1
|
Delgado MEP, Pérez JJM, García-Moreno M, López CA, Cordón RDA, González-Salvador MT. Estudio descriptivo de un programa de soporte emocional para familiares de pacientes hospitalizados por COVID-19 en el Hospital Puerta de Hierro de Madrid. CLÍNICA CONTEMPORÁNEA 2022. [DOI: 10.5093/cc2022a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
2
|
de-la-Cueva-Ariza L, Delgado-Hito P, Martínez-Estalella G, Via-Clavero G, Lluch-Canut T, Romero-García M. Implementation of the evidence for the improvement of nursing care to the critical patient's family: a Participatory Action Research. BMC Health Serv Res 2018; 18:357. [PMID: 29747635 PMCID: PMC5946428 DOI: 10.1186/s12913-018-3177-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 05/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. However, there is no widespread application of such evidence in clinical practice. There has also been no analysis made of the evolution of patterns of knowing during the act of improving clinical practice. Therefore, the purpose of the study is to understand the change process aimed at improving care to critical patient's families, and to explore the evolution of patterns of knowing that nurses use in this process. METHODS Qualitative study with a Participatory Action Research method, in accordance with the Kemmis and McTaggart model. In this model, nurses can observe their practice, reflect upon it and compare it with scientific evidence, as well as define, deploy and evaluate improvement strategies adapted to the context. Simultaneously, the process of empowerment derived from the Participatory Action Research allows for the identification of patterns of knowing and their development over time. The research will take place in the Intensive Care Units of a tertiary hospital. The participants will be nurses who are part of the regular workforce of these units, with more than five years of experience in critical patients, and who are motivated to consider and critique their practice. Data collection will take place through participant observation, multi-level discussion group meetings and documentary analysis. A content analysis will be carried out, following a process of codification and categorisation, with the help of Nvivo10. The approval date and the beginning of the funding were December 2012 and 2013, respectively. DISCUSSION The definition, introduction and evaluation of care strategies for family members will allow for their real and immediate implementation in practice. The study of the patterns of knowing in the Participatory Action Research will be part of the theoretical and practical feedback process of a professional discipline. Also, the identification of the construction and evolution of knowledge will provide decision elements to managers and academics when choosing strategies for increased quality.
Collapse
Affiliation(s)
- Laura de-la-Cueva-Ariza
- Fundamental and Medical-Surgical Nursing Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain
| | - Pilar Delgado-Hito
- Fundamental and Medical-Surgical Nursing Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain.
| | - Gemma Martínez-Estalella
- Fundamental and Medical-Surgical Nursing Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain.,Hospital Clínic, Barcelona, Spain
| | - Gemma Via-Clavero
- Fundamental and Medical-Surgical Nursing Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain.,Intensive Care Unit. Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Teresa Lluch-Canut
- Public Health, Mental Health and MCH Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain
| | - Marta Romero-García
- Fundamental and Medical-Surgical Nursing Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Humanization in healthcare arises from the need for a holistic approach to illness. Med Intensiva 2017; 42:99-109. [PMID: 29132912 DOI: 10.1016/j.medin.2017.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/25/2017] [Accepted: 08/03/2017] [Indexed: 11/21/2022]
Abstract
Suffering is not only exclusive to patients or their relatives, but also to the health professionals, who feel to be at the center of the depersonalization process. Over-technification and the fact that the disease process is sometimes the only focal point of our activities, together with the ever-increasing influence of institutional power seen in recent times, all cause the health professional to be the first in demanding a change in health institution dynamics. Following initial reflection from one of the most technified medical specialties (Intensive Care Medicine), classically isolated from the rest of the Hospital and from the community, we implemented a project aimed at securing integration and empathy in our approach to patients and their relatives in the Intensive Care Unit (ICU) of Infanta Margarita Hospital. The project was designed to incorporate tools for working on the most important elements of a humanization plan, i.e., the patients, their relatives, the health professionals and the community, attempting to disclose the work done in the ICU over a period of 12 months. This project is referred to as the Project ICU Infanta Margarita: 1 year: 12 months for 12 commitments.
Collapse
|
4
|
[Satisfaction of relatives of the patients admitted to an intensive careunit: Perceptions of relatives and professionals]. ENFERMERIA INTENSIVA 2016; 25:164-72. [PMID: 25457698 DOI: 10.1016/j.enfi.2014.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 09/28/2014] [Accepted: 10/02/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To estimate the satisfaction of relatives of critical care patients with regard to the environment, relationship with professionals and visitation and compare it to the perception of professionals. METHODOLOGY A descriptive study in two phases. In the first phase validated telephone survey within 15 days of discharge to the relatives of the patients was performed. In the second phase, the same modified questionnaire was self-administered to the professionals. The same variables were studied in both populations. RESULTS We interviewed 78 family members and 44 professionals. 95% of professionals vs 67% of the families claimed not to know the name of the nurses (P < .001). Over 70% of professionals and families agreed that the visit protocol is correct and that the information was adequate income. 70% of professionals felt that the information received at admission is not understood by the family although 97% of households claimed to have understood themselves. Statistically significant differences were observed in relation to the location of the unit assessment, the waiting, the aspects of information and comfort, always being the professionals who felt greater dissatisfaction (P < .05). CONCLUSIONS The perceptions of relatives and professionals were mostly uneven, making it necessary to continue exploring the differences through qualitative and participatory methodologies.
Collapse
|
5
|
Analysis of needs of the critically ill relatives and critical care professional's opinion. Med Intensiva 2016; 40:527-540. [PMID: 27181387 DOI: 10.1016/j.medin.2016.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To describe the needs of the families of patients admitted to the Intensive Care Unit (ICU) and the opinion of ICU professionals on aspects related to the presence of patient relatives in the unit. DESIGN A prospective descriptive study was carried out between March and June 2015. SETTING Polyvalent ICU of León University Healthcare Complex (Spain). PARTICIPANTS Two samples of volunteers were studied: one comprising the relatives emotionally closest to the primarily non-surgical patients admitted to the Unit for over 48hours, and the other composed of ICU professionals with over three months of experience in the ICU. INTERVENTION One self-administered questionnaire was delivered to each relative and another to each professional. MAIN VARIABLES OF INTEREST Sociodemographic data were collected. The variables in the questionnaire for relatives comprised the information received, closeness to the patient, safety of care, the support received, and comfort. In turn, the questionnaire for professionals addressed empathy and professional relationship with the family, visiting policy, and the effect of the family upon the patient. RESULTS A total of 59% of the relatives (35/61) answered the questionnaire. Of these subjects, 91.4% understood the information received, though 49.6% received no information on nursing care. A total of 82.9% agreed with the visiting policy applied (95.2% were patient offspring; P<.05). Participation on the part of the professionals in turn reached 76.3% (61/80). A total of 59.3% would flexibilize the visiting policy, and 78.3% considered that the family afforded emotional support for the patient, with no destabilizing effect. On the other hand, 62.3% routinely informed the family, and 88% considered training in communication skills to be needed. CONCLUSIONS Information was adequate, though insufficient in relation to nursing care. The professionals pointed to the need for training in communication skills.
Collapse
|
6
|
Alonso-Ovies A, Álvarez J, Velayos C, García MM, Luengo MJ. [Expectations of relatives of critically ill patients regarding medical information. Qualitative research study]. ACTA ACUST UNITED AC 2014; 29:325-33. [PMID: 25534566 DOI: 10.1016/j.cali.2014.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 11/07/2014] [Accepted: 11/18/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine and analyse the expectations, needs and experiences of relatives of critically ill patients as regards medical information and the level of their understanding. To find keys for improving communication and to draw up best practices in clinical information. MATERIAL AND METHODS Qualitative research study through semi-structured interviews carried out in a polyvalent adult intensive care unit (ICU) in a University Hospital. PARTICIPANTS relatives of patients who were admitted to the ICU and who were discharged alive from the Unit. Ten interviews were performed taking into account diversification variables such as, type of family relationship with patients, patient age, length of ICU stay, origin, and location at the time of the interview. RESULTS The results of the analysis of 10 interviews focused on: the subjective position of the family in the ICU (the agonizing wait), what the ICU represents for the family (surveillance and monitoring of a situation between life and death), perceived care (complete delegation of care), and medical information (what and how they expect and what and how they receive it), as much in the first information (sincerity, hope, delicacy) as in the successive. CONCLUSIONS There is divergence between what families expect and what they get as regards medical information. To know the expectations of the families will help to provide higher quality care and more humane treatment in the ICU.
Collapse
Affiliation(s)
- A Alonso-Ovies
- Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
| | - J Álvarez
- Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - C Velayos
- Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - M M García
- Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - M J Luengo
- Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| |
Collapse
|
7
|
For an open-door, more comfortable and humane intensive care unit. It is time for change. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.medine.2014.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
8
|
Escudero D, Viña L, Calleja C. Por una UCI de puertas abiertas, más confortable y humana. Es tiempo de cambio. Med Intensiva 2014; 38:371-5. [DOI: 10.1016/j.medin.2014.01.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/14/2014] [Accepted: 01/20/2014] [Indexed: 11/25/2022]
|
9
|
de la Cueva Ariza L. [The reality of cares to the family of the critical patient in Spain: action must be taken now]. ENFERMERIA INTENSIVA 2012; 23:153-4. [PMID: 23140795 DOI: 10.1016/j.enfi.2012.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 10/18/2012] [Indexed: 11/19/2022]
|
10
|
Errasti-Ibarrondo B, Tricas-Sauras S. [Benefits of flexible visitation in the intensive care units for the family of critical patients]. ENFERMERIA INTENSIVA 2012; 23:179-88. [PMID: 23040835 DOI: 10.1016/j.enfi.2012.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 04/25/2012] [Accepted: 08/20/2012] [Indexed: 11/18/2022]
Abstract
AIM To identify, analyze and summarize the main effects that may be related to flexible visitation policies for the relatives of critically ill adults. METHOD A review of the literature was conducted in the following databases: PubMed, CINAHL, PsycINFO, Cochrane Library and CUIDEN. Thematic content analysis was used to evaluate selected articles. RESULTS Fifteen articles were included in this review. Four main themes emerged from the thematic content analysis. Themes included the main effects of flexible visitation policies for the family of the critical patients such as: improvement of satisfaction, reduction of anxiety and stress, satisfaction regarding their own family needs, and the role of the family in the patient's care. CONCLUSION According to the existing evidence, flexible visitation policies appear to be both beneficial and decisive. It seems to be necessary to favor the participation of the family in the care of the intensive patient as well as the acquisition of a more prominent role the visitation context and in their relationship with the patient.
Collapse
Affiliation(s)
- B Errasti-Ibarrondo
- Departamento de Enfermería de la Persona Adulta, Facultad de Enfermería, Universidad de Navarra, Pamplona, España.
| | | |
Collapse
|
11
|
Detección de necesidades de los familiares de pacientes ingresados en la Unidad de Ictus. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s2013-5246(12)70012-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
12
|
López Chacón MA, Pérez-Rejón MP, Cabrera EM, Rodríguez GT, Quispe Hoxas LC, Sánchez DM, Hidalgo Blanco MA. Efecto de un protocolo de acogida sobre la encuesta de satisfacción familiar en una unidad de cuidados intensivos. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s0212-5382(11)70289-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Pardavila Belio MI, Vivar CG. [Needs of the family in the intensive care units: a review of the literature]. ENFERMERIA INTENSIVA 2011; 23:51-67. [PMID: 21775182 DOI: 10.1016/j.enfi.2011.06.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 06/06/2011] [Indexed: 11/17/2022]
Abstract
UNLABELLED Admission to the Intensive Care Units (ICU) is perceived by both patients and their family as a stressful experience. This situation can cause shock, skepticism and anxiety in the patient's setting. OBJECTIVE To analyze and present the needs of the family members of the critical patient. METHODOLOGY A review was made of the literature in the following data bases: Pubmed, CINAHL, Cuiden and Cochrane Library. Furthermore, three journals specialized in Intensive Cares were reviewed. RESULTS After including the articles that met the screening criteria, 30 articles were finally selected. Of these, 11 were reviews of the literature, 7 qualitative studies and 12 more were quantitative investigations. Four groups of needs in the families were identified after the analysis of these articles, these being cognitive, emotional, social and practical. DISCUSSION One of the main needs of the family is to receive better information from the professionals followed by the need for closeness with the ill family member. This review proposes that, in order to cover these needs, the information should be protocolized and the visiting hours should be made flexible. Furthermore, incorporation of two familial evaluation tools, the genogram and ecomap, is proposed. CONCLUSIONS This work has revealed the importance of having the Intensive Care nurses identify the needs of the family during the admission of the patient in the ICU in order to be able to provide help, support and counseling care that relieves the suffering of the families.
Collapse
Affiliation(s)
- M I Pardavila Belio
- Departamento de Cuidados Intensivos, Clínica Universidad de Navarra, Facultad de Enfermería, Universidad de Navarra, España.
| | | |
Collapse
|
14
|
Via Clavero G, Sanjuán Naváis M, Martínez Mesas M, Pena Alfaro M, Utrilla Antolín C, Zarragoikoetxea Jáuregui I. [Identity of gender and intensive care: influence of masculinity and femininity in the perception of nursing care]. ENFERMERIA INTENSIVA 2010; 21:104-12. [PMID: 20688266 DOI: 10.1016/j.enfi.2009.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 11/04/2009] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Nursing has essentially been the work of women. The increase in men incorporating into nursing makes us think about whether there are different ways of expressing and practicing a profession in relationship to gender. OBJECTIVE To describe if there are different ways of perceiving and assessing ICU work from a gender perspective. METHODOLOGY A qualitative phenomenological study. SAMPLE 6 male nurses and 6 female nurses from the ICU of the Hospital Universitario de Bellvitge (HUB). DATA COLLECTION In-depth semi-constructed interview. Content analysis. RESULTS Male nurses describe ICU work in terms of autonomy in making decisions and professional competence. They claim responsibility for their identity as nurses and stress the low social recognition of the profession. They prioritize the responsibility of decision making over the final outcome and evaluate family satisfaction in terms of prestige and competence. They are more practical. Female nurses describe the work in terms of control and follow-up of the patient's evolution. They emphasize the final care outcome and evaluate satisfaction in terms of a relationship of confidence and warm patient care. They are more meticulous. CONCLUSIONS There are differences in how they classify their ICU work, in the self-evaluation of professional identity, behavior in the development of the nursing care and in perception of family satisfaction. No differences are observed regarding problem solving with the technology.
Collapse
Affiliation(s)
- G Via Clavero
- Unidad de Cuidados Intensivos, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
| | | | | | | | | | | |
Collapse
|
15
|
Abstract
OBJECTIVES To identify the needs of the family of admitted patients in the Critical Care Unit (CCU), and their level of satisfaction with the attention that they received. DESIGN Cross-sectional, observational study. SETTING Critical Care Unit, Virgen Macarena University Hospital, Seville. SUBJECTS OF THE STUDY: Two-hundred and sixty-eight families were selected through a random sampling system. INSTRUMENTS A survey was developed using bibliography as reference. RESULTS According to information, it was observed that receiving information after visiting hours and its access was difficult in regards to unforeseen changes in the patient's course. On the other hand, there were high levels of satisfactions with the attention received and with the nursing cares. Nevertheless, several deficiencies were observed in the identification of all the professionals, the visiting hours, the physical conditions of the waiting room, and privacy within patient's care environment. CONCLUSIONS One of the principal needs of the relatives was to spend more time with the patients. Regarding to the information, access after visiting hours, and on that regarding unforeseen changes in the patient's evolution should be reviewed. Regarding satisfaction, in general, families were highly satisfied with the attention received, especially with the nurse's care. Nevertheless, these professionals should encourage the participation of the families in the patient's care. Moreover, all the areas of improvement observed should be dealt with urgently, mainly the visiting hours.
Collapse
|