scholarly journals The impact of the hospitalization process on the caregiver of a chronic critical patient hospitalized in a Semi-Intensive Care Unit

2018 ◽  
Vol 22 (2) ◽  
Author(s):  
Letícia Neves ◽  
Andressa Alencar Gondim ◽  
Sara Costa Martins Rodrigues Soares ◽  
Denis Pontes Coelho ◽  
Joana Angélica Marques Pinheiro

Abstract Objective: To understand the impact of the hospitalization process on the family companion of critical patients admitted to a Semi-Intensive Care Unit (SICU). Method: Exploratory research with a qualitative approach, conducted in the months of April to July of 2016 through a semi-structured interview applied to relatives who were accompanying patients hospitalized in an SICU of a high complexity care hospital in Fortaleza. The interviews were submitted to content analysis. Results: Three themes emerged through the perception of the family members, which reveal the companion's functioning during the hospitalization period: emotional, familiar and behavioural. Conclusion: The companion experiences an intense process of suffering and emotional fragility, causing changes in the family organization. The companion, being a caregiver, is subjected to high levels of stress, having to use coping skills, with; spirituality and social media among the most evident. The companion is an integral care unit for the hospitalized patient and a key piece in the humanization process of health.

2019 ◽  
Vol 28 ◽  
Author(s):  
Aliniana da Silva Santos ◽  
Lidiane do Nascimento Rodrigues ◽  
Maria Solange Nogueira dos Santos ◽  
George Jó Bezerra Sousa ◽  
Maria Corina Amaral Viana ◽  
...  

ABSTRACT Objective: to identify the experience of motherhood during the hospitalization period of the newborn in a neonatal intensive care unit. Method: a descriptive and exploratory research, with a qualitative approach, based on the Maternal Role Attainment Theory. A semi-structured interview was conducted in June 2018 with 23 mothers of newborns in a neonatal therapy unit of a public teaching hospital in the state of Ceará (Brazil). The method for data analysis was the Descending Hierarchical Classification based on the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software. Results: with the codings and analysis of the empirical material, it was found that mothers presented negative feelings such as fear, sadness and anguish. Consolidated feelings were based on experiences faced by these women, making it difficult to exercise the maternal role in the neonatal intensive care unit. Conclusion: data from this research signaled at the lack of maternal protagonism considered important by the theory used, so that the bond between mother and child is established in the neonatal intensive care unit.


2019 ◽  
Vol 72 (suppl 1) ◽  
pp. 105-113 ◽  
Author(s):  
Bianca Ribeiro Porto de Andrade ◽  
Fabiana de Mello Barros ◽  
Honorina Fátima Ângela de Lúcio ◽  
Juliana Faria Campos ◽  
Rafael Celestino da Silva

ABSTRACT Objective: To analyze the repercussions of the training of nurses working in the Intensive Care Unit for the management of continuous hemodialysis regarding the safety of critical patients with acute renal failure. Method: Qualitative research developed considering James Reason's reference in the Intensive Care Unit of a private hospital. The data was collected with 23 nurses who worked for more than three months in the management of continuous hemodialysis through a semi-structured interview, and analyzed with the thematic content analysis technique. Results: There are weaknesses in the training of intensive care nurses for the management of continuous hemodialysis that become a latent failure. Such a failure results in difficulties in handling hemodialysis, with risks for these professionals to commit active failures. Final considerations: The training program in service for the management of continuous hemodialysis must be perfected, to develop skills and competencies in nurses and improve their performance.


2010 ◽  
Vol 4 (4) ◽  
pp. 1587
Author(s):  
Natália Celião Leite ◽  
Josilene De Melo Buriti Vasconcelos ◽  
Wilma Dias de Fontes

ABSTRACTObjectives: to report the experience of the nursing team and family members of ICU patients as regards communication; to learn the meaning they attribute to the communication process. Methodology: a quantitative and qualitative exploratory study carried out at the Intensive Care Unit of the school hospital. Consisting of 15 family members and 15 nursing professionals who happened to be available there during the data collection, the sample resulted from semi-structured interview guidance. The data were analyzed by means of descriptive statistics, taking into account the absolute and percentage numbers, and the technique of the Collective Subject Discourse, with presentation throughout graph, table and charts. Results: the data showed gaps in the communication, which are inherent to some professionals who neither practice nor value the communication process with the family, mainly as regards the need to prepare them for the ICU environment and the real conditions of their family members. Conclusion: the need to adopt an efficient system of communication with relatives of ICU patients is widely known. Thus, the nurse will be adopting new ways of caring, which include valuing the family members as integrating part of the nursing care, with view to humanizing the assistance. Descriptors: communication; humanization of the assistance; intensive care unit. RESUMOObjetivos: relatar a experiência da equipe de enfermagem e de familiares de pacientes internados em uma UTI, na perspectiva da comunicação; apreender o significado por eles atribuído ao processo de comunicação. Métodologia: estudo exploratório, quantiqualitativo, realizado na Unidade de Terapia Intensiva de hospital escola. A amostra foi formada por 15 familiares e 15 profissionais de enfermagem que se encontravam no local, por ocasião da coleta de dados, a qual ocorreu por meio de um roteiro de entrevista semi-estruturado. Os dados foram analisados por meio da estatística descritiva, levando-se em conta os números absolutos e percentuais, e da técnica do Discurso do Sujeito Coletivo, com apresentação em gráfico, tabela e quadros. Resultados: os dados mostram lacunas na comunicação, as quais são inerentes a alguns profissionais que não praticam e não valorizam o processo de comunicação com a família, principalmente no que diz respeito à necessidade de prepará-los para compreender o ambiente da UTI e as reais condições de seus familiares. Conclusão: é notória a necessidade de se adotar um sistema eficaz de comunicação com os familiares de pacientes internados na UTI. Assim, o enfermeiro estará adotando novas formas de cuidar, que incluem a valorização dos familiares como parte integrante do cuidado de enfermagem na perspectiva da humanização da assistência. Descritores: comunicação; humanização da assistência; unidade de terapia intensiva.RESUMENObjetivos: relatar la experiencia del equipo de enfermería y parientes de pacientes de UTI, en cuanto a la comunicación; aprender el significado que ellos atribuyen al proceso de comunicación. Metodología: estudio exploratorio, cuantitativo y cualitativo, realizado en la Unidad de Terapia Intensiva del hospital escuela. Formada por 15 parientes y 15 profesionales de enfermería que se encontraban disponibles en el sitio durante el recogimiento de los datos, la muestra resultó de la rutina de una entrevista semi-estructurada. Los datos fueron analizados a través de la estadística descriptiva, llevándose en cuenta los números absolutos y porcentajes, la técnica del Discurso del Sujeto Colectivo, con presentación en gráfico, tabla y cuadros. Resultado: los datos enseñan brechas en la comunicación, las cuales son propias de algunos profesionales que no practican y no valoran el proceso de comunicación con la familia, principalmente en cuanto a la necesidad de les preparar a entender el ambiente de la UTI y las reales condiciones de sus parientes. Conclusión: es notoria la necesidad de adoptarse un sistema de comunicación eficiente con los parientes de pacientes de UTI. Así, el enfermero estará adoptando nuevas maneras de cuidar, las cuales incluyen la valoración de los parientes como parte del cuidado de enfermero, con vista a la humanización de la asistencia. Descriptores: comunicación; humanización de la asistencia; unidad de terapia intensiva. 


2013 ◽  
Vol 30 (2) ◽  
pp. 199-209
Author(s):  
Fernanda de Azevedo Lima ◽  
Maria Cristina Lopes de Almeida Amazonas ◽  
Carmem Lúcia Brito Tavares Barreto ◽  
Walfrido Nunes de Menezes

The aim of this study, in the area of Hospital Psychology, was to comprehend the experience of sons and daughters whose mother or father was hospitalized in an Intensive Care Unit. Participants were 10 sons and daughters who responded to a socio-demographic questionnaire and a semi-structured interview, which were submitted to Content Analysis. The following were verified in the interviews: feelings of suffering and fear; concerns regarding the fact that the patient spends most of the time alone; lack of trust regarding the treatment offered by the healthcare team for the patient; lack of motivation to continue day by day routines; positive reappraisal such as personal, spiritual and professional growth, and satisfaction with the hospital team's care to the family. This data highlights the needs of these sons and daughters during their parent's hospitalization in an Intensive Care Unit and may support more effective care from the healthcare team for this population.


Author(s):  
Apinya Koontalay ◽  
Wanich Suksatan ◽  
Jonaid M Sadang ◽  
Kantapong Prabsangob

Objective: This study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients. Patients and Methods: The current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions. Results: As a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores. Conclusion: The research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.


2019 ◽  
Vol 28 ◽  
Author(s):  
Bianca Ribeiro Porto de Andrade ◽  
Fabiana de Mello Barros ◽  
Honorina Fátima Ângela de Lúcio ◽  
Juliana Faria Campos ◽  
Rafael Celestino da Silva

ABSTRACT Objective: to analyze the professional experience of intensive care nurses and its influence on their work activities in the continuous hemodialysis process and patient safety in the intensive care unit within the scope of the collaborative model. Method: qualitative and exploratory research, based on the systemic paradigm of patient safety, developed at the Intensive Care Unit of a private institution in the city of Rio de Janeiro, Brazil. There were 23 nurse participants who had been working for more than three months in study scenery and in direct contact with continuous hemodialysis. The data were produced from June to October of 2016 by means of observation, analyzed using thick description as well as semi-structured interviews, and then submitted to the content analysis technique. Results: were organized in two categories: the first one portrays the influence of the professional working experience on the safety of nurses' performance, which verified that in relation to continuous hemodialysis, inexperienced nurses follow guidelines and manuals, without a complete evaluation of this care situation and face difficulties in the performance of everyday care. The second category demonstrates the impact of the nurse´s inexperience on the occurrence of active errors, evidencing actions that result in the occurrence of adverse events. Conclusion: the insertion of inexperienced nurses is a latent condition in the investigated system that results in the occurrence of incidents in the continuous hemodialysis process, requiring the improvement of the collaborative model through the systematic monitoring of the performance of these professionals, such as the proposal of a safety barrier.


2020 ◽  
Vol 55 (1) ◽  
pp. 15-24
Author(s):  
Michaelia D. Cucci ◽  
Brittany S. Cunningham ◽  
Jaimini S. Patel ◽  
Alan T. Shimer ◽  
Dania I. Mofleh ◽  
...  

Background: Approximately 17% of intensive care unit (ICU) patients are prescribed at least 1 home neuropsychiatric medication (NPM). When abruptly discontinued, withdrawal symptoms may occur manifesting as agitation or delirium in the ICU setting. Objective: To evaluate the impact of early reinitiation of NPMs. Methods: This was a retrospective, observational cohort of adult ICU patients in a tertiary care hospital. Patients were included if admitted to the ICU and prescribed a NPM prior to arrival. Study groups were based on the timing of reinitiation of at least 50% of NPMs: ≤72 hours (early group) versus >72 hours (late group). Results: The primary outcome was the proportion of patients with at least 1 agitation or delirium episode in the first 72 hours. Agitation and delirium were defined as at least 1 RASS assessment between +2 to +4 and a positive CAM-ICU assessment, respectively. A total of 300 patients were included, with 187 (62%) and 113 (38%) in the early and late groups, respectively. There was no difference in agitation or delirium (late 54 [48%] vs early 62 [33%]; adjusted odds ratio [aOR] = 1.5; 95% CI = 0.8-2.8; P = 0.193). Independent risk factors found to be associated with the primary outcome were restraints (aOR = 12.9; 95% CI = 6.9-24.0; P < 0.001) and benzodiazepines (BZDs; aOR = 2.0; 95% CI = 1.0-3.7; P = 0.038). Conclusions: After adjustment for baseline differences, there was no difference in agitation or delirium. Independent risk factors were restraint use and newly initiated BZDs.


2021 ◽  
Vol 10 (22) ◽  
pp. 5223
Author(s):  
Jean-Baptiste Bouillon-Minois ◽  
Vincent Roux ◽  
Matthieu Jabaudon ◽  
Mara Flannery ◽  
Jonathan Duchenne ◽  
...  

During the first wave of the COVID-19 pandemic, some French regions were more affected than others. To relieve those areas most affected, the French government organized transfers of critical patients, notably by plane or helicopter. Our objective was to investigate the impact of such transfers on the pulse oximetric saturation (SpO2)-to-inspired fraction of oxygen (FiO2) ratio among transferred critical patients with COVID-19. We conducted a retrospective study on medical and paramedical records. The primary endpoint was the change in SpO2/FiO2 during transfers. Thirty-eight patients were transferred between 28 March and 5 April 2020, with a mean age of 62.4 years and a mean body mass index of 29.8 kg/m2. The population was 69.7% male, and the leading medical history was hypertension (42.1%), diabetes (34.2%), and dyslipidemia (18.4%). Of 28 patients with full data, we found a decrease of 28.9 points in SpO2/FiO2 (95% confidence interval, 5.8 to 52.1, p = 0.01) between the starting and the arrival intensive care units (SpO2/FiO2, 187.3 ± 61.3 and 158.4 ± 62.8 mmHg, respectively). Air medical transfers organized to relieve intensive care unit teams under surging conditions during the first COVID wave were associated with significant decreases in arterial oxygenation.


2018 ◽  
Vol 7 (2) ◽  
pp. 140-155
Author(s):  
Alda Vanessa Cardoso Ferreira ◽  
Gabriela De Sousa Dantas Cunha ◽  
Marcelle Napoleão Do Rêgo Formiga

O presente estudo tem o objetivo de compreender como os profissionais de saúde da Unidade de Terapia Intensiva (UTI) cuidam dos pacientes críticos e quais são as variáveis emocionais que estão implicadas neste cuidado. Especificamente tem o propósito de compreender a percepção que os participantes têm sobre o que é cuidar, quais são as variáveis emocionais que favorecem e dificultam o cuidar, como percebem a própria disponibilidade e habilidade para cuidar e qual a visão que têm de si mesmos como cuidadores. Para tanto, realizou-se uma pesquisa qualitativa, de cunho exploratório descritivo. Foram entrevistados 13 sujeitos de uma UTI de um hospital público de referência na cidade de Teresina-Piauí. Para tanto, utilizou-se um questionário sociodemográfico para categorização dos sujeitos e uma entrevista semiestruturada com perguntas abertas. As entrevistas foram analisadas em seu conteúdo, tendo sido criadas cinco categorias para a discussão dos dados. A análise dos dados foi realizada com base na análise de conteúdo de Bardin, a qual opera em três polos principais: a pré-análise, a exploração do material e os resultados, com base na inferência e interpretação. Os resultados apontam que o cuidar envolve a dimensão física e emocional do paciente, assim como esse processo suscita no profissional vivências emocionais que facilitam e que também dificultam o cuidar, interferindo na qualidade dos cuidados oferecidos. Os discursos também apontam para a necessidade de voltar o olhar para os cuidadores, para que estejam mais atentos para a necessidade de cuidar de si mesmos ou tenham mais habilidade para tal.Palavras-chave: Cuidado intensivo. Profissionais de saúde. Emoções. THE INTENSIVE CARE UNDER THE PERSPECTIVE OF THE HEALTH PROFESSIONALS OF THE INTENSIVE CARE UNIT ABSTRACT: The present study aims to understand how the health professionals of the Intensive Care Unit (ICU) take care of critical patients and what are the emotional variables that are involved in this care. Specifically, it aims to understand the participants' perception about what is care, what are the emotional variables that favor and hinder caring, how they perceive their own availability and ability to care, and how they view themselves as caregivers. For that, a qualitative research was carried out, with a descriptive exploratory character. We interviewed 13 subjects from an ICU of a public reference hospital in the city of Teresina-Piauí. For this purpose, a sociodemographic questionnaire was used to categorize subjects and a semi-structured interview with open questions. The interviews were analyzed in their content, and five categories were created to discuss the data. Data analysis was performed based on the Bardin content analysis, which operates in three main poles: pre-analysis, material exploration and results, based on inference and interpretation. The results indicate that caring involves the physical and emotional dimension of the patient, just as this process raises in the professional emotional experiences that facilitate and also difficult the care, interfering in the quality of care offered. The speeches also indicates to the need to turn the gaze to the caregiveres so that them are more attentives to the need to take care of themselves or have more ability to do this.Keywords: Intensive care. Health Personnel. Emotions.


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