Bihdād (Apr 2020)
Exploring the Process of Patient Visiting in Adult Intensive Care Units
Abstract
Background: Today, critical care visitation is considered an important aspect of patient-centered care and its positive effects on patients and their relatives have been demonstrated. However, restricted visiting hours in the ICUs is often an adopted norm. Limited studies in this area have been carried out in Iran, So comprehensive and accurate information about the current process does not provide. Therefore, this study aimed to explain the process of patient visiting in adult intensive care unit, So that all dimensions, characteristics, facilitators and barriers are identified and discussed the perceptions of all stakeholders to be done. Method: A qualitative methodology and grounded theory approach conducted this study. Semistructured interviews were done with 27 participants who include 9 intensive care nurses, 6 head nurses, 2 patients, 7 visitors, 2 physicians and 1 general nurse. Data based on 2008 Corbin and Strauss version were analyzed in three levels of concepts, context and process. Memo writing as an analysis tool, helps the researcher to classify and categorize the concepts and also understanding the context and the phenomenon under investigation and ultimately helped provide the substantive theory. Findings: "maintaining the safe zone" was the core category of this study. “Culture” and “the nature of ICU” constituted the context and “patterns of maintaining control” explain the process of this phenomenon. Theory of” maintaining safe zone” is the substantive theory derived from this study which is represent the responses of nurses and their efforts to maintain control of the process of patient visiting which in the context of popular and organizational culture as well as the nature of the ICU takes the form. Conclusion: The findings showed that although protection of the patient was identified as the major rational for restricted visiting stated by participating nurses ,trying to maintain control over the ward, and in particular the staff privacy was the central concept of visiting process. Results showed that the health care workers often are not sensitive to the real needs of patients and families. Lack of internalization of holistic approach and also lack of emphasis on patient and family- centered care cause the patterns which resulting in considerable time on patient's physical condition and effort to maintain the control of ICU.
