Abstract
BackgroundThere 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.MethodsQualitative 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.DiscussionThe 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.
Highlights
There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members
Intensive Care Units (ICU) in different countries, in southern Europe, are often closed spaces that are regulated by health professionals, where internal organisation is designed without the participation of patients and their families [1, 2]
1.1 Analyse the characteristics of family care in the polyvalent ICU of the tertiary hospital. 1.2 Identify elements of change and improvement of nursing care provided to the family of the critical patient, derived from the reflection process. 1.3 Assess the effects of new practice on family and nurses from the point of view of the latter. 2.1 Identify the patterns of knowing used by the nurses for decision-making with regard to improvements of care to family members. 2.2 Analyse the evolution of the different patterns of knowing during the process of Participatory Action Research
Summary
There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. The usual pattern of these units is restrictive with rigid informative guidelines regarding visiting hours [3,4,5,6,7] and internal dynamics, promoting a significant separation, with family members on the one hand and healthcare teams and the patient on the other [2, 8, 9] In this context, technology and the complexity of the critical patient influence the development of technical skills and nurse care methods in the ICU. These stressors appear in a context in which the family sees their coping abilities exceeded, as its members become recipients of nursing care with a series of requirements that need to be met
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