS Pro. Correlations with environmental variables were tested using Pearson’s r. Participants: All emergency ambulance calls originating from mainland Malta between 1 January 2022 and 31 December 2024 were included. Calls with incomplete locality data or representing outbound inter-facility transfers were excluded. Results: Ambulance demand increased by approximately 22% across the study period, with consistent mid-morning peaks (around 10:00am) and dual seasonal surges in summer (July– August) and winter (December). Spatially, the Northern Harbour and Southern Harbour districts accounted for over half of all calls. A moderate, statistically significant correlation was found between daily maximum temperature and call volume (r = 0.297, p < 0.001). Conclusions: Ambulance demand in Malta is shaped by identifiable spatial, temporal, and environmental patterns. These findings provide a foundation for predictive modelling, targeted resource allocation, and evidence-based EMS planning in small-island health systems. Description: M.Sc.(Melit.)

The perceptions of ITU nurses on organ donation

2026-04-01T08:40:08Z

Title: The perceptions of ITU nurses on organ donation Abstract: Background: Organ Donation occurs when an individual consents to donate their healthy organ/s for transplantation into a recipient with compromised, failing, or dysfunctional organs. Donation after Brain Death, which is one out of the three types of organ donation, typically occurs in an ITU setting and ITU nurses are generally involved in all the processes related to this procedure. Aim: To explore the perceptions of ITU nurses working in a Local General Hospital in Malta regarding the process of organ donation. Methodology and Design: This study adopted a qualitative approach based on in-depth semi-structured interviews, drawing upon the principles of Grounded Theory. Setting: The study took place in an ITU setting within a General Hospital in Malta. Participants: Eight nurses working in the ITU setting were selected using a mixture of purposive and theoretical sampling. Participants had to be nurses working in the ITU and fluent in Maltese and/or English. Methods: Data was collected by semi-structured interviews which were transcribed verbatim. This study used analytical procedures that are in line with grounded theory methods involving coding and constant comparison of data which lead to the development of a theory about the ITU nurse’s perceptions on organ donation. Results: ITU nurses were found to have a central role in the organ donation process. As part of their role, they are involved in supporting relatives emotionally and in their decision-making regarding donating the organs of their loved one. It also involved preserving patient’s organs for donation while respecting their dignity. Various factors were found to influence ITU nurses’ roles. This included the hospital system and cultural factors. Nurses perceived their role at varied levels of difficulty and were all generally affected emotionally by the organ donation process. Conclusion: ITU nurses are centrally important in the process of organ donation and their role is complex and multifaceted. In this respect, they require support from the system within which they work. This, together with other factors are likely to influence the effectiveness and efficiency of the organ donation process Description: M.Sc.(Melit.)

LGBTIQ+ persons’ perception of cultural competence and cultural sensitivity in Maltese in-patient care

2026-04-01T08:15:09Z

Title: LGBTIQ+ persons’ perception of cultural competence and cultural sensitivity in Maltese in-patient care Abstract: Background: Malta has advanced LGBTIQ+ rights through progressive legislation, yet inclusive healthcare is not assured. Evidence shows that LGBTIQ+ patients still face stigma, discrimination, and reduced access in hospital settings. Nurses play a crucial role in shaping these experiences, but limited cultural competence and inadequate training can compromise trust and care quality. Objectives: The study explores how LGBTIQ+ individuals experience hospitalisation in Malta. It aims to explore the perceived extent to which (i) nursing care is culturally sensitive; (ii) the structural environment of the health care premises promotes cultural inclusivity; (iii) the local healthcare systems and policies are culturally competent. It also aims to (iv) identify facilitators and barriers to culturally competent care in relation to the local LGBTIQ+ community needs. Methodology: A phenomenological exploratory design employed semi-structured interviews to capture the lived experiences of ten LGBTIQ+ persons hospitalised in Malta, recruited through an intermediary and interviewed between December 2024 and January 2025. The analytic process integrated reflexive thematic approaches to preserve both the individuality of participants’ testimonies and the identification of cross-case meanings. Ethical approval was obtained from the University Research Ethics Committee. Results: Participants highlighted many respectful, supportive interactions while also noting areas for improvement. Findings indicate strong foundations for inclusive care, with clear opportunities to enhance consistency across services. Key barriers included subtle heteronormative assumptions, occasional lack of confidence in discussing sexuality or gender identity, and uneven knowledge of gender-affirming care. Differences in communication styles, documentation practices, and structural supports also contributed to variation in how inclusivity was experienced. Despite these challenges, participants’ experiences show meaningful progress and a strong platform for continued growth in culturally competent, person-centred care. Conclusion: The study recommends embedding cultural competence for LGBTIQ+ patients into healthcare systems rather than relying on individual goodwill. This requires sustained professional education, explicit policy reform, and organisational commitment to inclusive practices and environments. These actions are essential to ensuring more dignified, equitable, and responsive nursing care. Description: M.Sc.(Melit.)