|Title:||A phenomenological study of family presence during life-sustaining interventions in an accident and emergency department|
|Subject:||Hong Kong Polytechnic University -- Dissertations|
Emergency medicine -- China -- Hong Kong
Patients -- Care
|Department:||School of Nursing|
|Pages:||xi, 226 leaves : ill. ; 30 cm.|
|Abstract:||Aim. This study aims to illuminate the presence experience of family members when patients are receiving life-sustaining interventions in the resuscitation room of an Accident and emergency Department (AED). Background. The practice of family presence during resuscitation and invasive procedures in emergency care settings has attracted widespread interest in the last few decades. Allowing family members to remain at patients' bedside during resuscitation and invasive procedures is uncommon, and no guidelines or similar recommendations have been found in the Hospital Authority of Hong Kong. Little is known about family members' experience and feelings, and under what circumstances they wish or do not wish to be present. Method. This study followed an interpretive phenomenological approach, using qualitative interviews that were conducted with 18 family members of patients who had survived after life-sustaining interventions. The data were collected over a nine-month period in 2007-2008. Audio-recorded interviews were transcribed verbatim for thematic analysis. The emerging themes were verified with the participants in the second interviews. Findings. None of the participants was present in the resuscitation room during the life-sustaining interventions, and only five of them entered the room after the patients' condition was stable. The majority indicated a preference to be present if given the option. Three inter-related themes emerged: 1) emotional connectedness; 2) knowing the patient; and 3) perceived (in)appropriateness; with 10 subthemes representing affective, rational and contextual determinants of family presence preferences. These findings were further analysed that explained the interplay of these determinants and how they contributed to the strong or weak preference for family presence. Conclusions. There are differences among the contributing determinants to each family member's intention to be present. Relevant nursing interventions can be derived from the analyzed findings that can meet individualized needs during such critical and life-threatening moments. Guidelines or protocols in AED can be developed for future practice.|
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