182 M. Ha¨ ggstro¨m et al. transfer anxiety or relocation stress are used for the psychological and physical problems that transfer- ring causes for the patient (McKinney & Deeny, 2002). This stress may be exacerbated following transfer to a general ward. The anxiety is a common problem for patients and relatives, and both pre- and post-discharge are critical areas (Coyle, 2001). In the critical care environment, patients are often not able to express and communicate their own will either because of their present sedation or altered mental status. Hence, their relatives often find themselves in a stressful situation in an unfamiliar environment. The length of a patient’s stay in the ICU varies and can be from less than 24 h to a stay as long as several months (Watts, Gardner, & Pierson, 2005). Earlier research indicated that ward nurses feel that caring for recently discharged patients from the ICU is stressful (Hall-Smith, Ball & Coakley, 1997). It is important that all healthcare profes- sionals involved in the care of critically ill patients recognize the benefits of discharge planning for patients and their families (Coyle, 2001). The topic is an issue for medical research as well as for nursing research (Ball, 2005). Earlier studies often aim to study the relocation stress in the transfer, and therefore, this study aims to obtain a deeper under- standing of the main concerns in the ICU transi- tional process as experienced by nurses in intensive care units and general wards in Sweden. We strive to illuminate how nurses handle the process and to identify problems during the process. This study is a part of a larger project that endeavours to illuminate the process called ICU transitional care with a grounded-theory approach. Aim Method The aim of this study was to obtain a deeper understanding of the main concerns in the ICU transitional process as experienced by nurses in intensive care units and general wards in Sweden. Grounded theory (GT), specifically the Glaserian version of GT, was selected as suitable in this qualitative study of the main concerns in the ICU transitional process as experienced by nurses in intensive care units and general wards in Sweden (Glaser & Strauss, 1967). This version of GT, the classical version, seems to be ontologically closely positioned to positivism, which claims that only one real reality exists. According to Hallberg (2006), although Glaser never explicitly expresses this thought, he seems to assume an objective reality and a neutral researcher who discovers data in an objective way. Participants and procedure The participants have been open sampled, meaning that we sought a maximum variation of experiences in the group in order to obtain descriptions from contrasting milieus and backgrounds (Hallberg, 2006). To acquire this sort of heterogeneity in the group, different groups of nurses involved in ICU transitional care have been recruited. The nurses were recruited in three ICUs and five general wards in two different hospitals in Sweden. One hospital was located in the middle of Sweden, with around 3000 employees. The other hospital was located in the capital of Sweden, with around 4000 employees. The ICUs and wards specialized in surgical, medi- cal, or general fields. Data was collected between February 2008 and October 2008. The total num- bers of informants were 35 Swedish nurses, of which five were male and 30 female. The data was collected from focus groups and individual interviews for variation and heterogeneity in the data (see Table I). In a focus group interview, every group should have a purpose, its specific focus. Focus groups can be a useful methodology when investigating people’s attitudes and motives (Wibeck, 2000). In order to include the individual nurse’s experience of ICU transitional care, seven individual interviews were added to the study. The interviews were conducted at the respondents’ workplaces. The nurse in charge selected the respondents by asking nurses if they had interest in the study and following up with those who answered affirmatively. Written information about Table I. Overview of informants and interviews in chronological order. 1 2 3 4 5 6 7 Interview Focus group Focus group Focus group Focus group Focus group Focus group Individual 8 Individual 9 Individual 10 Individual 11 Individual 12a Individual 13a Individual Informants recruited from Intensive care unit Intensive care unit Intensive care unit A medical ward A surgical ward A medical ward Intensive care/ surgical ward A surgical ward A surgical ward A surgical ward Intensive care unit Intensive care unit Intensive care unit aTheoretical saturation fulfilled. Years of experience as RN 10 25 10 20 11 24 0.5 25 3 15 3.5 33 20 25 17 16 7 10 (as ICU nurse) 14