Family presence during resuscitation in emergency departments: professionals' attitudes in Brazil.

AIM: The study explored the views and attitudes of nurses and physicians on family presence during resuscitation in emergency departments in Brazil. BACKGROUND: International emergency associations endorse family presence during resuscitation; however, the extent to which it is practiced remains unclear, particularly in the Brazilian context. Research of emergency staff views and attitudes towards this practice is desirable so that actions can be identified to support families at the bedside. METHODS: A qualitative research was conducted. Thirty-two health professionals (11 physicians and 21 nurses) working in two emergency departments in southern Brazil were purposefully recruited in January 2015. In-depth interviews were conducted, and data were analysed using content analysis. FINDINGS: Nurses and physicians found family presence during resuscitation controversial and the general attitude towards this practice was negative. They reported that 'changes are needed' to adapt hospital infrastructures for family presence, and to train staff to respond to the information and emotional needs of families. DISCUSSION: Translating a family nursing framework into clinical practice involves the need for reassessing educational and management policies in clinical contexts. CONCLUSION: This research brings new understanding about the attitudes of some Brazilian nurses and physicians on the implementation of family presence during resuscitation and identifies the need to develop policies and strategies to improve family presence in emergency departments. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Hospital-based policies are required to improve family-centred care in emergency departments while providing a criterion of legality and safety to professionals to invite families to be present during invasive procedures. Also, family-focused education in health science degrees, continuing education and in the community is required.

The process of giving information to families in intensive care units: A narrative review. / El proceso de información a los familiares en las unidades de cuidados intensivos: una revisión narrativa.

AIM: Information is one of the most important needs of families of critical patients. Healthcare professionals also identify the great value of communication with families to reduce their anxiety and stress. Despite this, families may feel inadequately informed, causing added suffering. The purpose of this study is to provide an understanding of both families' and healthcare professionals' perspectives on information giving within intensive care units (ICU). METHOD: A narrative review was conducted using MEDLINE, CINAHL, PsycINFO databases and the Cochrane Library to identify studies published in either English or Spanish from 2002 to 2018. RESULTS: 47 studies were included, and five categories were identified: 1)"the need to know"; 2)family satisfaction with the information received; 3)impact of information on families' experiences in the ICU; 4)nurses and physicians' perceptions of information transmission, and 5)information process in the ICU. CONCLUSIONS: Providing honest and truthful information to the families of critical patients is essential to reduce family anxiety and increase family control, although this often appears to be inadequately accomplished by staff. Interdisciplinary involvement in information giving may be beneficial for both families and ICU professionals. This review brings new understanding about the process of information to families of ICU patients and it can be used to improve the quality and humanization of care in the ICUs.

The absence of the family in emergency care contributes to suffering in patients and family members. / La ausencia familiar en la atención de urgencia conlleva sufrimiento en pacientes y familiares.

AIM: To understand what the absence of the family during emergency care means to adult patients and their families to. METHOD: A grounded theory study was conducted in two emergency units of two public hospitals in southern Brazil. From October 2016 to February 2017, 15 interviews with patients and 15 with family members were carried out. The data were analyzed following the comparative method. RESULTS: The patients and families experienced the absence of the family in emergency care as a process of suffering caused by the separation of patient and family; they did not understand the reasons for family exclusion, and were resigned to the situation. CONCLUSION: Urgent care per se entails suffering in patients and their relatives; this suffering intensifies when the family is separated and cannot accompany the patient during emergency care. These results show the need to develop health strategies and policies that contribute to the comprehensive care of patients and families in hospital emergency units.

[Effectiveness of family interventions in nursing homes. A systematic review]. / Efectividad de las intervenciones familiares en centros geriátricos. Una revisión sistemática.

The process of nursing home placement can be a stressful event for both the dependent elderly person and the family. During admission, especially the first few months, the family may suffer feelings of loss, sadness, failure and guilt. In this context, support and guidance from health professionals are essential to address the needs of residents and families through effective interventions. The aim of this systematic review is to identify the most effective interventions to help families during the process of institutionalization of a relative in a nursing home. Two types of family interventions were identified: those that focused on family-staff relationship and those that focused on family support groups, the latter being the most effective. On the other hand, most interventions have an individualistic approach, focusing on the primary caregiver. Finally, there is a shortage of quality studies that present the results of family interventions in the geriatric field and also a lack of such studies in the Spanish context.