Development of an instrument to measure the degree of critical patient's satisfaction with nursing care: research protocol.

AIM: To investigate and understand patient's satisfaction with nursing care in the intensive care unit to identify the dimensions of the concept of 'satisfaction' from the patient's point of view. To design and validate a questionnaire that measures satisfaction levels in critical patients. BACKGROUND: There are many instruments capable of measuring satisfaction with nursing care; however, they do not address the reality for critical patients nor are they applicable in our context. DESIGN: A dual approach study comprising: a qualitative phase employing Grounded Theory and a quantitative and descriptive phase to prepare and validate the questionnaire. METHODS: Data collection in the qualitative phase will consist of: in-depth interview after theoretical sampling, on-site diary and expert discussion group. The sample size will depend on the expected theoretical saturation n = 27-36. Analysis will be based on Grounded Theory. For the quantitative phase, the sampling will be based on convenience (n = 200). A questionnaire will be designed on the basis of qualitative data. Descriptive and inferential statistics will be used. The validation will be developed on the basis of the validity of the content, the criteria of the construct and reliability of the instrument by the Cronbach's alpha and test-retest approach. Approval date for this protocol was November 2010. DISCUSSION: Self-perceptions, beliefs, experiences, demographic, socio-cultural epistemological and political factors are determinants for satisfaction, and these should be taken into account when compiling a questionnaire on satisfaction with nursing care among critical patients.

Revisión de la literatura sobre el uso del testamento vital por la población mayor / Review of literature about the use of living bill by elderly population

El Testamento Vital (TV) recoge las preferencias detratamiento de una persona para cuando sea incapazde tomar decisiones por sí misma. Nuestro país estádando los primeros pasos para su implantación. Paraque el TV sea accesible y útil para las personas mayores,conviene conocer cómo se ha desarrollado en otrospaíses. En EE.UU., el TV ha pasado de una concepciónformal y burocrática a otra integral, denominadade Planificación Anticipada de Decisiones Sanitarias.La población mayor española tiene una opinión favorablesobre el TV si se incluye en una estrategia de comunicacióncon la familia y los profesionales. Teneren cuenta los hallazgos de la literatura facilitará eldesarrollo de un modelo organizativo efectivo que normaliceen España el uso del testamento vital por partede los mayores(AU)

The Living Will (LW) gathers the treatment preferencesof a person. Spain is starting the LW’ implantation.In order to the TV will be accessible and usefulfor the older people, we have to know how it has beendeveloped in other countries. In United States, TV hashappened through different stages: from a formal andbureaucratic conception to an integral concept, denominatedAdvance Care Planning. Spanish oldadults have a favourable opinion about TV, but it isnecessary to include it in a strategy of communicationand dialogue with its family and its professionals caregivers.Review literature findings will facilitate the developmentof an effective organizational model thatstandardizes in Spain the use of the TV by the oldadults(AU)

[Impact of the relatives of the critical patient. In light of a protocolized reception]. / Impacto de los familiares del paciente crítico. Ante una acogida protocolizada.

OBJECTIVE: Know the degree of satisfaction and the level of information that the family members have after a protocolized reception (it includes the creation of informative guide). MATERIAL AND METHOD: We conducted an observational and descriptive prospective study about the relatives of the patients in hospital to ICU during a year. We utilized a sampling technique by desirability. We distributed 120 questionnaires, there were fulfilled 70. The variables studied were: level of information and value for the relative of the guide, and degree of satisfaction concerning the type of reception, confidence felt and feeling of integration and safety. RESULTS: The sample studied was of 70 family members with an average age of 51 years (16.23), the majority they were husband/wife (50%) or sons (31.4%). Hundred per cent of the family members perceive feelings in the moment of the hospitalisation that are manifested through severity (32%), distress (21%), fear (19%), and others. The results of the variables with regard to the protocol of reception and the information showed that 93% of the family members were received by the nurse, and 41% recalls that the nurse was presented by her name. Eighty-seven per cent received the informative guide and 3% did not recall it. With regard to the informative guide 76% manifested the need for the existence of a guide and 86% considered that it provides enough information. The results of the variables with regard to the satisfaction were measured with a scale from 1 to 10 utilizing the median value as instrument of analysis, obtaining a median of 9 in all the questions referred to: feeling of reception, confidence, information, value of the information facilitated by the nurse and feeling of integration in the process that the patient experiences. CONCLUSIONS: The degree of satisfaction it is high after a protocolized reception. It is deduced that the information that is provided through the informative guide responds to the needs of the family members which feel implied and express a feeling of security.

Impacto de los familiares delpaciente crítico ante una acogida protocolizada / Impact of the relatives of the critical patient in light of a protocolized reception

Objetivo. Conocer el grado de satisfacción y el nivel de información que tienen los familiares tras una acogida protocolizada (incluye la creación de guía informativa). Material y método. Estudio prospectivo observacional y descriptivo de los familiares de los pacientes ingresados en UCI durante un año. Utilizamos una técnica de muestreo por conveniencia. Repartimos 120 cuestionarios, de los que se cumplimentaron 70.Las variables estudiadas son: nivel de información y valor para el familiar de la guía, y grado de satisfacción en cuanto al tipo de acogida, confianza que sintió y sentimiento de integración y seguridad. Resultados. La muestra fue de 70 familiares, con una media de edad de 51 años (ñ16,23), la mayoría eran esposo/a (50 por ciento) o hijos (31,4 por ciento). El 100 por ciento de los familiares perciben sentimientos en el momento del ingreso que se manifiestan a través de gravedad (32 por ciento), angustia (21 por ciento), miedo (19 por ciento) y otros. Los resultados de las variables en relación al protocolo de acogida y la información evidenciaron que el 93 por ciento de los familiares fueron recibidos por la enfermera, y el 41 por ciento recuerda que la enfermera se presentó por su nombre. El 87 por ciento recibió la guía informativa y un 3 por ciento no lo recordaba. En cuanto a la guía informativa, un 76 por ciento manifestó la necesidad de su existencia, y el 86 por ciento consideraba que proporciona suficiente información. Los resultados de las variables en relación a la satisfacción se midieron con una escala del 1 al 10; utilizando la mediana como instrumento de análisis, se obtuvo una mediana de 9 en todas las preguntas referidas a: sentimiento de acogida, confianza, información, valor de la información facilitada por la enfermera y sentimiento de integración en el proceso que vive el enfermo. Conclusiones. El grado de satisfacción es alto después de una acogida protocolizada. Se deduce que la información que se proporciona a través de la guía informativa responde a las necesidades de los familiares, que se sienten implicados y expresan sensación de seguridad (AU)