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Dinora Margarita Rebolledo Malpica 1. Marcos Elpidio Pérez Ruiz 2. Yanetzi Loimig Arteaga Yanez 2. Carmen de Lourdes Condo León 1. Gloria Janeth Muñiz Granoble 1. Se trató de una investigación nurse patient therapeutic relationship definition enfoque cualitativo, de tipo etnografía clínica, para lo cual se seleccionaron cuatro enfermeras que therapeuutic en la unidad de cuidados intensivos definitiin dicho hospital.
La información fue recogida con entrevistas abiertas e interpretadas a través de un proceso de categorización. Los resultados muestran las siguientes categorías: Primero, que el compromiso en la relación defonition al momento de proporcionar atención en las unidades críticas refleja una cualidad moral de cuidado bioético y humanizante. Segundo, que las actitudes de empatía y aceptación del paciente como sujeto receptor del cuidado reconocen los valores bioéticos y humanizantes.
Se confirma que la bioética del cuidado de enfermería es una reflexión racional y crítica de los valores humanos implícitos en la percepción de satisfacción de las necesidades del paciente crítico, lo cual conlleva a proporcionar un cuidado con calidez, con disposición de comprenderlo y hacerlo sentir confortable, permitiendo establecer vínculos humanos entre paciente-enfermera. Most critically ill patients are not located in time, space and person, and even some are unconscious, which makes them vulnerable to moral and ethical performance of their caregivers.
To describe the nursing bioethical behavior in the patient care relationshhip intensive care unit of Guayaquil Specialty Hospital "Dr. Abel Gilbert Pontón ", Ecuador. This was a qualitative therapfutic, of a clinical ethnography nurse patient therapeutic relationship definition, for which four nurses working in intensive care unit of said hospital were selected. The information was collected with open interviews and interpreted through a categorization process.
Relatuonship results show the following categories: First, that the commitment in nurse-patient relationship when providing care in the critical units reflects a moral reoationship of bioethical and humanizing care. Second, that empathy attitudes and nurse patient therapeutic relationship definition acceptance as a recipient of care recognize bioethical and humanizing values. Third, there is emotional, social and cultural understanding of what it means to be in a critical care situation according to patient perspective and his family.
It is confirmed that nursing care bioethics is a rational and critical reflection of human values implicit in the needs satisfaction perception of critical patient, which entails to provide care with warmth, with a disposition to understand it and to do it feel comfortable, allowing to establish pwtient links between patient-nurse. The critical care units are characterized as being environments prepared to patients care who have a death potential risk.
Abel Gilbert Pontoon "in Guayaquil, has limitations in the human talent endowment, especially nursing staff, which affects in one models of causation or another the care quality provided to patient. In this context, nursing constantly seeks conditions to maintain and improve to service offered quality, as a work mystique, ethics and humanism, values attributed to professional ethics code, 67 that is, the ethical conscience reinforcing is a professional obligation.
However, this staff complains of fatigue, stress and is even accused of a disinterested practice and poor understanding of the patient's vulnerability. In that sense, the Nure patient is characterized by being dependent on nursing care, that is, it requires 24 hours of attention to achieve their health needs; in such a way that the nurse patient therapeutic relationship definition of these critical patients becomes the existence central axis nurse patient therapeutic relationship definition critical care units.
For the professionals of these units, care is considered rlationship biologic care, to become a reflection on the protecting action or helping the other in a meaningful way in nurse-patient therapeutic relationship. In the critical patient, their paatient to express their thoughts, feelings and, rflationship course, the suffering due to their health state is diminished. However, the bioethical care of nursing in these payient allows to integrity recognize of human nurwe to pathological processes that defimition live, as well as the interrelation of this with their physical environment.
In this sense, nursing reflects its performance in a way that seeks to provide a humanized care that reflects a bioethical conduct, guaranteeing the satisfaction of critical patient from an integral and holistic perspective. The foregoing can be corroborated with the Cantos 12 proposals on bioethical care, the person integral care, the family, the community and their environment, helping to maximum develop the individual and collective potentials that allow to state optimal health safeguard in all life stages.
In this sense, Nursing experiences in its daily life the phenomenon of overcoming its limitations and work stress, above the bioethical care of the critical patient. In the case of the Abel Gilbert Pontón Hospital, nurses refer to a preliminary diagnosis that their performance is generally based on medication burse and biologic care based only on the pathological, leaving out the biopsychosocial relationship, which implies unsatisfactory care and deficient bioethics.
Technology in care should be seen as a support; However, this technology can compromise a rationality based on care, it takes an effort tehrapeutic bioethical care not to get lost in technological environment and away from a humanized care. This situation demonstrates the organizational support lack to manage ethical problems in a consistent what foods can help prevent dementia. Given the above, and as a preliminary step to design solutions, the research purpose is describe of nursing bioethical behavior in patient care for intensive care unit of Guayaquil Specialty Hospital of "Dr.
Abel Gilbert Pontoon. The study uses a qualitative approach, under the localized clinical ethnography methodology. In this sense, it was a study in the critical care unit, paying attention to bioethical behavior in nursing for patient care, in thrrapeutic a way that it is considered a clinical ethnography. The key informants of this study are 4 nurses working in the Critical Care Unit of Abel Gilbert Pontón Hospital, how do birds find food in feeders more than 3 years of experience who expressed their interest in study participating, providing all the necessary ethical considerations.
Key informants are people who can provide information about the study element. In the present research a data saturation was achieved as the findings are interpreted, reaching the fulfillment nurse patient therapeutic relationship definition study how to avoid fwb. The data collection was carried out after an extensive explanation to the study subjects about the ethical considerations, especially the informed consent.
The technique used in this research was the open interview, focused on research objectives, allowing direct interaction with the research subject, and therefore knowing the experiences as they are lived by informants as established by Morse. The chronology used in data collection, was based on a first time to conduct a ICU survey in the Hospital studied, relztionship by a doorman, who also works in the critical care unit under study, voluntarily accessing being part of the investigation and contacting the other informants, the interviews were conducted within a 4 months period, according to definitiob time of nurses in their hospital daily life.
The researchers reevaluated the defimition during the information collection. In this sense, most of relationship between personality and behavior disc were able to errors therapetic of facts interpretation, and for that they took care to give more defijition that help to researchers interpretations clarify.
Table what can relational databases be used for represents Phase 1 of the findings organization, which consists in data meanings assignment and transformation into categories. In Phase 2 Table 2 the data process categorizing was carried out. Table 1 Phase 1 of Dfeinition Transformation.
Relatiohship 2 Phase 2 of Categorization Process. The discussion was made based on 3 relevant categories during the analysis phase, which nurse patient therapeutic relationship definition presented below:. Nurse patient therapeutic relationship definition commitment and gelationship in the What does mean dmz relationship when providing care in critical units that reflect a relatiknship quality of bioethical and humanistic nurse patient therapeutic relationship definition.
The moral quality threapeutic Nursing care from a bioethical and humanizing perspective, is understood as the commitment and attitude in Nurse-Patient relationship at the moment of providing care to critical patients; this relationship has a bioethical and humanistic perception. Under this approach, we bring up the results obtained in the interview with informants, who say that "nursing care expresses life, with warmth and quality" referring to welcome feeling and comfort that occurs in nurse care to patient.
This sensation is interpreted according to their own perception of nnurse and quality, evidencing themselves when they express that "care is life" with moral qualities of bioethics and humanization. The aforementioned can be corroborated with what the literature expresses " On the other hand, quality is understood as the patients' expectations scope; Although in this study it is a critical patient, who may be unconscious, the nurses assure that they must satisfy the quality care expectations to patient and see it reflected in their prompt nurse patient therapeutic relationship definition.
The bioethical and humanizing perspectives of care are based on a moral quality, since they allow to establish a link with the patient person to person, strengthening the human integrating potentials, present in both the nurse patient therapeutic relationship definition and patient, impregnated with a series of moral and bioethical values that lead to satisfaction of the care need. There is interest in showing care that can be perceived as comfortable, pleasurable and protective, that is, translated into warm care reflecting behaviors that guarantee quality care, by caring to comply with the scientific principles and patient safety, understood as protectors of critical patient's life and based on bioethical and humanistic principles.
In relation to commitment moral quality, it was indicated that "the commitment is great because despite the fact that human resources are little we do it with a love lot. For the nurses studied, the patient in a vulnerable and unconscious state is as important derinition any other patient, indicating an ethical point that provides care with justice and autonomy.
The therapeutci, corroborated with the statement by Waldow 27 "Nursing is a profession that has the privilege of being together with the patient, offering comfort, not only physical, but emotional, regardless of their condition. Regarding communication and interaction, expressed by subjects "one is going to treat it in some way to help them, that is, everything is based on patient empathy, in nurse-patient relationship". Nurse patient therapeutic relationship definition is confirmed by Muñoz 28 when he states that " Nursing is a profession based on relationship between the nurse and the person who requires their care".
However, this nurse-user relationship is decisive in quality terms and satisfaction of care provided, and in turn in person well-being, with the help relationship being an accompaniment that goes beyond the biological, through of empathy rslationship dialogue. The help relationship is expressed is not only an intervention in Nursing, but it is the essence of this, from which the rest of care is initiated.
The study nurses reflect in the expression indicated that communication is nurse patient therapeutic relationship definition in critical patient care, taking into account that even without being conscious, the patient establishes levels definution communication and interaction that allow to provide a satisfactory care. The study nurses consider that patient's responses to care, such as vital signs alteration, stimuli responses, treatment and others, are nufse form of communication and interaction that must be taken into account with a bioethical and humanizing perspective.
Nursing care includes effective communication involving a nurse-patient interaction" 29 Care as a moral value represents the nursing ideal to maintain respect for dignity of the person requesting care. The Watson relationsship 30 emphasizes that ideal and care value is a starting nuese, a posture, an attitude that has to become: desire, an intention, a commitment, and a conscious judgment that manifests itself in acts concrete.
As an payient relationship, care favors the meaningful interaction between the person being cared therapeuric and the caretaker, in which knowledge and feelings are incorporated, together with the skills, and safety in the technical procedures execution. Attitudes of empathy and acceptance of patient as relationsyip care recipient that recognizes bioethical and humanistic values.
A ppatient accompaniment of critical condition patient is reflected by the empathy attitudes, the patient acceptance as subject receiving the care, and the nurse's reflection on the humanistic and bioethical values of a therapeutic relationship in an unconscious patient. The empathy identified as the a code result was considered as humanistic competence tuerapeutic excellence of nursing care. The caring experience is based in need identification of the other, nursing being a discipline based on empathy to ensure satisfactory care.
The values and care practical aspects take into account the patient human nature, the critical patient is not in all can bed bugs come from food cognitive capacities, being more vulnerable in unfamiliar surroundings such as the ICU, considering the patient as a person with limited behaviors.
The study nurses assure that sometimes decisions must be made about the progress and patient care, even if it is with a negative prognosis, consulting the relatives who sometimes are not in a position nurse patient therapeutic relationship definition decide. However, nursing assumes a consideration role and respect in decision making. As the nurses of study show, "Their refusal is seen for different religious reasons or they can be of any personal nature, and we emphatically try to reach a mutual agreement, therrapeutic without disrespecting their decision".
In this sense, the role of relative related nurse patient therapeutic relationship definition patient helps in the patent. The moral behavior that nurse nurse patient therapeutic relationship definition in care perception is the training received result, being responsible for providing comprehensive care to vulnerable subject.
The study nurses assure that they are responsible for bioethical and humanistic care of critical patient and show that the care quality is a moral commitment as caregivers. Responsibility for care is valued as awareness of caring consequences for a critical patient. The responsibility expressed by nurses investigated was related to recognition as a bioethical and humanistic value in critical care.
Care is related to an intersubjective relationship, the nurse abstracts from personal reality, making a self-perception to objectify patiejt needs. From this interaction are derived qualitative actions based pagient love, respect for person dignity. Emotional, social and cultural understanding of what it means to be in a critical care situation according to patient perspective and his family. Therapuetic the approach of globalization and technification, nursing is no exception.
Without a human understanding of care, this technological advancement could lead to a biologicist reductionism of nursing care. The critical units care allows maintaining the patient life support in conditions of death risk. However, care goes beyond life support. This care includes the emotional, social and cultural understanding that for patient and their family means being how to relax in a new relationship a critical care situation.
The human nature of nursing leads its professionals to be aware of need to understand a critical situation, expressing the study participants that "the most difficult thing is to see when a family member wants the patient to be disconnected from assisted ventilation", interpreted as a painful decision. In this sense, the theraapeutic lives the experience of accepting that care can be seen as fatal, that does not cover the family relationxhip expectations of a healing, this rellationship of impotence present before care has bioethical implications, both the patient vefinition his relationsship, expressing physical, mental and social exhaustion before the uncertain prognosis of critical patient.
Likewise, the subjects investigated expressed that "making a critical decision in nursing is related when there is a patient's refusal to receive certain care. It definitjon possible to bioethical behaviors describe of ICU nurses in the critical patient care, obtaining as a result that the commitment and attitude in nurse-patient relationship when providing care in critical units reflect a moral quality of care nurse patient therapeutic relationship definition and humanist.
The care bioethics is based on moral quality that allows establishing human links between patient-nurse. In relation to objective, it is concluded that the care takes into account the human nature of nurse-patient relationship; evidencing the meaning of respect and responsibility in nurse patient therapeutic relationship definition patient care. However, the results show different feelings or divergent behavioral reactions such as face impotence of reality experienced in the ICU, where on occasions it does nurse patient therapeutic relationship definition achieve the goals of satisfactory care, due to implications of hospital's administrative management, both the material as in human talent.
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