Uncertainty in critical illness and the unexpected: important mediators in the process of nurse-family communication

Abstract

Objective: The purpose of this study was to understand, based on the Mishel’s Theory of Uncertainty in Illness and the Theory of Transitions of Meleis, in which way uncertainty in illness and the unexpected mediated the process of nurse-family communication and are translated into lived experience of the family. Method: Considering the intentionality of the research, it fits into a qualitative paradigm and a phenomenological approach, according to Van Manen. Participants were referred to as “snowball” and the data collection was performed by interview with open questions. Results: In the analysis of the data, three essential themes were identified: The antecedents of uncertainty: condition inherent to the subject; The process of assessing uncertainty: capacities and opportunities; The way to deal with uncertainty: coping strategies. Conclusion and implications for practice: Family member who lives the uncertainty has personal conditions that influence the process of appreciation and deal with uncertainty. The communication that establishes with the nurses, in particular in the search for information, will be mediated by the experience of uncertainty, in a constant unforeseen. The adaptation that is desired and demanded arises from coping strategies developed, with the nurses too, considering uncertainty a danger or an opportunity.

Multiprofessional team interventions in transporting critically ill patients: a systematic mixed-methods review

“…15,16,28,33 It is important to understand the level of satisfaction of the teams and their motivation in creating and implementing guidelines for increasingly safe transport. 30 Contrary to what was expected, the results of this review do not focus on the family members of the critically ill patient, 39 which can be considered a limitation of this study. If on the one hand, it should be considered that the situation of critical illness suddenly appears in the daily life of the family, making them more vulnerable and underlining the importance of an intervention focused on this nucleus, 39 on the other hand, the good practices of their inclusion in the transport process are recognized.…”

“…30 Contrary to what was expected, the results of this review do not focus on the family members of the critically ill patient, 39 which can be considered a limitation of this study. If on the one hand, it should be considered that the situation of critical illness suddenly appears in the daily life of the family, making them more vulnerable and underlining the importance of an intervention focused on this nucleus, 39 on the other hand, the good practices of their inclusion in the transport process are recognized. 15,16 Lastly, according to the Portuguese legislation, patient safety is a team responsibility, mobilizing the individual skills of each of its elements and implying the systemic management of all activities.…”

Intervenção de Enfermagem à Pessoa em Situação Crítica face ao distanciamento da família em cenário de pandemia: Revisão integrativa da literatura

“…Por sua vez, os familiares sentem-se desconetados, conduzindo a um aumento da vulnerabilidade emocional, o que representa uma barreira à recuperação do controlo (Wong et al, 2018 A necessidade de comunicar, classificada como a mais importante por familiares e enfermeiros, é determinante em UCI e SU (Hsiao et al, 2017). Mendes (2020) tendo por base a Teoria da Incerteza na doença de Mishel e a Teoria das Transições de Meleis, constatou que a comunicação que é estabelecida entre familiares e enfermeiros em UCI, nomeadamente em busca de informação, é mediada pela vivência da incerteza, num imprevisto constante. Casarini el al.…”

Busca de qualidade e segurança no cuidado ao filho: interações familiares com profissionais de Home Care

“…Nesse sentido, querer aprender sobre o cuidado profissional, dentre outras estratégias citadas neste estudo, fazem parte deste processo de adaptação das famílias, que ocorre à medida em que os cuidadores recebem informações e são orientados pela equipe multiprofissional. 28 Sobre este aspecto, a literatura destaca o hibridismo entre o fazer profissional e o familiar, acarretado pela interferência mútua destas lógicas, a partir das interpretações de aspectos simbólicos entre os sujeitos perante o cotidiano do Home Care. 20 De acordo com Interacionismo Simbólico, a capacidade do ser humano de se antever a um evento futuro é alcançado quando o mesmo se coloca no lugar do outro.…”