Relatives' involvement in the care of patients in acute medical wards in two different countries-An ethnographic study.

To explore the nature of relatives' involvement in the care of patients in acute medical settings in Australia and Saudi Arabia and to explore the perceptions, attitudes and experiences of nurses. There is little known about how relatives respond to being involved in patient care and the impact this has on the quality of care. Equally, little is known about how nurses enable such involvement. Previous studies have focused on settings such as critical care and paediatrics where relatives' involvement as advocates is mostly acknowledged and accepted. The study used a qualitative ethnographic approach based on an interpretive paradigm. Data collection was carried out in medical settings in two major hospitals: one in Australia and another in Saudi Arabia. Data were collected by observations and interviews over a 6-month period, with 3 months spent in each setting. In both fields, relatives and nurses faced ongoing ambiguity about the role relatives should play in the hospital environment. Nurses were challenged by the unpredictability of relatives' participation in patient care. The nurses' fear of taking responsibility and uncertainty about the relatives' role led them to take varied and individualised approaches to the involvement of relatives in patient care. Relatives were unclear about how to behave in the role; what the needs of patients were; and whether they were contributing positively to care and this resulted in frustration. The results show that ambiguity regarding the role of relatives led to problems in patient care such as safety concerns and conflict with nurses. This study identified the need for patients' relatives and nursing staff to more actively engage in negotiating and managing their respective roles in acute medical areas. This could be supported by the development and use of a set of principles or guidelines for nurses, relatives and patients regarding relatives' involvement in hospital care settings to reduce ambiguity for all involved.

Alshahrani S ，Magarey J ，Kitson A 《-》

Relatives' involvement in nursing care: a qualitative study describing critical care nurses' experiences.

When patients become critically ill it also affects their relatives. The aim of this study was to describe critical care nurses' experience of relatives' involvement in the nursing care of patients in an intensive care unit. Semi-structured personal interviews with eight critical care nurses in an intensive care unit in the northern part of Sweden were conducted during 2010. The interview texts were subjected to qualitative content analysis which resulted in the formulation of two main categories and five sub-categories. The findings showed that relatives' involvement was appreciated and seen as great resource for both patients and critical care nurses. Protecting the integrity of patients was one reason for limiting their involvement. The environment and lack of time were experienced as other obstacles to the involvement of relatives. Aligning the needs of the relatives to be involved in the care with the needs of the patient and the work situation of the nurses requires open communication between all three parties.

Engström B ，Uusitalo A ，Engström A 《-》

Close relatives in intensive care from the perspective of critical care nurses.

Engström A ，Söderberg S 《JOURNAL OF CLINICAL NURSING》

Like an ace up the sleeve: an interview study of nurses' experiences of the contact with relatives in a somatic emergency ward.

Research indicates that active involvement of patients' relatives generally has a positive impact on patients' hospitalisation, including patient safety. Campaigns urge relatives to ask questions in relation to nursing care and treatment to enhance patient safety and to increase involvement of both patient and relatives. The question is how nurses experience relatives who ask questions. The aim of this study was to explore how nurses experienced contact with patients' relatives during admissions to a somatic emergency ward including nurses' experience of relatives asking questions related to nursing care and treatment. Six nurses were interviewed. The participants gave written consent to participate after receiving both oral and written information about the study. Data were analysed using combined theory and data-driven qualitative content analysis. The findings formed three main themes: (i) relatives' involvement as a means to efficiency during hospitalisation, (ii) relatives welcomed on the terms of the system and (iii) tension between high ideals and frustrating realities. The six interviews answered the research questions. However, more interviews could have broadened the study and contributed with further details. The nurses experienced relatives as an important resource - 'an ace up the sleeve', while reality seemed to challenge the relationship between nurses and relatives. The study contributes to discussions before development and implementation of specific initiatives aiming at increasing involvement of relatives of patients in a somatic emergency ward.

Hoffmann E ，Olsen PR 《-》

Experiences of intensive care nurses assessing sedation/agitation in critically ill patients.

Weir S ，O'Neill A 《-》