Vivencias de familiares en terapia intensiva: el otro lado del ingreso

La propuesta de este estudio es comprender las vivencias de familiares de pacientes ingresados en Unidad de Terapia Intensiva (UTI), con la intención de contribuir para la humanización del cuidado en ese contexto. Considerando la naturaleza del objeto de investigación, el estudio fue conducido en la búsqueda de la comprensión del fenómeno Ser una familia que pasa por la experiencia del ingreso de un familiar en la UTI. La fenomenología se utilizó como referencial metodológico. Se entrevistaron a 17 familias de pacientes adultos ingresados en un UTI de la Santa Casa de Londrina, de septiembre hasta diciembre de 2004. Del análisis de esas entrevistas, emergieron las categorías temáticas: experiencia difícil, dolorosa, sin palabras; ponerse en el lugar y percibir el otro: proximidad al sufrimiento del paciente; rompimiento de la relación con el cotidiano familiar; el miedo de la muerte del familiar; UTI: escenario temido, pero necesario; preocupación con el cuidado del familiar. Algunas facetas relativas la vivencia de la familia en UTI han sido desveladas, contribuyendo para la construcción de un cuidado humanizado vuelto para la singularidad de la familia y del paciente crítico.A proposta deste estudo é compreender as vivências de familiares de pacientes internados em Unidade de Terapia Intensiva (UTI), com a intenção de contribuir para a humanização do cuidado nesse contexto. Considerando a natureza do objeto de investigação, o estudo foi conduzido na busca de compreensão do fenômeno Ser família que experiencia a hospitalização de um familiar na UTI, tendo como referencial metodológico a fenomenologia. Foram entrevistados 17 familiares de pacientes adultos, internados em uma UTI da Santa Casa de Londrina, de setembro a dezembro de 2004. Da análise dessas entrevistas, emergiram as seguintes categorias temáticas: experiência difícil, dolorosa, sem palavras; colocar-se no lugar e perceber o outro: aproximação do sofrimento do paciente; rompimento da relação com o cotidiano familiar; o medo da morte do familiar; UTI: cenário temido, mas necessário; preocupação com o cuidado do familiar. Algumas facetas relativas à vivência da família em UTI foram desveladas, contribuindo para a construção de cuidado humanizado, voltado para a singularidade da família e do paciente crítico.This study aims at understanding the experience concerning family members of patients in the Intensive Care Unit (ICU), with the purpose of contributing to care humanization in this context. Considering the nature of the research object, this research was carried out to understand the phenomenon Being a family that experiences the hospitalization of a family member in ICU. Phenomenology was used as a methodological reference framework. Seventeen family members of adult patients in the Intensive Care Unit (ICU) at the Santa Casa in Londrina were interviewed from September to December 2004. Through analysis of these interviews, some theme categories emerged: difficult, painful, speechless experience; experiencing and recognizing somebody's life: approaching the patient's suffering; break-up of the family's daily routine; fear of having a family member die; ICU: a fearsome scene, but necessary; concern with family care. Some issues related to the family's attendance in the ICU were discussed, contributing to the establishment of humanized care delivery to critical patients and their families' uniqueness

Caring for critically ill patients outside intensive care units due to full units: a cohort study

OBJECTIVES: This study sought to analyze the clinical and epidemiologic characteristics of critically ill patients who were denied intensive care unit admission due to the unavailability of beds and to estimate the direct costs of treatment. METHODS: A prospective cohort study was performed with critically ill patients treated in a university hospital. All consecutive patients denied intensive care unit beds due to a full unit from February 2012 to February 2013 were included. The data collected included clinical data, calculation of costs, prognostic scores, and outcomes. The patients were followed for data collection until intensive care unit admission or cancellation of the request for the intensive care unit bed. Vital status at hospital discharge was noted, and patients were classified as survivors or non-survivors considering this endpoint. RESULTS: Four hundred and fifty-four patients were analyzed. Patients were predominantly male (54.6%), and the median age was 62 (interquartile range (ITQ): 47 - 73) years. The median APACHE II score was 22.5 (ITQ: 16 - 29). Invasive mechanical ventilation was used in 298 patients (65.6%), and vasoactive drugs were used in 44.9% of patients. The median time of follow-up was 3 days (ITQ: 2 - 6); after this time, 204 patients were admitted to the intensive care unit and 250 had the intensive care unit bed request canceled. The median total cost per patient was US$ 5,945.98. CONCLUSIONS: Patients presented a high severity in terms of disease scores, had multiple organ dysfunction and needed multiple invasive therapeutic interventions. The study patients received intensive care with specialized consultation during their stay in the hospital wards and presented high costs of treatment

Experiences of families of the patients treated in intensive therapy: the other side of the treatment.

Considerando a importância de se construir um atendimento em saúde que considere a pessoa em sua integralidade, em qualquer nível de atenção, a proposta deste estudo é compreender a vivência de familiares de pacientes internados em Centro de Terapia Intensiva (CTI), na intenção de contribuir para a humanização do cuidado nesse contexto. Tendo em vista a natureza do objeto de investigação, envolvendo questões de ordem subjetiva e social, este trabalho foi conduzido a partir de algumas idéias fundamentais do referencial fenomenológico. Nos meses de setembro a dezembro de 2004, foram entrevistadas 17 famílias de pacientes adultos internados em um CTI da Santa Casa de Londrina, instituição filantrópica que atende pacientes do SUS, conveniados e particulares. A questão norteadora deste estudo foi: Como está sendo para você ter um familiar internado aqui? Descreva para mim. Da análise dessas entrevistas, emergiram algumas categorias temáticas: Experiência difícil, dolorosa, sem palavras; Colocar-se no lugar e perceber o outro: aproximação ao sofrimento do paciente; Rompimento da relação com o cotidiano familiar; O medo da morte do familiar; CTI: cenário temido, mas necessário; Preocupação com o cuidado do familiar. Algumas facetas relativas ao atendimento da família em CTI foram desveladas, emergindo pontos significativos a serem refletidos pelos profissionais que ali atuam, contribuindo para a construção de um cuidado humanizado, contemplando a singularidade da família e do paciente crítico.Considering the importance of establishing a care in health, which considers the person in its completeness, in any level of caring, the proposal of this study is to understand the experience of the families of the patients treated in Center of Intensive Therapy, with the purpose of contributing for the humanization of caring in this context. In view of the nature of the inquired object, involving subjective and social issues, this work has been conducted from some fundamental ideas of the phenomenological reference. From September to December of 2004, 17 families of the adult patients treated in a Center of Intensive Therapy from Santa Casa de Londrina, philanthropic institution that cares patients from SUS, insured and privates, have been interviewed The polemic question of this study was: How has it been for you to have a family member treated here? Describe it for me. From the analysis of these interviews, some topic issues have emerged: Difficult, painful, speechless experience; Experiencing and recognizing somebodys life: getting close to the patients suffering; The Breakup of the familiar daily routine relationship; The fear of the family members death; CIT: feared scene, but necessary; Concern over the family care. Some issues related to the family care in CIT have been brought out, emerging considerable points to be analyzed by the professionals, contemplating the establishment of a humanized care towards the singularity of the family and the critical patient

Relatives' experience of intensive care: the other side of hospitalization

This study aims at understanding the experience concerning family members of patients in the Intensive Care Unit (ICU), with the purpose of contributing to care humanization in this context. Considering the nature of the research object, this research was carried out to understand the phenomenon Being a family that experiences the hospitalization of a family member in ICU. Phenomenology was used as a methodological reference framework. Seventeen family members of adult patients in the Intensive Care Unit (ICU) at the Santa Casa in Londrina were interviewed from September to December 2004. Through analysis of these interviews, some theme categories emerged: difficult, painful, speechless experience; experiencing and recognizing somebody's life: approaching the patient's suffering; break-up of the family's daily routine; fear of having a family member die; ICU: a fearsome scene, but necessary; concern with family care. Some issues related to the family's attendance in the ICU were discussed, contributing to the establishment of humanized care delivery to critical patients and their families' uniqueness

Caring for critically ill patients outside intensive care units due to full units: a cohort study

OBJECTIVES: This study sought to analyze the clinical and epidemiologic characteristics of critically ill patients who were denied intensive care unit admission due to the unavailability of beds and to estimate the direct costs of treatment. METHODS: A prospective cohort study was performed with critically ill patients treated in a university hospital. All consecutive patients denied intensive care unit beds due to a full unit from February 2012 to February 2013 were included. The data collected included clinical data, calculation of costs, prognostic scores, and outcomes. The patients were followed for data collection until intensive care unit admission or cancellation of the request for the intensive care unit bed. Vital status at hospital discharge was noted, and patients were classified as survivors or non-survivors considering this endpoint. RESULTS: Four hundred and fifty-four patients were analyzed. Patients were predominantly male (54.6%), and the median age was 62 (interquartile range (ITQ): 47 - 73) years. The median APACHE II score was 22.5 (ITQ: 16 - 29). Invasive mechanical ventilation was used in 298 patients (65.6%), and vasoactive drugs were used in 44.9% of patients. The median time of follow-up was 3 days (ITQ: 2 - 6); after this time, 204 patients were admitted to the intensive care unit and 250 had the intensive care unit bed request canceled. The median total cost per patient was US$ 5,945.98. CONCLUSIONS: Patients presented a high severity in terms of disease scores, had multiple organ dysfunction and needed multiple invasive therapeutic interventions. The study patients received intensive care with specialized consultation during their stay in the hospital wards and presented high costs of treatment

Vivência de familiares de pacientes internados em unidades de terapia intensiva

OBJETIVOS: A proposta deste estudo é compreender as vivências de familiares de pacientes internados em unidade de terapia intensiva de hospital público e privado através de uma aproximação ao referencial da fenomenologia. MÉTODOS: Foram entrevistados 27 familiares de pacientes adultos, sendo 10 de instituição pública e 17 de instituição privada. RESULTADOS: Da análise das entrevistas da instituição pública emergiram quatro categorias temáticas. Na instituição privada somaram-se seis categorias. Na busca de suas semelhanças e diferenças quatro categorias temáticas foram encontradas nas duas instituições e apenas duas não emergiram no estudo do hospital público. CONCLUSÃO: Não há diferenças significativas das categorias dos hospitais público e privado, o que demonstra que a forma como a família vivencia a internação de um paciente na unidade de terapia intensiva não se relaciona a aspectos sociais ou financeiros. Entretanto, faz-se necessário um maior conhecimento de diretrizes e programas do governo federal que favorecem a humanização ao permitir o acompanhamento da família nos serviços terciários