Professionals' narratives of interactions with patients' families in intensive care.
Nurs Ethics 2022;
29:885-898. [PMID:
35196935 PMCID:
PMC9289990 DOI:
10.1177/09697330211050995]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: ICU patients’ family members are in a new, uncertain,
and vulnerable situation due to the patient’s critical illness and complete
dependence on the ICU nurses and physicians. Family members’ feeling of being
cared for is closely linked to clinicians’ attitudes and behavior.
Aim: To explore ICU nurses’ and physicians’ bedside interaction with
critically ill ICU patients´ families and discuss this in light of the ethics of
care.
Research design: A qualitative study using participant observation,
focus groups, and thematic narrative analysis.
Participants and research context: Data were gathered from July 2017
to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven
focus groups with ICU nurses and physicians.
Ethical considerations: The Regional Committee for Medical and
Health Research Ethics and the Norwegian Centre for Research Data approved the
study. Findings: Quality of ICU family care depends on nurses’ and
physicians’ attitudes, behavior, and personality traits. Three main themes were
identified: being attentive, an active
approach, and degree of tolerance.
Discussion: The findings are discussed in light of the ethics of
care and empirical research from the intensive care environment.
Conclusions: This study shows that attentive, active, and tolerant
clinicians represent a culture of ethical care that gives families greater
freedom of action and active participation in patient care. Clinicians must not
bear sole responsibility for this culture; it must have a firm basis in the
hospital and ICU and be established through training, interprofessional
reflection, and support of clinicians.
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