Interaction with potential donors' families: The professionals' community of concern—a phenomenological study

The aim of this paper was to explore the health professionals' experiences and gain a deeper understanding of interaction with families of critically ill or traumatized patients with severe brain injuries. The methodological approach was qualitative and phenomenological. Data were collected through participant observation and in-depth interviews with nurses, physicians, and chaplains working in two ICUs in a Norwegian university hospital. A thematic analysis was used for analyzing data. Two main themes emerged from analysis: Patient oriented even when present and Family oriented even when absent. Each main theme is divided into two sub-themes. The themes appeared as phases in an interaction process. In the two first phases the interaction may be characterized as Alternating between being absent and present and Following up and withholding information and in the two last phases as Turning point and changing focus and Partly present when waiting for death. The findings are in the discussion illuminated by the phenomenological concept of concern. Concern is visible as care, and the distinction in care between “leaps in” and “leaps ahead” and “ready-to-hand” and “unready-to-hand” are topics in the discussion. Because of the complexity of caring for both patient and family, the situation demands efforts to relieve nurses in particular, during the most demanding phases of the process

Autonomia/mutualidade na assistência de enfermagem Autonomía/participación mutua en la asistencia de enfermería Autonomy/mutuality in nursing care

Utilizando um estudo de caso como ilustração, a autora discute as possibilidades da participação ativa dos pacientes na assistência à saúde, visando estimulá-los ao autocuidado. A partir de considerações sobre as formas tradicionais e autoritárias da assistência à saúde nos quais os profissionais determinam os procedimentos e os pacientes aceitam passivamente o que lhes é determinado, o estudo discute as questões da dependência e independência da enfermeira e do cliente no processo saúde-doença, propondo uma inter-relação que mantenha a autonomia de um e de outro. No sentido de que ambos participem ativamente do processo de enfermagem. Tal postura entre a autonomia e a mutualidade é descrita como uma relação dialética entre duas pessoas que se percebem nas suas especificidades e potencialidades, tendo como objetivo comum desenvolver uma assistência de enfermagem que contempla os valores éticos e humanísticos.<br>Teniendo como referenciales principales las consideraciones sobre las formas tradicionales y autoritarias en la asistencia a la salud, la autora discute las cuestiones de la dependencia e independencia de la enfermera y del enfermo en el proceso salud-enfermedad. Dentro de esto concepto se propone una relación de interdependencia en la cual se mantengan la autonomía de uno y de otro de forma que los dos tengan participación activa en el proceso de enfermería.<br>Taking into consideration the traditional official health assistance forms, the present paper discusses questions related to dependence and independence of nurse and patient in the health/illness process. Under that perspective it proposes a relationship that preserves the autonomy of one and the other, so that both can participate in the process of nursing and self-care