The family in the intensive care unit in the face of a situational crisis.

OBJECTIVE: to explore the experience of family members of a relative hospitalised in the Intensive Care Unit and recognise their emotions and needs and describe the phases or milestones they go through and the strategies they use to cope with the situations that arise. METHOD: Qualitative study developed under the grounded theory method proposed by Anselm Strauss and Juliet Corbin. During the period from July 2017 to July 2019, semi-structured interviews were conducted with 26 relatives of hospitalised patients in fifteen third-level private clinics in the city of Manizales and Medellín, Colombia. In the latter, 200 h of participant observation were performed in ICUs of two private third-level clinics. The analysis procedure consisted of a microanalysis of the data and the process of open, axial, and selective coding of the information was continued. RESULTS: We identified that the experience of relatives when they accompany their sick relative in the Intensive Care Unit is represented in two categories: family disorganisation which is characterised by generating a change and mismatch in family dynamics and, family reorganisation in which a restoration of order is sought to cope with the situation. CONCLUSIONS: The family in the Intensive Care Unit develops a situational crisis characterised by intense, varied, and negative emotions and needs that wear down the relatives. Faced with this, family members undertake a reorganisation process to restore the order of family dynamics to cope with the situation and overcome difficulties.

La familia en la unidad de cuidados intensivos frente a una crisis situacional / The family in the intensive care unit in the face of a situational crisis

Objetivo:Explorar cómo vive una familia la experiencia de tener un pariente hospitalizado en la unidad de cuidados intensivos (UCI) y reconocer sus emociones y necesidades, describir las fases o momentos por los que pasan y las estrategias que utilizan para hacerle frente a las situaciones que se les presentan.Método:Estudio cualitativo desarrollado bajo el método de la teoría fundamentada propuesta por Anselm Strauss y Juliet Corbin. Durante el periodo de julio de 2017 a julio del 2019 se realizaron entrevistas semiestructuradas a 26 familiares de pacientes hospitalizados en 15 clínicas privadas de tercer nivel de la ciudad de Manizales y Medellín, Colombia. En esta última se realizó 200h de observación participante en la UCI de 2 clínicas privadas de tercer nivel. El procedimiento de análisis consistió en un microanálisis de los datos, y se continuó con el proceso de codificación abierta, axial y selectiva de la información.Resultados:Se identificó que la experiencia de los familiares cuando acompañan a su pariente enfermo en la UCI se representa en 2 categorías: 1) Desorganización familiar (como una crisis situacional): implica un cambio y un desajuste de la dinámica familiar, y 2) Reorganización familiar en la que se busca un restablecimiento del orden para hacerle frente a la situación.Conclusiones:La familia en la UCI desarrolla una crisis situacional caracterizada por emociones y necesidades intensas, variadas y negativas que desgastan a los familiares. Frente a esto, los familiares emprenden un proceso de reorganización para restablecer el orden de la dinámica familiar para hacerle frente a la situación y superar las dificultades.

Objective:To explore the experience of family members of a relative hospitalized in the intensive care unit and recognize their emotions and needs and describe the phases or milestones they go through and the strategies they use to cope with the situations that arise.Method:Qualitative study developed under the grounded theory method proposed by Anselm Strauss and Juliet Corbin. During the period from July 2017 to July 2019, semi-structured interviews were conducted with 26 relatives of hospitalized patients in fifteen third-level private clinics in the city of Manizales and Medellín, Colombia. In the latter, 200 hours of participant observation were performed in ICUs of two private third-level clinics. The analysis procedure consisted of a microanalysis of the data and the process of open, axial, and selective coding of the information was continued.Results:We identified that the experience of relatives when they accompany their sick relative in the intensive care unit is represented in two categories: family disorganization which is characterized by generating a change and mismatch in family dynamics and, family reorganization in which a restoration of order is sought to cope with the situation.Conclusions:The family in the intensive care unit develops a situational crisis characterized by intense, varied, and negative emotions and needs that wear down the relatives. Faced with this, family members undertake a reorganization process to restore the order of family dynamics to cope with the situation and overcome difficulties.

The family in the intensive care unit in the face of a situational crisis. / La familia en la unidad de cuidados intensivos frente a una crisis situacional.

OBJECTIVE: To explore the experience of family members of a relative hospitalized in the intensive care unit and recognize their emotions and needs and describe the phases or milestones they go through and the strategies they use to cope with the situations that arise. METHOD: Qualitative study developed under the grounded theory method proposed by Anselm Strauss and Juliet Corbin. During the period from July 2017 to July 2019, semi-structured interviews were conducted with 26 relatives of hospitalized patients in fifteen third-level private clinics in the city of Manizales and Medellín, Colombia. In the latter, 200 hours of participant observation were performed in ICUs of two private third-level clinics. The analysis procedure consisted of a microanalysis of the data and the process of open, axial, and selective coding of the information was continued. RESULTS: We identified that the experience of relatives when they accompany their sick relative in the intensive care unit is represented in two categories: family disorganization which is characterized by generating a change and mismatch in family dynamics and, family reorganization in which a restoration of order is sought to cope with the situation. CONCLUSIONS: The family in the intensive care unit develops a situational crisis characterized by intense, varied, and negative emotions and needs that wear down the relatives. Faced with this, family members undertake a reorganization process to restore the order of family dynamics to cope with the situation and overcome difficulties.

Relación enfermera-familia. Más allá de la apertura de puertas y horarios / Nurse-family relationship. Beyond the opening of doors and schedules

INTRODUCCIÓN: El cuidado en la unidad de cuidados intensivos implica contemplar, entre otras dimensiones del paciente, a la familia. Para esto es necesario que la enfermera establezca relaciones con los familiares del paciente. OBJETIVO: Identificar la forma en que se establece la relación enfermera-familia en la UCI de adultos, al igual que las condiciones, elementos y factores que la favorecen o la dificultan. MÉTODO: Revisión narrativa integrativa de la literatura científica. Las bases de datos consultadas fueron: Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Académico y Scielo. Se buscaron artículos en inglés y español publicados entre el 2014 y el 2018. Los descriptores y fórmulas utilizadas se seleccionaron de acuerdo con el acrónimo Population and their problems, Exposure and Outcomes or themes (PEO). La población correspondió a las enfermeras de UCI y los familiares de pacientes en estado crítico; la exposición o contexto, a la unidad de cuidados intensivos adultos y los resultados esperados, a la forma como estos se relacionan. Para la evaluación metodológica se utilizaron la guía STROBE para artículos observacionales, PRISMA para artículos de revisión, COREQ para artículos cualitativos y CASPe para artículos derivados de proyectos. RESULTADOS: Se identificaron 214 artículos, de los cuales se seleccionaron 63 para incluir en la revisión. Las temáticas centrales identificadas fueron: el entorno de la UCI y sus efectos sobre el familiar, la empatía como indicador de la relación, la interacción como medio para relacionarse, la comunicación como centro de las relaciones y las barreras para el establecimiento de relaciones. CONCLUSIONES: La relación enfermera-familia en la unidad de cuidados intensivos se da a partir de la interacción y la comunicación en medio de barreras humanas, físicas, normativas y administrativas. Mejorar la relación enfermera-familia contribuye a la humanización de las unidades de cuidados intensivos de adultos

INTRODUCTION: Care in the Intensive Care Unit involves contemplating, among other dimensions of the patient, the family. For this, it is necessary for the nurse to establish relationships with the patient's relatives. OBJECTIVE: To identify the way in which the nurse-family relationship is established in the adult ICU, as well as the conditions, elements and factors that favour or hinder it. METHOD: Integrative narrative review of the scientific literature. The databases consulted were Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Scholar and Scielo. Articles in English and Spanish published between 2014 and 2018 were searched. The descriptors and formulas used were selected according to the acronym Population and their problems, Exposure and Outcomes or themes- PEO. The population comprised ICU nurses and the relatives of patients in critical condition; Adult Intensive Care Unit exposure or context; the expected results, and how they are related. For the methodological evaluation, the STROBE guide was used for observational articles, PRISMA for review articles, COREQ for qualitative articles and CASPe for articles derived from projects. RESULTS: We identified 214 articles, of which 63 were selected to be included in the review. The central themes identified were: the ICU environment and its effects on the family, empathy as an indicator of relationship, interaction as a means of relating, communication as the centre of relationships and barriers to the establishment of relationships. CONCLUSIONS: The nurse-family relationship in the Intensive Care Unit is based on interaction and communication amidst human, physical, regulatory and administrative barriers. Improving the nurse-family relationship contributes to the humanization of Adult Intensive Care Units

Nurse-family relationship. Beyond the opening of doors and schedules. / Relación enfermera-familia. Más allá de la apertura de puertas y horarios.

INTRODUCTION: Care in the Intensive Care Unit involves contemplating, among other dimensions of the patient, the family. For this, it is necessary for the nurse to establish relationships with the patient's relatives. OBJECTIVE: To identify the way in which the nurse-family relationship is established in the adult ICU, as well as the conditions, elements and factors that favour or hinder it. METHOD: Integrative narrative review of the scientific literature. The databases consulted were Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Scholar and Scielo. Articles in English and Spanish published between 2014 and 2018 were searched. The descriptors and formulas used were selected according to the acronym Population and their problems, Exposure and Outcomes or themes- PEO. The population comprised ICU nurses and the relatives of patients in critical condition; Adult Intensive Care Unit exposure or context; the expected results, and how they are related. For the methodological evaluation, the STROBE guide was used for observational articles, PRISMA for review articles, COREQ for qualitative articles and CASPe for articles derived from projects. RESULTS: We identified 214 articles, of which 63 were selected to be included in the review. The central themes identified were: the ICU environment and its effects on the family, empathy as an indicator of relationship, interaction as a means of relating, communication as the centre of relationships and barriers to the establishment of relationships. CONCLUSIONS: The nurse-family relationship in the Intensive Care Unit is based on interaction and communication amidst human, physical, regulatory and administrative barriers. Improving the nurse-family relationship contributes to the humanization of Adult Intensive Care Units.